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[德国抑郁症长期健康保险支付情况——常规数据的二次分析]

[Long-term health insurance payments for depression in Germany - a secondary analysis of routine data].

作者信息

Stamm Klaus, Reinhard Iris, Salize Hans Joachim

机构信息

Zentralinstitut für Seelische Gesundheit, Mannheim.

出版信息

Neuropsychiatr. 2010;24(2):99-107.

Abstract

BACKGROUND

A common disease, depression poses a significant burden both to the individual and to society. Despite the growing body of health economics research, cost studies still most frequently stem from English speaking countries. Also, even in the international literature, there is a lack of data dealing with the topic of longterm costs.

METHODS

All members of a health insurance company for a large chemical trust in Germany who suffered from depression (ICD 10 diagnosis F32, F33) in the year 2002 (index year) were identified (N = 591). Mean annual average costs and costs for hospital treatment, medication and sickness benefits were calculated for the index year and the years 2000 - 2005 (long term costs) and compared with those for insured persons without a psychiatric disorder. For members with new episodes beginning in the index year, the course of costs was examined.

RESULTS

With total annual costs of 4,102 euro vs. 1,103 euro in the index year and 2,380 euro vs. 792 euro for the long - term costs depressive insured are markedly more expensive. The costs for newly diagnosed patients show a clear peak in the index year, but cost differences also exist two years earlier and three years later.

CONCLUSIONS

A diagnosis of depression is associated with enormous economic consequences. Especially the onset of this illness leads to a steep increase in costs. There is an urgent need to enhance primary prevention and early intervention strategies.

摘要

背景

抑郁症作为一种常见疾病,给个人和社会都带来了沉重负担。尽管健康经济学研究不断增加,但成本研究仍大多来自英语国家。此外,即使在国际文献中,也缺乏关于长期成本主题的数据。

方法

确定了德国一家大型化工企业信托健康保险公司在2002年(索引年)患有抑郁症(国际疾病分类第10版诊断F32、F33)的所有成员(N = 591)。计算了索引年以及2000 - 2005年(长期成本)的年平均成本、住院治疗成本、药物成本和疾病津贴成本,并与无精神疾病的被保险人的成本进行比较。对于在索引年开始出现新发作的成员,研究了成本变化过程。

结果

抑郁症患者的年总成本在索引年为4,102欧元,而对照组为1,103欧元;长期成本为2,380欧元,而对照组为792欧元,抑郁症患者的成本明显更高。新诊断患者的成本在索引年出现明显峰值,但在两年前和三年后也存在成本差异。

结论

抑郁症的诊断会带来巨大的经济后果。尤其是这种疾病的发作会导致成本急剧增加。迫切需要加强一级预防和早期干预策略。

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