Repräsentative Studie zur Verteilung schizophrener Patienten auf medizinische Versorgungseinrichtungen in Deutschland

Besthehorn, Maike; Tischer, B.; Gläser, Petra; Mast, O.; Schmidt, Dorothee

doi:10.1055/s-2007-995225

Cited by 16 publications

(11 citation statements)

References 1 publication

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“…As schizophrenia is a chronic disease with early onset, it is among the most expensive mental disorders. Data on overall annual costs of schizophrenia in Germany range between 1.7 and 4.7 billion euros [11][12][13][14]. The German welfare system is divided into sectors and respective sectoral payers, including public health insurance (Krankenkassen), pension insurance (Rentenversicherung), social welfare (Sozialhilfe), compulsory nursing care insurance (Pflegeversicherung) and unemployment insurance (Arbeitslosenversicherung) [15,16].…”

Section: Introductionmentioning

confidence: 99%

Predisposing factors for early retirement in patients with Schizophrenia in Germany

Schnabel¹,

Friedel²,

Erfurth

et al. 2007

Eur J Health Econ

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Although early retirement causes major changes in the life of schizophrenic patients and is among the major cost factors to be covered by payers, the causes leading to early retirement of schizophrenic patients have not been investigated in detail. Therefore, the objective of this retrospective non-interventional case-control study was to generate hypotheses on predisposing factors for early retirement in schizophrenia. Logistic regression was used to explore potential predisposing parameters with regard to their effect on the outcome early retirement. As the study results indicate, schizophrenia severity, assistance or care in the patient's everyday life, age and antipsychotic treatment with typical antipsychotics are linked to the occurrence of early retirement. Further research should be planned to confirm or refute the hypotheses determined in this retrospective analysis and to determine whether atypical antipsychotics could help to avoid early retirement and to improve the situation of schizophrenic patients.

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Section: Introductionmentioning

confidence: 99%

Predisposing factors for early retirement in patients with Schizophrenia in Germany

Schnabel¹,

Friedel²,

Erfurth

et al. 2007

Eur J Health Econ

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“…Lebensjahr (Lebenszeitprävalenz). Die bisher einzige repräsentative Studie zur Prä-valenz der Schizophrenie in Deutschland von Bestehorn ergab, dass rund 136 000 Patienten mit der Diagnose Schizophrenie (ICD-10 F20) in Deutschland fachärztlich versorgt wurden [4].…”

Section: Krankheitsbild Und Epidemiologie Der Schizophrenieunclassified

“…[5]. Nach der Auswertung von Bestehorn ist hingegen der relative Anteil der Rehabilitation wesentlich niedriger anzusetzen (Gewichtung mit der durchschnittlichen Verweildauer, [4] [5]). …”

Section: Direkte Und Indirekte Kosten Der Schizophrenieunclassified

Kosten der Frühverrentung am Beispiel der Schizophrenie

Clouth¹

2004

Psychiatr Prax

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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.

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“…Zur Ermittlung der entsprechenden Patientenrelationen wurden analog zu dem Verfahren von Besthehorn et al [7] alle an der Behandlung psychischer Erkrankung beteiligten Einrichtungen inkl. aller niedergelassenen Fachärzte für Psychiatrie, Psychotherapie und Neurologie der Stadt Leipzig gebeten,die Zahl der von ihnen im ersten Quartal 1997 behandelten Patienten mit der Diagnose Schizophrenie zu übermitteln.Als Ergebnis dieser Befragung wurden insgesamt 1118 Patienten gemeldet, die zu 37,6% von niedergelassenen Fachärzten, zu 11,2% von Institutsambulanzen,zu 41% von Einrichtungen des Verbunds Gemeindenahe Psychiatrie, zu 1,3% von teilstationären Einrichtungen und zu 8,9% von stationären Einrichtungen behandelt wurden.Weiterhin wurden alle in Leipzig angesiedelten Wohn-und Pflegeheime nach der Zahl der dort lebenden Bewohner mit schizophrenen Erkrankungen befragt.…”

Section: Stichprobenbildungunclassified

“…Weiterhin lag der Anteil der Heimbewohner in der Gruppe der Studienteilnehmer mit 11% höher als in der Gruppe der Studienverweigerer mit 8%.Bei allen übrigen soziodemografischen Merkmalen zeigten sich keine Unterschiede zwischen den beiden Gruppen.Als Ergebnis dieses Rekrutierungsverfahrens wurden 8,8% der Untersuchungsteilnehmer im stationären Bereich, 1,3% im teilstationären Bereich, 78,8% im ambulanten Bereich (niedergelassene Nervenärzte, Institutsambulanzen,Verbund gemeindenahe Psychiatrie) sowie 10,1% in Wohn-oder Pflegeheimen rekrutiert. Diese Relationen unterscheiden sich nur geringfügig von den von Besthehorn et al [7] für die Bundesrepublik Deutschland insgesamt berechneten Relationen [15]. …”

Section: Stichprobenbildungunclassified

Die Einflüsse des Studiendesigns und der Stichprobenauswahl auf die Berechnung psychiatrischer Versorgungskosten

2003

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In this paper the impact of the study design and the sampling procedure on the assessment of the costs of schizophrenia treatment will be analyzed. The study sample consists of 307 patients with the diagnosis of schizophrenia (ICD 10F20) with the age between 18 and 65 years. Study participants were recruited consecutively in inpatient and outpatient treatment settings and in accommodation facilities according to the proportions of patients treated in these settings in Leipzig which have been assessed before. Treatment costs have been assessed by means of the German version of the Client Sociodemographic and Service Receipt Inventory at five follow-ups at six-months intervals. For the whole study period significant differences of the mean service costs due to the recruitment setting have been found. The mean yearly costs amounted to 44.669 DM for participants recruited in sheltered accommodation, 27.975 DM for participants in inpatient treatment and 5691 DM for patients in outpatient facilities. A random-effect regression model confirmed significant effects of the recruitment setting over all five follow-ups. Additionally, the variance of costs over time indicates that cost assessment by means of cross sectional data involves the danger of errors due to random dispersion.

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Repräsentative Studie zur Verteilung schizophrener Patienten auf medizinische Versorgungseinrichtungen in Deutschland

Cited by 16 publications

References 1 publication

Predisposing factors for early retirement in patients with Schizophrenia in Germany

Predisposing factors for early retirement in patients with Schizophrenia in Germany

Kosten der Frühverrentung am Beispiel der Schizophrenie

Die Einflüsse des Studiendesigns und der Stichprobenauswahl auf die Berechnung psychiatrischer Versorgungskosten

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