Long-term Care Insurance In Germany Research Articles

The effectiveness of digital care applications in people with need of home care: A systematic review

The effectiveness of digital care applications in people with need of home care: A systematic review Abstract: Background: The growing need for long-term care poses challenges for healthcare systems. In June 2021, digital care applications (DiPA) were introduced as a new service in the statutory long-term care insurance in Germany. Their aim is to counteract the increased care need and/or support independence in the home. Aim: This project systematically identified and reported on national and international evidence on DiPA effectiveness, as described by the Federal Institute for Drugs and Medical Devices (BfArM). Methods: The systematic review was conducted in accordance with the PRISMA statement by means of systematic searches in the databases Medline and Cinahl, and supplemented by an extensive manual search (08/2022). Study quality was assessed using the Risk of Bias Tool (RoB2). The results were synthesized narratively. Results: Eight randomized controlled studies were included; improvements in cognition, activities of daily living, and mobility in home care patients, were reported. Study quality was low to moderate, due to mostly unblinded study designs and low case numbers. Conclusions: The currently available evidence fails to provide a reliable basis for assessing the benefits of DiPA, to neither DiPA manufacturers, nor to responsible parties in the healthcare system. Further research on DiPA effectiveness, particularly with high-quality studies, are necessary to assess its potential in the German care sector.

A probabilistic projection of beneficiaries of long-term care insurance in Germany by severity of disability

Demographic aging puts social insurance systems under immense pressure as frailty risks increase with age. The statutory long-term care insurance in Germany (GPV), whose society has been aging for decades due to low fertility and decreasing mortality, faces massive future pressure. The present study presents a stochastic outlook on long-term care insurance in Germany until 2045 by forecasting the future number of frail persons who could claim insurance services by severity level with theory-based Monte Carlo simulations. The simulations result in credible intervals for age-, sex- and severity-specific care rates as well as the numbers of persons for all combinations of age, sex and severity by definition of the GPV on an annual basis. The model accounts for demographic trends through time series analysis and considers all realistic epidemiological developments by simulation. The study shows that increases in the general prevalence of disabilities, especially for severe disabilities, caused by the demographic development in Germany are unavoidable, whereas the influence of changes in age-specific care risks does not affect the outcome significantly. The results may serve as a basis for estimating the future demand for care nurses and the financial expenses of the GPV.

Selection Behavior in the Market for Private Complementary Long-Term Care Insurance in Germany

Using data from an insurance company, we examine the selection behaviour in the German market for private complementary long-term care insurance (CompLTCI). We provide a detailed analysis of the holding, the uptake and the lapse of CompLTCI policies. The analysis identifies the preference for insurance, the occupation as well as the residential location as unused observables. Our findings suggest that the socioeconomic status is a robust factor in explaining the uptake and lapse behaviour in the German market for CompLTCI. More generally, our findings indicate that the mere identification of unused observables is insufficient to derive robust conclusions about the redistribution between different risk types in insurance markets with long-term policies.

Impact of the Introduction of the Social Long-Term Care Insurance in Germany on Financial Security Assessment in Case of Long-Term Care Need

The discussion concerning long-term care insurance in Germany barely exceeds the financial state of the social system. The view of the insured involved is largely ignored. This paper analyses the effect of the introduction of compulsory long-term care insurance in 1995 in Germany on the perception of financial security when needing long-term care. Using different regression techniques on a subset of the German Socio-Economic Panel (SOEP) data, we show that the introduction led to a general positive shift of the assessment. Furthermore, experience with long-term care had no significant effect before the introduction but a positive effect afterwards. Also, the perception of financial security is found to be increasing with income at both times with similar magnitudes.

