Epidemiology and cost of hospital care for Lyme borreliosis in Germany: Lessons from a health care utilization database analysis

被引:42
作者
Lohr, B. [1 ]
Muller, I. [1 ]
Mai, M. [1 ]
Norris, D. E. [2 ]
Schoeffski, O. [3 ]
Hunfeld, K. -P. [1 ]
机构
[1] Goethe Univ Frankfurt, Acad Teaching Hosp, Inst Lab Med Microbiol & Infect Control, Fac Med, D-60488 Frankfurt, Germany
[2] Johns Hopkins Univ, Johns Hopkins Malaria Res Inst, Bloomberg Sch Publ Hlth, Dept Mol Microbiol & Immunol, Baltimore, MD 21205 USA
[3] Univ Erlangen Nurnberg, Chair Hlth Management, D-90403 Nurnberg, Germany
关键词
Lyme borreliosis; Hospital care; Costs; Epidemiology; Germany; Health care utilization database; SECONDARY DATA-ANALYSIS; SURVEILLANCE DATA; EUROPEAN-UNION; OF-ILLNESS; DISEASE; STATES; NEUROBORRELIOSIS; CHALLENGES; DIAGNOSIS; FEATURES;
D O I
10.1016/j.ttbdis.2014.09.004
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
To date, relatively little is known about the economic and medical impact of Lyme borreliosis (LB) on European health care systems, especially for the inpatient sector. This retrospective analysis is based on data provided for the years 2007-2011 by a German statutory health insurance company (DAK-Gesundheit) covering approximately 6 million insured. Total cost was calculated for a 1-year period both from the third-party payers and from the societal perspective, respectively. In our cohort the incident diagnosis of LB was coded for 2163 inpatient cases during the years 2008-2011. The median inpatient time was 9 days resulting in a median direct medical cost per hospital stay of 3917(sic) for adolescents and 2843 for adults. Based on extrapolation of our findings to the German population, we would expect an average hospital admission of 5200 adults and 2300 adolescents (<18 years) for LB treatment incurring direct medical costs of more than 23 million Euro annually. The annual indirect costs due to loss of productivity would add up to more than 7 million Euro as assessed by the human capital method. Cases tended to accumulate between June and September with remarkable changes in disease manifestations in the course of the year documented in the coded secondary diagnoses. Also specific differences in the disease pattern of adolescents and adults became obvious. Age-specific incidence showed male predominance and a bimodal distribution. Incidence was highest in children aged between 3 and 17 (highest mean incidence of 29 cases/100,000 inhabitants in 6-9 year olds) with a second peak in 60-79 year old individuals. During the study period the nationwide inpatient incidence was 9/100,000 with marked regional variability. In summary, our study is one of the first European investigations on hospital care for LB inpatients and identifies LB as a possibly underestimated socioeconomic factor for health care in Germany. (C) 2014 Elsevier GmbH. All rights reserved.
引用
收藏
页码:56 / 62
页数:7
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