W Häuser1, U Marschall, H L'hoest, K Komossa, P Henningsen. 1. Klinik für Innere Medizin I (Gastroenterologie, Hepatologie, Stoffwechsel- und Infektionskrankheiten, Psychosomatik), Klinikum Saarbrücken gGmbH, Winterberg 1, 66119, Saarbrücken, Deutschland. whaeuser@klinikum-saarbruecken.de
Abstract
INTRODUCTION: Data on administrative prevalence, types of treatment and disease costs of patients diagnosed with somatoform pain disorder (according to ICD 10) in Germany were not previously available. MATERIALS AND METHODS: We analysed health insurance data from 2008-2010 of 8.5 million people of the German statutory health insurance company BARMER GEK on administrative prevalence of insurants with at least one billing code F 45.4x in 2009 and at least one second billing code F 45.4x in the time period 2008-2010 stratified by age and gender, different professions being involved in treatment, diagnostics and treatment methods applied. The types and costs of out-patient treatment and of in-patient treatment in case of any discharge with diagnosis of F45.4 were analysed. RESULTS: The administrative prevalence doubled from 2008 to 2010 after the separation of the previous code F45.4 into F45.40 and F45.41. In 2009, 0.5 % of the insurants were diagnosed with F 45.4, whereby F 45.4 was diagnosed 2.3-fold more often in women than in men. Family practitioners (41 %) and anaesthesiologists (28 %) were the leading specialties in the care of chronic patients. In 2009, 54 % of patients underwent x-ray examination, 25 % magnetic resonance imaging and 11 % computed tomography. In all, 66 % of the chronic patients received basic psychosomatic care, 38 % were prescribed opioids, 12 % underwent spinal nerve anaesthesia and 14 % received psychotherapy. In 2009, the average direct and indirect treatment costs per patient with somatoform pain disorder were 5500 <euro>. CONCLUSION: Insurants diagnosed with somatoform pain disorder were probably overtreated with radiology and invasive procedures and with opioids.
INTRODUCTION: Data on administrative prevalence, types of treatment and disease costs of patients diagnosed with somatoform pain disorder (according to ICD 10) in Germany were not previously available. MATERIALS AND METHODS: We analysed health insurance data from 2008-2010 of 8.5 million people of the German statutory health insurance company BARMER GEK on administrative prevalence of insurants with at least one billing code F 45.4x in 2009 and at least one second billing code F 45.4x in the time period 2008-2010 stratified by age and gender, different professions being involved in treatment, diagnostics and treatment methods applied. The types and costs of out-patient treatment and of in-patient treatment in case of any discharge with diagnosis of F45.4 were analysed. RESULTS: The administrative prevalence doubled from 2008 to 2010 after the separation of the previous code F45.4 into F45.40 and F45.41. In 2009, 0.5 % of the insurants were diagnosed with F 45.4, whereby F 45.4 was diagnosed 2.3-fold more often in women than in men. Family practitioners (41 %) and anaesthesiologists (28 %) were the leading specialties in the care of chronic patients. In 2009, 54 % of patients underwent x-ray examination, 25 % magnetic resonance imaging and 11 % computed tomography. In all, 66 % of the chronic patients received basic psychosomatic care, 38 % were prescribed opioids, 12 % underwent spinal nerve anaesthesia and 14 % received psychotherapy. In 2009, the average direct and indirect treatment costs per patient with somatoform pain disorder were 5500 <euro>. CONCLUSION: Insurants diagnosed with somatoform pain disorder were probably overtreated with radiology and invasive procedures and with opioids.
Authors: W Häuser; F Bock; P Engeser; G Hege-Scheuing; M Hüppe; G Lindena; C Maier; H Norda; L Radbruch; R Sabatowski; M Schäfer; M Schiltenwolf; M Schuler; H Sorgatz; T Tölle; A Willweber-Strumpf; F Petzke Journal: Schmerz Date: 2015-02 Impact factor: 1.107