Marschall U, Arnold B, Häuser W
Hauptabteilung Unternehmensstrategie, BARMER GEK Hauptverwaltung, Wuppertal.
Schmerz. 2011 Aug;25(4):402-4, 406-10. doi: 10.1007/s00482-011-1079-3.
The data available on the types of treatment delivered and healthcare costs of fibromyalgia syndrome (FMS) patients in Germany are currently not representative.
The data from all 6,897,846 insured persons of the German statutory health insurance company Barmer Ersatzkasse (BEK) before the fusion with the Gmünder Ersatzkasse (GEK) were analyzed if more than 2 billing cases with the diagnosis M79.7 were found (FMS cases) in the 8 consecutive quarter years of 2007-2008. In these cases the types and costs of out-patient treatment as well as the operation and procedure key (OPS) classification of in-patient treatment in cases of any discharge diagnosis of FMS were analyzed.
A diagnosis of FMS was recorded in 14,870 insured persons in out-patient care and in 6130 in-patients from 1(st) January 2008 to 31(st) December 2009. The 1-year prevalence of FMS diagnosis was 19,592 of the patients (0.3%). Non-steroidal agents were prescribed in 48%, weak opioids in 21% and strong opioids in 11% of the out-patients with FMS. Out-patient psychotherapy was conducted in 8% of the FMS cases. In 31% of the cases hospital treatment was carried out of which 14% received multicomponent therapy. The average healthcare costs were 4,331
The data of the BEK document high healthcare costs and treatment which is mainly not in line with the recommendations of the German guidelines on the management of FMS.
目前德国有关纤维肌痛综合征(FMS)患者所接受治疗类型及医疗费用的数据并不具有代表性。
分析德国法定健康保险公司巴尔默替代保险社(BEK)在与京德替代保险社(GEK)合并之前的所有6897846名参保人员的数据,条件是在2007 - 2008年连续8个季度中发现超过2例诊断为M79.7的计费病例(FMS病例)。对于这些病例,分析了门诊治疗的类型和费用,以及任何FMS出院诊断病例的住院治疗的手术和操作编码(OPS)分类。
2008年1月1日至2009年12月31日期间,门诊有14870名参保人员被诊断为FMS,住院有6130名。FMS诊断的1年患病率为19592名患者(0.3%)。FMS门诊患者中,48%的患者使用了非甾体类药物,21%使用了弱阿片类药物,11%使用了强阿片类药物。8%的FMS病例接受了门诊心理治疗。31%的病例进行了住院治疗,其中14%接受了多组分治疗。平均每年医疗费用为4331欧元。
BEK的数据表明医疗费用高昂,且治疗方式主要不符合德国FMS管理指南的建议。