Roick Christiane, Waltersbacher Andrea
AOK-Bundesverband, Berlin.
Wissenschaftliches Institut der AOK (WIdO), Berlin.
Psychiatr Prax. 2015 Jan;42(1):21-9. doi: 10.1055/s-0033-1349516. Epub 2013 Sep 23.
To analyse the administrative prevalence and regional differences in hyperkinetic disorder (HK) diagnoses in Germany.
The administrative prevalence of HK (ICD-10 F90) was analysed for 3,6 million children, up to 18 years old and in the whole year 2009 insured by the AOK, using health insurance data. Additionally, administrative prevalence changes between 2006 and 2008 were investigated. The prevalence analyses were differenciated according to postal code areas and regions of the associations of statutory health insurance physicians (SHIP-regions).
The analyses revealed a continous increase of the administrative HK-prevalence between 2006 (2,8 %) and 2009 (3,8 %). The administrative prevalence was notably lower in the city states Bremen, Hamburg and Berlin, but rather high in four of five SHIP-regions in the New Laender. 14 % of children with HK were diagnosed with HK and ICD-10 F98.8. In 47 % these different diagnoses had been coded by different physicians.
Regional differences in administrative prevalence rates and discrepancies in diagnosis coding by different physicians may indicate uncertainties regarding HK-diagnosis in routine health care. Future studies should analyse these associations more detailed.
分析德国多动障碍（HK）诊断的行政患病率及地区差异。
利用医疗保险数据，对2009年全年参保于AOK的360万18岁及以下儿童的HK（国际疾病分类第十版F90）行政患病率进行分析。此外，还调查了2006年至2008年间行政患病率的变化。患病率分析根据邮政编码区域和法定医疗保险医生协会（SHIP区域）的地区进行区分。
分析显示，2006年（2.8%）至2009年（3.8%）期间，HK行政患病率持续上升。在不来梅、汉堡和柏林等城市州，行政患病率显著较低，但在新联邦州的五个SHIP区域中的四个区域则相当高。14%的HK儿童被诊断为HK及国际疾病分类第十版F98.8。在47%的情况下，这些不同的诊断是由不同的医生编码的。
行政患病率的地区差异以及不同医生在诊断编码上的差异可能表明常规医疗保健中HK诊断存在不确定性。未来的研究应更详细地分析这些关联。