The Social Long-Term Care Insurance in Germany: Origin, Situation, Threats, and Perspectives

This paper describes the Social Long-Term Care Insurance (SLTCI) in Germany. Based on a short review of the history of long-term care organization and the preceding laws in Germany, the implementation of the SLTCI as a self-standing pillar within the system of social insurances in Germany and its set-up with regard to eligibility criteria, service provision and financial budget are presented. Since SLTCI is a universal, contribution-financed insurance the ageing society and the corresponding shifts in the number of persons in need of care and the number of persons potentially providing informal care are challenges for its sustainability. Therefore, recently suggested reform options are discussed at the end of the paper showing potential pathways to a sufficient provision of care services in the future.

Lessons From Public Long-Term Care Insurance In Germany And Japan

The U.S. Congress is considering the Community Living Assistance Services and Supports (CLASS) Act, a voluntary insurance program that would help pay for long-term services and supports to disabled Americans. In Germany and Japan, social insurance programs are universal, support family caregivers, and allow individuals considerable flexibility in securing the services they require. We explored differences between Germany and Japan in program goals, eligibility process, scope, size, and sustainability for possible applications in the United States. Moreover, when we compared public spending on long-term care, we found that spending in the United States is actually higher than in Germany even now, prior to enactment of the CLASS Act, and is only slightly lower than in Japan.

After the launch of long-term care insurance in Germany: analyzing the transition of LTCI from 1999 to 2005 by state

This study focuses on the public long-term care insurance (LTCI) program in Germany, considers the progress of LTCI in view of economic indicators from the 16 inland states (Lander in Germany) from 1999 to 2005, shows transitions by each state, and describes the latest problems concerning the LTCI program. A principal component analysis was conducted using 21 variables related to LTCI. Four interpretable significant principal components were found. Component I clearly demonstrated a relationship between individual economic strength and care. It is labeled economics for care. Component II is associated with the availability of home care services. It is labeled tendency to use home care services. Component III is related to the use of nursing homes. It is labeled tendency to use nursing homes. Component IV showed a relationship between aging and needing care. It is labeled aging and needing care. The economics for care component showed the highest scores for Baden-Wurttemberg and lowest scores for Mecklenburg-Vorpommern. The tendency to use home care services component showed Hamburg demonstrating the highest scores and Bayern the lowest scores. The tendency to use nursing homes component showed Schleswig-Holstein with the highest scores and Bremen with the lowest scores. The aging and needing care showed Schleswig-Holstein and Berlin with the highest scores and Sachsen with the lowest scores. LTCI in Germany tended to become popular according to regional needs. The tendency of benefits for each region came to be recognized as fitting each local lifestyle, economic strength, size of population, and so on. City states appeared to use home care services. Other states seemed to prefer care at nursing homes to care at home. Furthermore, people seemed to prefer using professional home care services to using care allowances at home year by year. Finally, this study suggested that the number of people needing care tended to decrease even though aging progressed.

Long-term care insurance in Germany: analyzing its progress from the perspective of economic indicators

Germany enabled public long-term care insurance (LTCI), a social insurance system, in 1995. This study focuses on the LTCI program in Germany, analyzes progress of LTCI in view of economic indicators in the inland 16 states (“Lander” in Germany), categorizes 16 states, and describes problems concerning the LTCI program. Statistical analysis was conducted using 24 variables of LTCI and the economic index. The 16 states were categorized in five clusters. The results revealed gaps in adoption rates of LTCI care services among 16 states, suggesting that each of the states developed its own service system of LTCI dependent on regional variables such as economic power and size of population. All former East German states tended to have lower economic resources of care. States with many requests for cash benefits tended to offer lower amounts of care services. The characteristics of these 16 states provide useful information for developing LTCI policies in Germany and offer an informative guide to other countries.

Private Compulsory Long-term Care Insurance in Germany

In Germany compulsory long-term care insurance was established in 1995. Private health insurers undertook to implement compulsory long-term care insurance for that part of the population that had a supplementary private health insurance. This paper deals with the history of private compulsory long-term care insurance and how it is calculated, based on the principle of equivalence for lifelong premiums (provided that there is no inflation in benefits) and on an ageing provision. Furthermore, it explains its transfer elements and financial equalization, which are necessary to compensate both the insurance of very old people and those needing long-term care as well as legal restrictions on premiums.

