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[德国丙型肝炎:法定医疗保险基金理赔数据分析]

[Hepatitis C in Germany: an analysis of statutory sickness funds claims data].

作者信息

Tomeczkowski Jörg, Cornberg Markus

机构信息

Janssen-Cilag GmbH, Abteilung Health Economics, Neuss.

Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover.

出版信息

Dtsch Med Wochenschr. 2015 Apr;140(8):e67-73. doi: 10.1055/s-0041-101101. Epub 2015 Apr 16.

Abstract

BACKGROUND

The aim of this study was to investigate the number of persons who obtain medical attention for Hepatitis C Virus (HCV). In addition, we wanted to get an overview of the supply situation (frequency and length of therapy or lab controls) for patients with HCV infection.

METHODOLOGY

Data obtained from statutory insurance companies were analyzed.

RESULTS

The prevalence of HCV diagnosis was 0.19 % within 3 years. Following a positive HCV-test in 19 % of patients the diagnosis of acute HCV was documented. In 2008, 9.3 % of patients were treated with pegylated Interferon alpha with or without Ribavirin (11.9 % for chronic and 3.6 % for acute HCV). A general practitioner initiated in about 5.1 % and a specialist in 21.7 % of cases a therapy within a year. 37.0 % of patients treated by a general practitioner and 57.0 % of patients treated by specialists received prescriptions in the third quarter after initiating the therapy. Not all patients had a documented test for viral load prior to therapy.

CONCLUSIONS

50 % of HCV-patients visited a physician in a 3 year time period while an average of 9 % received a therapy within a year. For the coding of acute HCV diagnosis, duration of therapy and the necessary viral load test prior therapy, the analyses showed deviations from the guideline and differences between general practitioners and specialists. For future therapies, patients with HCV-infection should be treated in specialized centers so that these therapies may develop their efficiency in the health system.

摘要

背景

本研究旨在调查因丙型肝炎病毒(HCV)就医的人数。此外,我们还想了解HCV感染患者的治疗供应情况(治疗频率和时长或实验室检查)。

方法

对法定健康保险公司提供的数据进行分析。

结果

3年内HCV诊断的患病率为0.19%。19%的患者HCV检测呈阳性后被诊断为急性HCV。2008年,9.3%的患者接受了聚乙二醇化干扰素α联合或不联合利巴韦林治疗(慢性HCV患者为11.9%,急性HCV患者为3.6%)。一年内,约5.1%的病例由全科医生启动治疗,21.7%的病例由专科医生启动治疗。在治疗开始后的第三季度,37.0%由全科医生治疗的患者和57.0%由专科医生治疗的患者接受了处方。并非所有患者在治疗前都有病毒载量检测记录。

结论

50%的HCV患者在3年时间内看过医生,而平均9%的患者在一年内接受了治疗。对于急性HCV诊断的编码、治疗时长以及治疗前必要的病毒载量检测,分析显示与指南存在偏差,且全科医生和专科医生之间存在差异。对于未来的治疗,HCV感染患者应在专科中心接受治疗,以便这些治疗能在医疗系统中发挥其疗效。

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