Salize Hans Joachim, Stamm Klaus, Schubert Matthias, Bergmann Frank, Härter Martin, Berger Mathias, Gaebel Wolfgang, Schneider Frank
Zentralinstitut für Seelische Gesundheit, Mannheim.
Psychiatr Prax. 2004 Apr;31(3):147-56. doi: 10.1055/s-2003-814828.
Service utilization and total direct cost of care was assessed in 270 patients suffering from depressive disorder. Patients were recruited from primary care physicians or family doctors (n = 43) or psychiatrists (n = 23) in office practice, from three different regions in Germany (county of Düren and city of Aachen, Lörrach-county, city of Munich). A detailed catalogue of unit costs (including inpatient, outpatient and rehabilitative services) was used for calculating total cost of care on an individual basis. Service utilization and costs referred to 2001. Mean cost of total medical care of the study patients was euro 3849 (excluding cost of drugs for physical illness). The cost for treating depressive disorders and additional psychiatric co-morbidity (which is included into the total cost of care) was euro 2073 per patient and year. When cross-checking with ICD-10 criteria for depressive disorders, the original diagnosis by family doctors or psychiatrists could be confirmed in 186 patients of the total sample (n = 270), suggesting that there is a high amount of falsely diagnosed patients in primary and specialized care of depressive patients in Germany. Direct cost of the 186 confirmed patients was higher (total care cost: euro 4715, cost for treatment of depression and psychiatric co-morbidity: euro 2541) than in the total group and should be considered as reference cost, when discussing cost of care in depressive patients in Germany. Results suggest to analyse cost of care in depressive patients further and to discuss a more efficient allocation of health budgets in the field.
对270名抑郁症患者的医疗服务利用情况和护理总直接成本进行了评估。患者从德国三个不同地区（迪伦县和亚琛市、洛拉赫县、慕尼黑市）的基层医疗医生或家庭医生（n = 43）或精神科医生（n = 23）的门诊中招募。使用详细的单位成本目录（包括住院、门诊和康复服务）来计算个体的护理总成本。医疗服务利用情况和成本数据参考2001年。研究患者的总医疗护理平均成本为3849欧元（不包括躯体疾病药物成本）。每位患者每年治疗抑郁症和其他精神共病（包含在护理总成本中）的成本为2073欧元。根据国际疾病分类第十版（ICD - 10）的抑郁症标准进行交叉核对时，在全部样本（n = 270）中的186名患者中，家庭医生或精神科医生的初始诊断得到了证实，这表明在德国抑郁症患者的基层和专科护理中存在大量误诊患者。186名确诊患者的直接成本（总护理成本：4715欧元，抑郁症和精神共病治疗成本：2541欧元）高于总体组，在讨论德国抑郁症患者的护理成本时，应将其视为参考成本。结果表明需要进一步分析抑郁症患者的护理成本，并讨论该领域更有效的卫生预算分配。
