Development Of Long-Term Care Dependency And Utilisation Of Long-Term Care Services From 2017 To 2022 In Germany, Saxony-Anhalt: Analysis Of Health Insurance Data

Abstract

Saxony-Anhalt has the highest old-age dependency ratio among the German federal states. The proportion of long-term care-dependent people can be expected to increase in the future, given the aging of the population. The SARS-CoV-2 pandemic has influenced nursing care, reduced the utilisation of services and led to changes in care arrangements. The aim of this study was to analyse the development of long-term care-dependency in Saxony-Anhalt, Germany, taking into account the legal changes, the pandemic and the development after the lifting of the contact ban. The analysis uses aggregated and anonymised health claims data from people insured with AOK Saxony-Anhalt from 2017 to 2022 in need of long-term care. Changes over time in the use of various care services were analysed. In 2017, 64,591 people insured in the statutory health insurance AOK Saxony-Anhalt (AOK ST) were in need of long-term care. The prevalence increased continuously throughout the observation years. For the lowest level of care (minor impairment of independence), the most significant and strongest increase was recorded in the first years after its introduction from 2017-2019. The majority of people in need of long-term care (41-44%) were in the category of care level 2 (considerable impairment of independence). Overall, the proportion of cash benefits has risen steadily since 2017, from 40.5% to 50.3% in 2022. At the same time, the proportion of long-term care in nursing homes decreased at all care levels. The trend toward less nursing home care has become stronger since 2017 and particularly since the onset of the SARS-CoV-2 pandemic in 2020. Since the introduction of the new definition of the need for long-term care in Germany, the analysis shows an increase in the number of people in need of long-term care, with those with considerable impairment of independence making up the largest proportion. There has been a significant increase in the number of people receiving cash benefits and a decline in nursing home care. Compared to the nationwide data of health claims, data show a greater use of nursing services in home-based arrangements. The analysis during the COVID-19 pandemic shows a trend towards home care, but no fundamental change. Special situations such as contact restrictions may have influenced the use of care services. Future research should examine the design of home care arrangements and the needs of those affected in greater detail.