Šmit Renata, Wojtalewicz Nathalie, Vierbaum Laura, Nourbakhsh Farzin, Schellenberg Ingo, Hunfeld Klaus-Peter, Lohr Benedikt
Northwest Medical Centre, Medical Faculty, Academic Teaching Hospital, Institute for Laboratory Medicine, Microbiology and Infection Control, Goethe University, Frankfurt, Germany.
INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany.
Front Public Health. 2022 Apr 26;10:883564. doi: 10.3389/fpubh.2022.883564. eCollection 2022.
A multi-dimensional model can be a useful tool for estimating the general impact of disease on the different sectors of the healthcare system. We chose the sexually transmitted disease syphilis for our model due to the good quality of reported data in Germany.
The model included gender- and age-stratified incident cases of syphilis (in- and outpatients) provided by a German statutory health insurance company, as well as seroprevalence data on syphilis in first-time blood donors. Age standardized rates were calculated based on the standard German population. The test quality was assessed by extrapolating the number of false-positive and false-negative results based on data from Europe-wide external quality assessment (EQA) schemes. The model analysis was validated with the reported cases and diagnosis-related group (DRG)-statistics from 2010 to 2012. The annual direct and indirect economic burden was estimated based on the outcomes of our model.
The standardized results were slightly higher than the results reported between 2010 and 2012. This could be due to an underassessment of cases in Germany or due to limitations of the dataset. The number of estimated inpatients was predicted with an accuracy of 89.8 %. Results from EQA schemes indicated an average sensitivity of 92.8 % and an average specificity of 99.9 % for the recommended sequential testing for syphilis. Based on our model, we estimated a total average minimal annual burden of €20,292,110 for syphilis on the German healthcare system between 2010 and 2012.
The linking of claims data, results from EQA schemes, and blood donor surveillance can be a useful tool for assessing the burden of disease on the healthcare system. It can help raise awareness in populations potentially at risk for infectious diseases, demonstrate the need to educate potential risk groups, and may help with predictive cost calculations and planning.
多维模型可能是评估疾病对医疗保健系统不同部门总体影响的有用工具。由于德国报告数据质量良好，我们在模型中选择了性传播疾病梅毒。
该模型纳入了德国一家法定健康保险公司提供的按性别和年龄分层的梅毒发病病例（门诊和住院患者），以及首次献血者的梅毒血清阳性率数据。年龄标准化率基于德国标准人口计算。根据全欧洲外部质量评估（EQA）计划的数据推断假阳性和假阴性结果的数量，以此评估检测质量。利用2010年至2012年报告的病例和诊断相关分组（DRG）统计数据对模型分析进行验证。根据我们模型的结果估算年度直接和间接经济负担。
标准化结果略高于2010年至2012年报告的结果。这可能是由于德国对病例评估不足或数据集存在局限性。预测的住院患者数量准确率为89.8%。EQA计划的结果表明，推荐的梅毒序贯检测平均敏感度为92.8%，平均特异度为99.9%。根据我们的模型，我们估算出2010年至2012年梅毒给德国医疗保健系统造成的年均总负担最低为20,292,110欧元。
理赔数据、EQA计划结果和献血者监测数据的关联，可能是评估疾病对医疗保健系统负担的有用工具。它有助于提高潜在传染病风险人群的意识，表明对潜在风险群体进行教育的必要性，并可能有助于进行预测性成本计算和规划。
