[Outpatient and inpatient medical care of the elderly]

Abstract

This contribution discusses the outpatient and inpatient medical care of elderly patients in Germany. The paper first focuses on the increasing utilization of the two care sectors especially by the very old in the sense of a "geriatrization" of the system followed by a detailed analysis of the costs associated with a higher frequency of contact with the medical care system. On the one hand, the determining factor for outpatient treatment costs is more likely to be the patient's age rather than the type of disease. On the other hand it was found that inpatient treatment costs are associated more with closeness to death than with patient's age. A third central point beside these quantitative aspects continues to be the discussion about current deficits in the care of elderly patients. While the discussion on the outpatient medical care centers on physician-related factors and their influence on the quality of care exemplified by depression and dementia, the discussion on inpatient care focuses on structural problems. This is followed by the discussion of central organizational and research needs in the medical care of the elderly.