BackgroundTraumatization in childhood can result in lifelong health impairment and may have a negative impact on other areas of life such as education, social contacts and employment as well. Despite the frequent occurrence of traumatization, which is reflected in a 14.5 percent prevalence rate of severe child abuse and neglect, the economic burden of the consequences is hardly known. The objective of this prevalence-based cost-of-illness study is to show how impairment of the individual is reflected in economic trauma follow-up costs borne by society as a whole in Germany and to compare the results with other countries’ costs.MethodsFrom a societal perspective trauma follow-up costs were estimated using a bottom-up approach. The literature-based prevalence rate includes emotional, physical and sexual abuse as well as physical and emotional neglect in Germany. Costs are derived from individual case scenarios of child endangerment presented in a German cost-benefit-analysis. A comparison with trauma follow-up costs in Australia, Canada and the USA is based on purchasing power parity.ResultsThe annual trauma follow-up costs total to a margin of EUR 11.1 billion for the lower bound and to EUR 29.8 billion for the upper bound. This equals EUR 134.84 and EUR 363.58, respectively, per capita for the German population. These results conform to the ones obtained from cost studies conducted in Australia (lower bound) and Canada (upper bound), whereas the result for the United States is much lower.ConclusionChild abuse and neglect result in trauma follow-up costs of economically relevant magnitude for the German society. Although the result is well in line with other countries’ costs, the general lack of data should be fought in order to enable more detailed future studies. Creating a reliable cost data basis in the first place can pave the way for long-term cost savings.

Background: Traumatization in childhood can result in lifelong health impairment and may have a negative impact on other areas of life such as education, social contacts and employment as well. Despite the frequent occurrence of traumatization, which is reflected in a 14.5 percent prevalence rate of severe child abuse and neglect, the economic burden of the consequences is hardly known. The objective of this prevalence-based cost-of-illness study is to show how impairment of the individual is reflected in economic trauma follow-up costs borne by society as a whole in Germany and to compare the results with other countries' costs. Methods: From a societal perspective trauma follow-up costs were estimated using a bottom-up approach. The literature-based prevalence rate includes emotional, physical and sexual abuse as well as physical and emotional neglect in Germany. Costs are derived from individual case scenarios of child endangerment presented in a German cost-benefit-analysis. A comparison with trauma follow-up costs in Australia, Canada and the USA is based on purchasing power parity. Results: The annual trauma follow-up costs total to a margin of EUR 11.1 billion for the lower bound and to EUR 29.8 billion for the upper bound. This equals EUR 134.84 and EUR 363.58, respectively, per capita for the German population. These results conform to the ones obtained from cost studies conducted in Australia (lower bound) and Canada (upper bound), whereas the result for the United States is much lower.

lung und Rehabilitation in der Psychoso− matischen Medizin und Psychotherapie wird kontrovers diskutiert. Die beteilig− ten Parteien, die eigentlich als Partner ein gemeinsames Anliegen vertreten soll− ten, haben zum Teil sehr unterschiedli− che Auffassungen und Vorstellungen zu stationärer Psychotherapie. Vor allem die Leistungserbringer in dem System, die Krankenhäuser und die Rehaeinrich− tungen, tragen konkurrierende Stand− punkte vor. Es stellt sich die Frage, ob sie einander dadurch nicht mehr behin− dern als fördern, in einem Gesundheits− markt, dessen wesentliches Entschei− dungskriterium in den Auseinanderset− zungen mit Kostenträgern und Politik die Erfüllung der Anforderungen an klini− sche Qualität und zugleich Ökonomie ge− worden ist. Es ist nicht zu übersehen, dass sich in dem Verhältnis von Kranken− haus und Rehabilitation in der Psycho− therapie erhebliche Probleme aufgetürmt haben, die einer Lösung bedürfen. Dazu müssen auch die Kosten− bzw. Leistungs− träger in die Pflicht genommen werden, denen gerne pauschal unterstellt wird, zulasten der Behandlungsqualität nur sparen zu wollen, die aber auch gerne pauschal argumentieren, es werde un− wirtschaftlich zu viel Geld ausgegeben. Entsprechend werden Kürzungen vorge− nommen oder es wird die Notwendigkeit der Kostenübernahme von stationärer Krankenhausbehandlung über die Medi− zinischen Dienste bestritten und vor die Sozialgerichte getragen.

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