N Lübke1, M Meinck. 1. Kompetenz-Centrum Geriatrie des GKV-Spitzenverbandes und der Medizinischen Dienste, c/o MDK Nord, Hammerbrookstr. 5, 20097, Hamburg, Deutschland. norbert.luebke@kcgeriatrie.de
Abstract
BACKGROUND: In Germany, typical geriatric multimorbidity is--next to age itself--of special significance for the identification of target groups for specific geriatric care offers. The present article primarily focuses on typical geriatric multimorbidity in the claims data of statutory health insurance and long-term care insurance in Germany. Using the definition of "the geriatric patient" that is agreed on by providers of services as well as by cost bearers, geriatric multimorbidity is defined as the coexistence of at least 2 of 15 typical geriatric conditions. A suggestion made by the German Geriatric Association was to assign ICD-10-GM codes to each of these 15 conditions. Thus, it becomes possible to identify the corresponding geriatric conditions in claims data. METHODS: The article investigates the frequency of geriatric conditions and, thus, of geriatric multimorbidity of patients aged ≥ 60 years admitted to a hospital with a geriatric ward. Patients treated in a geriatric ward were compared with those who did not receive geriatric care. In anticipation of a high correlation between typical geriatric conditions and specific features that are preconditions for receiving long-term care insurance benefits (such as care levels and status of a nursing home resident), claims data of the long-term care insurance were included for external validation. RESULTS: The analyses showed a distinctly higher proportion of insured people with typical geriatric multimorbidity or rather a certain care level among the geriatrically treated cases than among those patients not receiving geriatric treatment (68.5%/67.9% versus 24.2%/33.4%). The different proportions of typical geriatric multimorbidity coded among the patients with features of a certain care level in the two given groups give rise to the suspicion that typical geriatric multimorbidity is not always statistically recorded--especially in cases of treatment without provision of geriatric care. CONCLUSION: The frequency of cases of typical geriatric multimorbidity and a certain care level shows that--even when a specific geriatric offer exists--a considerable proportion of cases with typical geriatric conditions are treated in other medical departments.
BACKGROUND: In Germany, typical geriatric multimorbidity is--next to age itself--of special significance for the identification of target groups for specific geriatric care offers. The present article primarily focuses on typical geriatric multimorbidity in the claims data of statutory health insurance and long-term care insurance in Germany. Using the definition of "the geriatric patient" that is agreed on by providers of services as well as by cost bearers, geriatric multimorbidity is defined as the coexistence of at least 2 of 15 typical geriatric conditions. A suggestion made by the German Geriatric Association was to assign ICD-10-GM codes to each of these 15 conditions. Thus, it becomes possible to identify the corresponding geriatric conditions in claims data. METHODS: The article investigates the frequency of geriatric conditions and, thus, of geriatric multimorbidity of patients aged ≥ 60 years admitted to a hospital with a geriatric ward. Patients treated in a geriatric ward were compared with those who did not receive geriatric care. In anticipation of a high correlation between typical geriatric conditions and specific features that are preconditions for receiving long-term care insurance benefits (such as care levels and status of a nursing home resident), claims data of the long-term care insurance were included for external validation. RESULTS: The analyses showed a distinctly higher proportion of insured people with typical geriatric multimorbidity or rather a certain care level among the geriatrically treated cases than among those patients not receiving geriatric treatment (68.5%/67.9% versus 24.2%/33.4%). The different proportions of typical geriatric multimorbidity coded among the patients with features of a certain care level in the two given groups give rise to the suspicion that typical geriatric multimorbidity is not always statistically recorded--especially in cases of treatment without provision of geriatric care. CONCLUSION: The frequency of cases of typical geriatric multimorbidity and a certain care level shows that--even when a specific geriatric offer exists--a considerable proportion of cases with typical geriatric conditions are treated in other medical departments.
Authors: Samuel Schülein; Jens Barth; Alexander Rampp; Roland Rupprecht; Björn M Eskofier; Jürgen Winkler; Karl-Günter Gaßmann; Jochen Klucken Journal: J Neuroeng Rehabil Date: 2017-02-27 Impact factor: 4.262