Kosten der Frühverrentung am Beispiel der Schizophrenie

Abstract

Schizophrenia is a severe psychic disorder that occurs at young age and often leads to a work disability. The disease not only induces direct costs in the health care system but also indirect costs that show up in the social security system. In this study, we apply statistics from the social security administration on early retirement due to disability. Over 6000-males and females per year retire with the diagnosis schizophrenia (classified as 295, ICD-9). The average retirement age is 39 for males and 42 for females. Schizophrenia is the most important single reason for early retirement before age 40. Of all male cases of disability retirement under the age of 40, 14.7 % are due to schizophrenia. The present discounted value of pensions paid out before the standard retirement age of 65 is 215 000 Euro for an average male. Moreover, the revenue loss in income taxes and payroll contributions amounts to 345 000 Euro. In the year 2000, a total of 125 000 persons under the age of 65, who originally entered retirement with the diagnosis schizophrenia, are estimated to be receiving a pension. The corresponding annual expenditures of the social security system reach 1.3 Billion Euro; the revenue loss (pay-roll plus income taxes) reaches 2 Billion Euro. Since only two thirds of the working age population is covered by the social security system, the costs of early retirement due to schizophrenia are underestimated by a factor of at least one third.

Prediction and prevention of psychosis: current progress and future tasks

“…Regarding psychoses, theses costs rose to roughly 70 % [24]. A main cause is chronic unemployment beginning early during life time [15,69,100]. This reflects a still considerable proportion of unfavorable courses, despite advances in treatments [31].…”

Klinische Prädiktion und Prävention von Psychosen

“…Dennoch unterliegen vor allem die schizophrenen Psychosen hinsichtlich Verlauf und Ausgang deutlichen individuellen Schwankungen. In Deutschland etwa stellt die Schizophrenie die mit Abstand wichtigste einzelne Ursache für Erwerbsunfähigkeit in der Altersgruppe unter 40 Jahren dar 1 . Die Angehörigen sind in ihrer Lebensführung und Gesundheit ebenfalls erheblich belastet, zumal auch sie einer Stigmatisierung seitens der Gesellschaft unterliegen.…”

Prädiktion und Prävention psychischer Störungen am Beispiel der Psychosen

“…Daher stellenaus Sicht derWHO präventive Maßnahmeng egenwärtig die vielversprechendste Option zur Verbesserung dieserSituation dar:"Giventhe current limitationsineffectivenessoftreatment modalitiesfor decreasing disabilitydue to mental and behavioural disorders, the only sustainable methodfor reducing the burden caused by these disorders is prevention", S. 14 (1). Dies gilt in besonderem Maße für die Psychosen, vor allemdie verschiedenen Formen derSchizophrenie, die eine hohe Belastungfür die Betroffenen,i hre Angehörigenu nd unter ökonomischen Gesichtspunkten auchfür die Gesellschaft darstellen (2)(3)(4)(5)(6).…”