Stock Stephanie, Ihle Peter, Simic Dusan, Rupprecht Christoph, Schubert Ingrid, Lappe Veronika, Kalbe Elke, Tebest Ralf, Lorrek Kristina
Institut für Gesundheitsökonomie und klinische Epidemiologie, Uniklinik Köln (AöR), Gleueler Straße 176-178, 50935, Köln, Deutschland.
PMV Forschungsgruppe, Universität zu Köln, Köln, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018 Apr;61(4):404-411. doi: 10.1007/s00103-018-2711-5.
Elderly people with a non-German background are a fast growing population in Germany.
Is administrative prevalence of dementia and uptake of nursing-home care similar in the German and non-German insured?
Based on routine data, administrative prevalence rates for dementia were calculated for 2013 from a full census of data from one large sickness fund. Patients with dementia (PWD) were identified via ICD-10 codes (F00; F01; F03; F05; G30).
Administrative prevalence of dementia was 2.67% in the study population; 3.06% in Germans, and 0.96% in non-Germans (p value <0.001). Age and sex adjusted prevalence was comparable in the insured with and without German citizenship, except in women aged 80-84 (17.2 vs. 15.4) and for men in the age groups 80-84 (16.5 vs. 14.2), 85-89 years (23.4 vs. 21.5), and above 90 years of age (32.3 vs. 26.3). Standardized to the population of all investigated insured, 31.4% of all Germans with dementia had no longterm care entitlement vs. 35.5% of all patients without German citizenship. Of German patients, 55.1% were institutionalized vs. 39.5% of all patients without German citizenship.
There was a higher prevalence of dementia in the very old insured without German citizenship compared to those with German citizenship, especially in men. Non-Germans showed lower uptake of nursing home care compared to Germans. Additionally, Germans had slightly higher nursing care entitlements. It should be investigated further how much of the difference is due to underdiagnosis, cultural differences, or lack of adequate diagnostic work-up.
在德国，非德国背景的老年人数量增长迅速。
德国参保者与非德国参保者中痴呆症的行政患病率及养老院护理的接受情况是否相似？
基于常规数据，从一家大型疾病基金的完整数据普查中计算出2013年痴呆症的行政患病率。通过国际疾病分类第十版代码（F00；F01；F03；F05；G30）识别痴呆症患者（PWD）。
研究人群中痴呆症的行政患病率为2.67%；德国人中为3.06%，非德国人中为0.96%（p值<0.001）。年龄和性别调整后的患病率在有德国国籍和无德国国籍的参保者中相当，但80 - 84岁女性（17.2对15.4）以及80 - 84岁、85 - 89岁和90岁以上男性中除外（分别为16.5对14.2、23.4对21.5、32.3对26.3）。以所有被调查参保者的人口为标准，所有患痴呆症的德国人中有31.4%没有长期护理资格，而无德国国籍的所有患者中这一比例为35.5%。德国患者中有55.1%被安置在机构中，而无德国国籍的所有患者中这一比例为39.5%。
与有德国国籍的参保者相比，无德国国籍的高龄参保者中痴呆症患病率更高，尤其是男性。与德国人相比，非德国人接受养老院护理的比例较低。此外，德国人享有略高的护理资格。应进一步调查这种差异在多大程度上是由于诊断不足、文化差异或缺乏充分的诊断检查所致。
