Grochtdreis Thomas, König Hans-Helmut, Leichsenring Falk, Beutel Manfred E, Feix Lila, Gündel Harald, Hermann Andrea, Hitzler Melissa, Knaevelsrud Christine, Kolassa Iris-Tatjana, Kruse Johannes, Niemeyer Helen, Nöske Fatima, Salzer Simone, Sauer Karoline Sophie, Schuster Patrick, Steinert Christiane, Weidner Kerstin, von Wietersheim Jörn, Hoyer Jürgen, Dams Judith
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Psychotherapy and Psychosomatics, Justus Liebig University Giessen, Giessen, Germany.
Eur Psychiatry. 2025 Jan 22;68(1):e24. doi: 10.1192/j.eurpsy.2025.6.
Childhood maltreatment (CM) significantly increases the risk of developing post-traumatic stress disorder (PTSD) for which the prevalence in Europe is higher than initially assumed. While the high economic burden of PTSD is well-documented, little is known about the health care cost differences between individuals with PTSD-CM and those without PTSD in Germany. This study aimed to determine the excess health care and absenteeism costs associated with PTSD-CM in Germany.
Baseline data from a multi-center randomized controlled trial on individuals with PTSD-CM (n = 361) were combined with data from individuals without PTSD (n = 4760). Entropy balancing was used to balance the data sets with regard to sociodemographic characteristics. Six-month excess health care costs from a societal perspective were calculated for 2022, using two-part models with logit specification for the first part and a generalized linear model for the second part.
The total six-month excess costs associated with PTSD-CM were €8864 (95% CI: €6855 to €10,873) per person. Of this, the excess health care costs accounted for €4647 (95% CI €3296 to €5997) and the excess costs of absenteeism for €4217 (95% CI: €3121 to €5314). Individuals with mild to moderate PTSD symptoms incurred total excess costs of €6038 (95% CI: €3879 to €8197), while those with severe to extreme symptoms faced €11,433 (95% CI: €8220 to €14,646).
Excess health care and absenteeism costs associated with PTSD-CM were substantial, with absenteeism accounting for roughly half of the total excess costs.
童年期虐待(CM)会显著增加患创伤后应激障碍(PTSD)的风险,而欧洲PTSD的患病率高于最初的估计。虽然PTSD高昂的经济负担已有充分记录,但在德国,患有PTSD-CM的个体与未患PTSD的个体之间的医疗保健成本差异却鲜为人知。本研究旨在确定德国与PTSD-CM相关的额外医疗保健和旷工成本。
将一项关于PTSD-CM个体(n = 361)的多中心随机对照试验的基线数据与未患PTSD个体(n = 4760)的数据相结合。采用熵平衡法在社会人口学特征方面平衡数据集。从社会角度计算了2022年六个月的额外医疗保健成本,使用两部分模型,第一部分采用logit规范,第二部分采用广义线性模型。
与PTSD-CM相关的六个月总额外成本为每人8864欧元(95%置信区间:6855欧元至10873欧元)。其中,额外医疗保健成本为4647欧元(95%置信区间3296欧元至5997欧元),旷工额外成本为4217欧元(95%置信区间:3121欧元至5314欧元)。有轻度至中度PTSD症状的个体总额外成本为6038欧元(95%置信区间:3879欧元至8197欧元),而有重度至极重度症状的个体则面临11433欧元(95%置信区间:8220欧元至14646欧元)。
与PTSD-CM相关的额外医疗保健和旷工成本很高,旷工成本约占总额外成本的一半。