Stock Stephanie A K, Stollenwerk Björn, Redaelli Marcus, Civello Daniele, Lauterbach Karl W
Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany.
J Womens Health (Larchmt). 2008 Apr;17(3):343-54. doi: 10.1089/jwh.2007.0422.
The goal of this study was to investigate gender-specific differences in prevalence, healthcare costs, and treatment patterns in the German Statutory Health Insurance (SHI).
The study analyzed administrative claims data of over 26 million insured with respect to prevalence and cost of illness of six chronic diseases. Insured were identified using the ATC code for medication prescription and ICD-9 code for diagnosis. The influences of gender, age, and comorbidity on cost differences were analyzed via multivariate regression analysis.
Adjusted for age and comorbidity, gender had a significant influence on both hospital and medication spending. Hospital costs on average were 17.1% (95% CI 14.1; 20.2) higher for men compared with women. Medication spending for men exceeded that for women on average by 13.8% (95% CI 10.9; 16.7). The diagnoses with the highest prevalence were hypertension and heart failure. Women had a higher prevalence of diabetes, coronary artery disease (CAD), heart failure, and hypertension. Medication costs were higher for men in three of five diagnoses and comparable for two diagnoses (diabetes and asthma). Women received more medication prescriptions than men, but on average prescriptions for men were 14%-26% more expensive than prescriptions for women. Regarding treatment patterns men were treated with different drug classes in cardiovascular disease (CVD) compared with women. Total medication spending stratified by diagnosis was highest for diabetes.
Gender differences for costs and prescribing patterns for chronic diseases vary disease specifically, but generally men had higher inpatient costs and more expensive medication prescriptions, whereas women had higher numbers of prescriptions.
本研究的目的是调查德国法定医疗保险（SHI）中患病率、医疗费用和治疗模式的性别差异。
该研究分析了超过2600万参保人的行政索赔数据，涉及六种慢性病的患病率和疾病成本。通过药物处方的ATC代码和诊断的ICD-9代码来识别参保人。通过多变量回归分析性别、年龄和合并症对成本差异的影响。
在调整年龄和合并症后，性别对住院和药物支出均有显著影响。与女性相比，男性的住院费用平均高出17.1%（95%置信区间14.1；20.2）。男性的药物支出平均比女性高出13.8%（95%置信区间10.9；16.7）。患病率最高的诊断是高血压和心力衰竭。女性在糖尿病、冠状动脉疾病（CAD）、心力衰竭和高血压方面的患病率较高。在五种诊断中的三种中，男性的药物成本较高，两种诊断（糖尿病和哮喘）的成本相当。女性收到的药物处方比男性多，但男性的处方平均比女性的处方贵14%-26%。在心血管疾病（CVD）方面，男性与女性的治疗药物类别不同。按诊断分层的总药物支出中，糖尿病最高。
慢性病的成本和处方模式的性别差异因疾病而异，但一般来说，男性的住院成本较高，药物处方较贵，而女性的处方数量较多。
