[Prevention in long-term care: an overview of the recommendations according to § 18b SGB XI and their implementation]

Prevention and health promotion can be a way of helping to improve the autonomy, independence, well-being and quality of life of people who are at risk of, at the beginning of or already in need of care. This study is based on the hypothesis that frailty as a defined care risk can be contained or, if necessary, prevented so that people can live longer and age more healthily in their home environment. There is sufficient evidence that relationship and behavioral factors have a much stronger influence on development opportunities in old age than genetic and biological dispositions. Against this background, social legislation has established preventive measures in Social Code XI in addition to the preventive services offered in Social Code V with the introduction of the Prevention Act (PrävG) in 2015. In order to determine the potential for prevention, the Medical Service was obliged to check in each of its reports on the need for care whether preventive measures should be recommended beyond the current care situation. Based on anonymized routine data from a large long-term care insurance company, the Medical Service reports from 2022 and 2023 were analyzed nationwide to determine the need for long-term care. A mixed-methods approach was used to interpret potential indications between insurance-related aspects and the recommendation practice in the expert reports. Our study revealed a gap between preventive healthcare offered and recommendations for such support in the legislative codes. This gap needs to be closed to improve healthy aging.