Kühnl A, Söllner H, Eckstein H-H
Klinik und Poliklinik für Vaskuläre und Endovaskuläre Chirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675 Munich, Germany.
Gefasschirurgie. 2016;21(Suppl 1):14-23. doi: 10.1007/s00772-015-0095-5. Epub 2015 Oct 23.
Non-cardiac vascular diseases account for approximately 10 % of the total burden of disease in the German population as measured in disability-adjusted life years (DALY). Thus, from the social perspective, much attention should be paid to optimization of the provision of vascular services especially in elderly people.
This article describes the structure of inpatient care and the provision of vascular treatment as well as age- and gender-specific hospital incidence rates of vascular diseases in Germany between 2005 and 2013.
Secondary data analysis is based on basic data from German hospitals as well as nationwide aggregated data from the diagnosis-related groups' statistics from the Federal Statistical Office.
Since 2005, the incidence of non-cardiac vascular diseases has increased and showed a significant dependency on sex and age. In general, men were affected consistently more frequently by vascular diseases. In contrast, hospital admission rates due to varicose veins or acute ischemia of the legs were higher in women. Treatment of arterial diseases was performed predominantly in general surgery units or departments for vascular surgery. From 1991 to 2013, the number of hospitals employing specialists for vascular surgery almost doubled, and the number of vascular surgeons working full-time in German hospitals was nearly tripled. Endovascular approaches were used particularly for revascularization of peripheral arteries as well as aortic aneurysm repair. In contrast, carotid surgery as well as peripheral embolectomy were predominately performed using open surgical techniques.
Since 1991, the increasing need for vascular services for patients has been met by continuously growing structures for the provision of vascular surgical treatment; however, the suitability and efficiency of provision of vascular services could only be assessed in an appropriate way by using more differentiated and disaggregated data.
Additional information is available in the online version of this article (doi:10.1007/s00772-015-0095-5).
以伤残调整生命年(DALY)衡量,非心脏血管疾病约占德国人口疾病总负担的10%。因此,从社会角度来看,应特别关注优化血管服务的提供,尤其是在老年人中。
本文描述了2005年至2013年德国住院护理结构和血管治疗的提供情况,以及血管疾病的年龄和性别特异性住院发病率。
二次数据分析基于德国医院的基础数据以及联邦统计局诊断相关组统计的全国汇总数据。
自2005年以来,非心脏血管疾病的发病率有所上升,并且显示出对性别和年龄的显著依赖性。总体而言,男性患血管疾病的频率一直更高。相比之下,女性因静脉曲张或腿部急性缺血而住院的比率更高。动脉疾病的治疗主要在普通外科或血管外科进行。从1991年到2013年,聘用血管外科专家的医院数量几乎翻了一番,在德国医院全职工作的血管外科医生数量几乎增加了两倍。血管内介入方法尤其用于外周动脉血运重建以及主动脉瘤修复。相比之下,颈动脉手术以及外周动脉取栓术主要采用开放手术技术。
自1991年以来,不断增长的血管外科治疗结构满足了患者对血管服务日益增长的需求;然而,只有通过使用更具区分性和细分的数据,才能以适当的方式评估血管服务提供的适用性和效率。
本文的在线版本提供了更多信息(doi:10.1007/s00772-015-0095-5)。