Koltermann Katharina C, Schlotmann Andreas, Schröder Helmut, Willich Stefan N, Reinhold Thomas
Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Wissenschaftliches Institut der AOK (WIdO), Berlin, Germany.
Z Evid Fortbild Qual Gesundhwes. 2016 Dec;118-119:24-30. doi: 10.1016/j.zefq.2016.09.006. Epub 2016 Oct 21.
Until now, there has been little discussion of the costs of the deep infiltrating endometriosis (DIE) of the bowel or the bladder. The aim of the present secondary data analysis was to describe the population affected by this disease and to determine the economic burden in Germany from a payer's perspective.
Health claims data of women diagnosed with DIE of the bladder or bowel, who were surgically treated as inpatients between Jan 1, 2008 and Dec 31, 2012, were evaluated retrospectively. All data were extrapolated on a national statutory health insurance (SHI) level and normalized based on the year of surgery (index year). Case-individual information on age, comorbidities and prescribed drugs were presented for the index year. Direct medical cost data were analysed before and after the index year, differentiated by cost sector and age group.
The data of 825 women with DIE were analysed. Sample size for different time points varied depending on insurance eligibility and continuous case information. The average age at surgery was 39 years. Besides DIE, 41 % of the women had at least one additional disease of the peritoneum. The mean annual total healthcare costs per DIE case were 12,868 Euros in the index year. Before surgery, mean annual costs varied between 548 and 2,475 Euros per case and after surgery between 1,739 and 2,818 Euros per case. In total, mean costs were higher in younger women as compared to older women, with a cost difference of 616 Euros over all time points.
Direct costs are highest during the year of surgical treatment, but DIE of the bowel and bladder places a substantial burden on the SHI also before and after surgery. Further studies on indirect costs would be desirable to complete the knowledge on the economic burden of DIE.
迄今为止，关于肠道或膀胱深部浸润型子宫内膜异位症（DIE）的成本讨论甚少。本二次数据分析的目的是描述受该疾病影响的人群，并从支付方的角度确定德国的经济负担。
回顾性评估2008年1月1日至2012年12月31日期间因膀胱或肠道DIE接受手术治疗的住院女性的健康保险理赔数据。所有数据均外推至国家法定健康保险（SHI）水平，并根据手术年份（索引年份）进行标准化。列出索引年份的病例个体年龄、合并症和处方药信息。按成本部门和年龄组对索引年份前后的直接医疗成本数据进行分析。
分析了825例DIE女性的数据。不同时间点的样本量因保险资格和连续病例信息而异。手术时的平均年龄为39岁。除DIE外，41%的女性至少还有一种腹膜疾病。索引年份每例DIE病例的年平均总医疗费用为12,868欧元。手术前，每例病例的年平均费用在548欧元至2,475欧元之间，手术后在1,739欧元至2,818欧元之间。总体而言，年轻女性的平均费用高于老年女性，所有时间点的费用差异为616欧元。
直接成本在手术治疗当年最高，但肠道和膀胱DIE在手术前后也给SHI带来了沉重负担。需要进一步研究间接成本，以完善对DIE经济负担的认识。
