Gerdau-Heitmann Cornelia, Mümken Sarah, Eberhard Sveja, Koppelin Frauke
Abt. Technik und Gesundheit für Menschen, Jade Hochschule, Ofener Str. 16/19, 26121, Oldenburg, Deutschland.
Politik und Versorgungsforschung, AOK - Die Gesundheitskasse für Niedersachsen, Hannover, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2017 Dec;60(12):1346-1355. doi: 10.1007/s00103-017-2638-2.
Mental disorder is the subject of ever-increasing attention in the field of public health. However, the actual number of such cases is difficult to determine owing to the lack of comprehensive longitudinal studies.
The administrative incidence and prevalence of mental disorders were estimated on the basis of data from 2010 to 2013 provided by the health insurance company AOK, Lower Saxony, and were assessed according to age and gender. Additionally, possible correlations between local conditions and the occurrence of diagnosed mental disorders were examined for both urban and rural districts.
Analyses were conducted using the secondary datasets of 1.5 million persons born between 1940 and 1994 who had been continuously insured throughout the period specified. Only documented diagnoses from outpatient care were taken into account.
One third of the insured persons showed at least one documented diagnosis of a mental disorder within a 12-month period. In approximately 11 out of 100 cases, there was a newly documented diagnosis in 2012. With the exception of cases relating to psychotropic substance use, women were significantly more frequently affected than men. Age-specific differences were also determined. At a regional level, in relation to administrative prevalence, mental disorders showed positive correlations in the density of doctors and psychotherapists. Moreover, regions with a high rate of unemployment generally show a higher prevalence of mental disorders.
Despite certain limitations, the use of administrative incidence and prevalence data is a viable approach to assessing gender- and age-specific, and regional differences. Our regional analyses suggest a correlation between the local job situation and the level of regional administrative prevalence.
精神障碍是公共卫生领域日益受到关注的主题。然而，由于缺乏全面的纵向研究，此类病例的实际数量难以确定。
根据下萨克森州AOK健康保险公司提供的2010年至2013年的数据，估算精神障碍的行政发病率和患病率，并按年龄和性别进行评估。此外，还对城乡地区的当地情况与确诊精神障碍的发生之间可能存在的相关性进行了研究。
使用1940年至1994年出生的150万人的二次数据集进行分析，这些人在指定期间一直参保。仅考虑门诊护理的记录诊断。
三分之一的参保人员在12个月内至少有一次精神障碍的记录诊断。在大约每100例病例中，有11例在2012年有新的记录诊断。除与使用精神药物有关的病例外，女性受影响的频率明显高于男性。还确定了年龄特异性差异。在区域层面，就行政患病率而言，精神障碍与医生和心理治疗师的密度呈正相关。此外，失业率高的地区精神障碍患病率通常也较高。
尽管存在一定局限性，但使用行政发病率和患病率数据是评估性别、年龄特异性及区域差异的可行方法。我们的区域分析表明，当地就业情况与区域行政患病率水平之间存在相关性。
