[Pathways through the need for care in Hessen from 1999 to 2002. Results of a longitudinal study]. / Verläufe von Pflegebedürftigkeit in Hessen in den Jahren 1999 bis 2002. Ergebnisse einer Längsschnittstudie.

AIM OF STUDY: This paper looks at pathways through care for care-dependent persons (as defined by the German statutory long-term care insurance) through longitudinal and cross-sectional analysis of types of benefits and benefit levels over a period of 4 years. METHODS: The prospective cohort study with back dated recording consists of monthly data on the type and level of benefit for each care-dependent person. Cohorts of care-dependent people (n = 6.928) are followed over time to record the benefit type and level at program entry and during enrollment. Each change of benefit type or level, including exit from the program such as in the case of death is noted for a time period of 48 months. RESULTS: The 4-years longitudinal study (1999 through 2002) proves important differences between courses of long-term care in relation to benefit types. Recipients of the cash benefit remain for a longer period of time in that benefit type (28.1 %), have lower transition rates to institutional care (6.9 %) and lower mortality rates (57.3 %) in comparison to recipients of other benefit types over the course of 4 years. Only 8 % respectively 10.7 % of recipients of the combined or the service benefit have the same type of benefit after 48 months. Transition rates to institutional care for professionally cared persons are 10.1 % (combined benefit) respectively 11.8 % (service benefit). Mortality rates of other than cash benefit recipients are about 70 %. CONCLUSIONS: Further research should consider risk factors for entry into institutional care and mortality rates as well as questions regarding the prevention of care dependency and effectiveness of rehabilitation. Pathways through care should be analysed by focusing social variables like sex and chronic diseases of older people. Secondary analysis of process data from German statutory long-term care insurance program is a powerful tool for the study pathways through of long-term care.

[Depot neuroleptics in social psychiatric practice]. / Depotneuroleptika in der sozialpsychiatrischen Praxis.

In recent years, depot neuroleptics have gained in importance in the outpatient treatment of chronic schizophrenics. These neuroleptics make drug therapy safer than before, thus improving the prerequisites for socio-therapeutic and rehabilitative measures. The present study analyses the ranking and value of this kind of treatment in the management of outpatients. A random sample of 80 schizophrenics treated as outpatients, by a psychiatric university clinic working on a sectorial basis was examined for the purpose of this study. Treatment results, problems of indication, limitations of therapeutic possibilities using depot neuroleptics, as well as constellative conditions under which therapy was discontinued, are discussed.