[Guide to geriatric treatment in Bremen]

The demographic pressure exerted on the national health care system has led to the establishment of specialised geriatric centres. These centres aim at an early, patient-related coordination of the medical aspects of treatment with a concept for rehabilitation. Acute geriatric care, rehabilitation, and social medicine are practically integrated in contrast to the segmentation practised in other branches of medical care. The necessary assessment of patients in terms of "disease sequelae" according to the ICD is inadequate while the ICIDH as an alternative still has no legal foundation. The "Guide to Geriatric Treatment in Bremen" provides the necessary organisational structure with regard to aspects of quality assurance. To this end, guidelines for patient identification by means of expert medical evaluation and geriatric assessment on the basis of the ICIDH were developed as well as rules for the overall organisation and interaction of the geriatric centres with other specialties, with health insurers, and with the medical services of health insurers. The total duration of treatment of a patient was established as the primary parameter for determining professional and economic efficiency. The introduction of a specific nomenclature to be used by all parties involved reflects the "geriatrification" of the system.