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Restructuring Care for the Elderly in Germany

Health insurance typically falls short of meeting the needs of frail elderly and other disabled persons. In 1995, Germany began implementing new provisions in its national health insurance law to provide for long-term care assistance. Payments are available for family caregivers, community-based services and nursing homes and institutions for the disabled This article is based on interviews carried out in the autumn of 1996 with German citizens and health care, insurance company and government officials. The insurance program has created: (1) affordable access to long-term care services for frail and disabled persons; (2) a restructuring toward community-based care; (3) the emergence of hundreds of new agencies; (4) new issues concerning the quality of care by families and by home care agencies; and (5) a recognition that eligibility criteria and benefits are overly narrow for certain types of disabilities.

Key Words: disabled • elderly • German health insurance • health care financing • insurance • long-term care

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