Is German long-term care insurance a model for the United States?

German long-term care insurance, implemented in 1995, significantly extends the coverage of care-related risks. Given the similarities of German and U.S. institutional features, the German social insurance approach has been put forward as a possible model for long-term care in the United States. Using a political economy framework, the authors conducted a policy analysis that compares the main shortfalls of long-term care (LTC) provision in the United States and Germany, examines the responses provided by LTC insurance in Germany, and relates them to broader trends and proposals for change in welfare policy in both countries. German LTC insurance includes a high degree of consumer direction and compensation and protection for informal caregivers; it supports the extension of community-based services. Its shortfalls include the continued split between health and LTC insurance. In both countries, decentralization and institutional and financial fragmentation are some of the characteristics responsible for the failure to promote egalitarian social policy and substantially expand social protection to family- and care-related risks. The German LTC program is a good model for the United States. With a social insurance approach to LTC, costs are spread across the largest possible risk pool. Major goals that can be reached with such a program include establishment of universal entitlements to LTC benefits, consumer choice, and equitability and uniformity.

Life expectancy and the need for nursing care in Germany

Effects of further gains in life expectancy on the health and autonomy of the elderly population are a matter of controversy. Health indicators, which integrate information on both mortality and morbidity could help to clarify whether the additional years are spent in health or disease. Since the introduction of a statutory long-term care insurance in Germany, national data on the prevalence of dependency are available. These data were used for the calculation of dependency-free life expectancy and life expectancy in a state of dependency according to Sullivans method. The calculations are based on 71.5 million insured at mid-year 1999 and on the period life-table for the years 1995/97. At the age of 65 the average duration of dependency is 15.4 months for men and 29.4 months for women. Men can expect to spend 91.4% of their remaining lifetime dependency-free, whereas the dependency-free proportion among women is only 86.9%. The distribution of severity grades of dependency is similar for both sexes. Women, however, spend 35.4% of the total duration of dependency in institutional care (10.4 months), men only 22.1% (3.5 months). Information from long-term care insurance appears suitable for the monitoring of time trends in the health of the elderly population and for projections of future needs for health and social services.

Implementing Universal Long-Term Care Insurance in Germany

Journal Article Implementing Universal Long-Term Care Insurance in Germany Get access Alison Evans Cuellar, Alison Evans Cuellar Search for other works by this author on: Oxford Academic Google Scholar Joshua M Wiener Joshua M Wiener Search for other works by this author on: Oxford Academic Google Scholar Public Policy & Aging Report, Volume 10, Issue 3, Fall 1999, Pages 1–15, https://doi.org/10.1093/ppar/10.3.1a Published: 01 September 1999

XI The Function and the Role of Long-Term Care Insurance in Germany : How to Change the Situation by the Introduction of New Public Statutory Long-Term Care Insurance?

XI The Function and the Role of Long-Term Care Insurance in Germany : How to Change the Situation by the Introduction of New Public Statutory Long-Term Care Insurance?

The Long Road to Long-Term Care Insurance in Germany

ABSTRACTThis paper represents a case study in welfare state expansion. It takes an actor-centered point of view and reconstructs the long process which has ultimately led to a compromise solution to the problem of providing long-term care, especially for the elderly. It describes the previously means-tested arrangement of long-term care provision and its shortcomings. Furthermore, it sketches the different stages through which the political debate on this issue has passed during the last twenty years: from the initial phase of defining the “social problem”, to the final stage when the approval of the compromise package became a question of “all or nothing”. The analysis of the politics of long-term care insurance reveals that the difficulties of reaching an agreement mainly resulted from the complex decision-making situation. It was in essence a problem of decision-making under conditions of general uncertainty.