Augustin M, Anastasiadou Z, Schaarschmidt M L, Krensel M, Schäfer I, Reusch M
Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 5, 20246, Hamburg, Deutschland.
Dermatologische Gemeinschaftspraxis am Tibarg, Hamburg, Deutschland.
Hautarzt. 2016 Jul;67(7):544-8. doi: 10.1007/s00105-016-3816-0.
Treatment for skin cancer is a major component of dermatological care in western countries.
The purpose of this work is to analyze health care provision and providers for skin cancer care in Germany.
From the complete claims data set from 2007-2009 of the German statutory health insurance DAK (approximately 6.1 million insured persons), insurees with skin cancer and melanocytic naevi were extracted by ICD-10 codes. Surgical procedures and physician specialties were identified by specific codes. Data from the German statistical agency (Destatis) were derived from public domain for the years 2008-2010.
Among the annual ambulatory surgical treatments (n = 6695) for melanoma, 83.6 % were conducted by dermatologists, followed by general surgeons (11.1 %), and facial surgeons (3.0 %). In melanocytic naevi (n = 51,659), 79.1 % were treated by dermatologists, followed by general surgeons (15.5 %), facial surgeons (3.6 %), and general practitioners (1.1 %), while in epithelial cancers (ICD-10 C44), 76.4 % were operated by dermatologists, followed by general surgeons (12.7 %) and facial surgeons (7.9 %). Overall, related to Germany, about 830,000 ambulatory operations for skin cancer were conducted in 2009 which is about 40 % more than in 2007. In hospitalized patients, 79,448 out of 195,558 inpatient cases (45.5 %) were treated in dermatological departments in the year 2012. Average annual growth rates of the inpatient cases in the DAK between 2007 and 2010 were 8.9 % for MM and 11.1 % for SCC/BCC.
Skin cancer is associated with a significant and still growing need for surgical care in which dermatology has a leading role in Germany. Thus, there is an increasing need for dermato-surgical specialist training.
在西方国家，皮肤癌治疗是皮肤科护理的主要组成部分。
本研究旨在分析德国皮肤癌护理的医疗服务提供情况及提供者。
从德国法定医疗保险DAK 2007 - 2009年的完整理赔数据集（约610万参保人）中，通过ICD - 10编码提取患有皮肤癌和黑素细胞痣的被保险人。通过特定编码确定手术程序和医生专业。德国统计局（联邦统计局）2008 - 2010年的数据来自公共领域。
在黑色素瘤的年度门诊手术治疗（n = 6695）中，83.6%由皮肤科医生进行，其次是普通外科医生（11.1%）和面部外科医生（3.0%）。在黑素细胞痣（n = 51659）治疗中，79.1%由皮肤科医生进行，其次是普通外科医生（15.5%）、面部外科医生（3.6%）和全科医生（1.1%），而在上皮癌（ICD - 10 C44）治疗中，76.4%由皮肤科医生进行手术，其次是普通外科医生（12.7%）和面部外科医生（7.9%）。总体而言，就德国而言，2009年约有83万例皮肤癌门诊手术，比2007年增加了约40%。2012年，在住院患者中，195558例住院病例中有79448例（45.5%）在皮肤科接受治疗。2007年至2010年期间，DAK中MM住院病例的年均增长率为8.9%，SCC/BCC为11.1%。
皮肤癌与外科护理的巨大且仍在增长的需求相关，在德国皮肤科在其中发挥主导作用。因此，对皮肤外科专科培训的需求日益增加。
