Thea Kreutzburg1, Frederik Peters1, Henrik C Rieß1, Sandra Hischke2, Ursula Marschall3, Levente Kriston4, Helmut L'Hoest3, Art Sedrakyan5, Eike S Debus1, Christian-Alexander Behrendt6. 1. Department of Vascular Medicine, Research Group GermanVasc, University Heart and Vascular Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. 2. Department of Vascular Medicine, Research Group GermanVasc, University Heart and Vascular Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. 3. BARMER, Wuppertal, Germany. 4. Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. 5. Healthcare Policy and Research, Weill Cornell Medical College, New York City, NY, USA. 6. Department of Vascular Medicine, Research Group GermanVasc, University Heart and Vascular Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. Electronic address: behrendt@hamburg.de.
Abstract
OBJECTIVE: Patients suffering from peripheral arterial occlusive disease (PAOD) are a central target population for multidisciplinary vascular medicine. This study aimed to highlight trends in treatment patterns and comorbidities using up to date longitudinal patient related data from Germany. METHODS: This study is a retrospective health insurance claims data analysis of patients insured by the second largest health insurance provider in Germany, BARMER. All PAOD patient hospitalisations between 2008 and 2016 were included. The comorbidities were categorised with Elixhauser groups using WHO ICD-10 codes and summarised as the linear van Walraven score (vWS). A trend analysis of the comorbidities was performed after standardisation by age and sex. RESULTS: A total of 156 217 patients underwent 202 961 hospitalisations (49.4% for chronic limb threatening ischaemia in 2016) with PAOD during the study period. Although the estimated annual incidence of PAOD among the BARMER cohort decreased slightly (- 4.4%), an increase was observed in the prevalence of PAOD (+ 23.1%), number of hospitalisations (+ 25.1%), peripheral vascular interventions (PVI, + 61.1%), and disease related reimbursement costs (+ 31%) from 2008 to 2016. Meanwhile, the number of major amputations decreased (- 15.1%). The proportion of patients aged 71-80 years increased about +10% among PAOD patients and the mean vWS also increased by two points during the study period. Considerable increases were found in the rates of hypertension, renal failure, and hypothyroidism, whereas the rates of diabetes and congestive heart failure decreased over time. CONCLUSION: Increasing numbers of PVI performed on these ageing and sicker patients lead to rising costs but correlate with decreasing major amputation rates.
OBJECTIVE:Patients suffering from peripheral arterial occlusive disease (PAOD) are a central target population for multidisciplinary vascular medicine. This study aimed to highlight trends in treatment patterns and comorbidities using up to date longitudinal patient related data from Germany. METHODS: This study is a retrospective health insurance claims data analysis of patients insured by the second largest health insurance provider in Germany, BARMER. All PAOD patient hospitalisations between 2008 and 2016 were included. The comorbidities were categorised with Elixhauser groups using WHO ICD-10 codes and summarised as the linear van Walraven score (vWS). A trend analysis of the comorbidities was performed after standardisation by age and sex. RESULTS: A total of 156 217 patients underwent 202 961 hospitalisations (49.4% for chronic limb threatening ischaemia in 2016) with PAOD during the study period. Although the estimated annual incidence of PAOD among the BARMER cohort decreased slightly (- 4.4%), an increase was observed in the prevalence of PAOD (+ 23.1%), number of hospitalisations (+ 25.1%), peripheral vascular interventions (PVI, + 61.1%), and disease related reimbursement costs (+ 31%) from 2008 to 2016. Meanwhile, the number of major amputations decreased (- 15.1%). The proportion of patients aged 71-80 years increased about +10% among PAOD patients and the mean vWS also increased by two points during the study period. Considerable increases were found in the rates of hypertension, renal failure, and hypothyroidism, whereas the rates of diabetes and congestive heart failure decreased over time. CONCLUSION: Increasing numbers of PVI performed on these ageing and sicker patients lead to rising costs but correlate with decreasing major amputation rates.
Authors: Moritz Hadwiger; Nikolaos Dagres; Gerhard Hindricks; Helmut L'hoest; Ursula Marschall; Alexander Katalinic; Fabian-Simon Frielitz Journal: Ger Med Sci Date: 2022-03-04
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Authors: Moritz Seiffert; Fabian J Brunner; Marko Remmel; Götz Thomalla; Ursula Marschall; Helmut L'Hoest; Laura Acar; Eike S Debus; Stefan Blankenberg; Christian Gerloff; Christian-Alexander Behrendt Journal: Clin Res Cardiol Date: 2020-08-04 Impact factor: 5.460
Authors: Christian-Alexander Behrendt; Birgitta Sigvant; Jenny Kuchenbecker; Matthew J Grima; Marc Schermerhorn; Ian A Thomson; Martin Altreuther; Carlo Setacci; Alexei Svetlikov; Elin H Laxdal; Frederico Bastos Goncalves; Eric A Secemsky; E Sebastian Debus; Kevin Cassar; Barry Beiles; Adam W Beck; Kevin Mani; Daniel Bertges Journal: Eur J Vasc Endovasc Surg Date: 2020-09-29 Impact factor: 7.069