[Utilization of social departments before and after effectiveness of the 'need for disability care' health service reform in Mannheim]. / Die Inanspruchnahme von Sozialstationen vor und nach Inkrafttreten des Leistungstatbestandes 'Schwerpflegebedürftigkeit'--eine Studie in Mannheim.

Constituting a part of the new health reform in Germany ("Bundesgesundheitsreformgesetz"), a new arrangement to support home care for the very frail and severely disabled took effect in 1991. Since then the costs of basic nursing care and home-making services are partly covered by health insurance. To examine the impact of the new arrangement on the use of the community nursing services (the so-called "Sozialstationen") we compared two cross-sections of elderly patients under care in the city of Mannheim. The cross-sections encompassed all over 65-year old patients visited during January 1990 (first cross-section) and during May 1993 (second cross-section) by the "Sozialstationen" in Mannheim. The characteristics of the patients (degree of disability in everyday life, level of cognitive functioning etc.), together with the forms of care provided, were recorded by the nurses. The results show that the number of patients cared for by the "Sozialstationen" was smaller in May 1993 (n = 1649) than in January 1990 (n = 1842); especially the number of the severely disabled and demented patients was reduced. Although these findings can be viewed only as preliminary, one can conclude that--contrary to all expectations--there was no run on the "Sozialstationen" in the course of the implementation of the new social code.