Dierich Andreas, Schmidt Kristin, Lison Andreas, Schulze Christoph, Schmeil Melanie, Löffler Christin, Altiner Attila
Leiter, Sanitätsunterstützungszentrum Neubrandenburg, Trollenhagen, Germany.
Qualitätsmanagement, Sanitätsunterstützungszentrum Neubrandenburg, Neubrandenburg, Germany.
Gesundheitswesen. 2023 Oct;85(10):878-886. doi: 10.1055/a-1987-5847. Epub 2023 Feb 27.
Sickness-related absences are of particular importance both in the German armed forces and in the civilian sector.
was to analyze the incidence of sick leave among soldiers in comparison to the working population covered by the statutory health insurance (SHI) system.
According to the systematics of the SHI, the key figures on incapacity to work in the period 2008-2018 are calculated in an age- and gender-standardized manner. Likewise, a list of the TOP 20 ICD-10 diagnoses in relation to incapacity to work was determined, and their average annual rates of change were calculated for trend analysis.
The annual rate of sick leave among soldiers was between 1.5 and 2.3%, which was lower than that of the SHI (3.1 to 5.0%). The duration of illness (sick days per case) among soldiers was between 9.0-15.6 days per year, compared with 10.9-14.4 days in the SHI system. The sickness frequency (cases per 100 persons) was lower among soldiers (48.2-75.0 cases) than in the SHI (96.8-131.0 cases). Most days of absence among soldiers were due to "respiratory infections (J06)" with 13.2%, "stress reactions (F43)" with 8.7%, "other infectious gastroenteritis and colitis (A09)" with 6.5%, "back pain (M54)" with 4.4% and "depressive episode (F32)" with 4.0% of all days of absence and were comparable to the values in SHI. "Depressive episode (F32)", "injuries (T14)", sreactions (F43)", "respiratory infections (J06)" and "pregnancy complaints (O26)" showed the highest rates of increase of+6.1% to+3.6% of days off work.
For the first time, it was possible to compare the sickness rate of soldiers with that of the general population in Germany, which may also provide indications for further measures for primary, secondary and tertiary prevention. The lower sickness rate among soldiers compared with the general population is mainly due to a lower incidence of illness, with a similar duration and pattern of illness, but with an overall upward trend. The ICD-10 diagnoses "Depressive episode (F32)," "injuries (T14)," "stress reactions (F43)," "acute upper respiratory tract infections (J06)" and "pregnancy complaints (O26)," which are increasing at an above-average rate in relation to the number of days absent, require further analysis. This approach seems promising, for example, to generate hypotheses and ideas for further improvement of health care.
与疾病相关的缺勤在德国武装部队和民用部门都尤为重要。
是分析士兵病假发生率，并与法定医疗保险（SHI）系统覆盖的劳动人口进行比较。
根据SHI系统的分类方法，以年龄和性别标准化的方式计算2008 - 2018年期间的工作能力丧失关键数据。同样，确定了与工作能力丧失相关的前20种国际疾病分类第十版（ICD - 10）诊断清单，并计算其平均年变化率以进行趋势分析。
士兵的年病假率在1.5%至2.3%之间，低于SHI系统（3.1%至5.0%）。士兵的疾病持续时间（每例病假天数）为每年9.0 - 15.6天，而SHI系统为10.9 - 14.4天。士兵的疾病频率（每100人患病数）低于SHI系统（士兵为48.2 - 75.0例，SHI系统为96.8 - 131.0例）。士兵缺勤的大多数天数归因于“呼吸道感染（J06）”，占所有缺勤天数的13.2%，“应激反应（F43）”占8.7%，“其他感染性肠胃炎和结肠炎（A09）”占6.5%，“背痛（M54）”占4.4%，“抑郁发作（F32）”占4.0%，且与SHI系统中的数值相当。“抑郁发作（F32）”、“损伤（T14）”、“应激反应（F43）”、“呼吸道感染（J06）”和“妊娠相关不适（O26）”的病假天数增加率最高，为+6.1%至+3.6%。
首次得以将德国士兵的发病率与普通人群的发病率进行比较，这也可为一级、二级和三级预防的进一步措施提供指示。与普通人群相比，士兵发病率较低主要是由于疾病发生率较低，疾病持续时间和模式相似，但总体呈上升趋势。ICD - 10诊断中的“抑郁发作（F32）”、“损伤（T14）”、“应激反应（F43）”、“急性上呼吸道感染（J06）”和“妊娠相关不适（O26）”，其缺勤天数的增加率高于平均水平，需要进一步分析。例如，这种方法似乎有望为进一步改善医疗保健产生假设和思路。
