Impact of outpatient palliative care on healthcare costs in Germany - an analysis of cancer and non-cancer patients based on health insurance data.

Background: Palliative care (PC) aims at improving the quality of life of patients suffering from life-threatening and life-limiting illnesses. International studies have found that PC is not only helpful for controlling symptoms and reducing hospital stays at the end of life, but also associated with reduced healthcare costs. However, evidence on the economic implications of outpatient PC in Germany is scarce.

Decreasing COPD-related incidences and hospital admissions in a German health insurance population.

Chronic obstructive pulmonary disease (COPD) is associated with smoking and work-related health hazards. Most studies have reported prevalences, and the number of studies examining incidences and social inequalities is small. We analyzed the development of social inequalities of COPD-incidences in terms of income and exacerbations in terms of hospital admissions.

[Prevalence of metabolic syndrome : Analysis based on routine statutory health insurance data].

Background: The metabolic syndrome is a decisive risk factor for the manifestation of cardiovascular and metabolic diseases. Metabolic syndrome is the term used to describe the joint presence of specific diseases (obesity, hypertension, type 2 diabetes mellitus, disorders of fat metabolism). A classification is made more difficult by inconsistent definition criteria and a missing International Statistical Classification of Diseases and Related Health Problems (ICD) code.

[Informal care and occupation: Factors influencing the willingness to provide care].

Introduction: The proportion of people in need of care will continue to rise in Germany. In 2019, the majority of people in need of care was cared for at home. Reconciling caregiving and work poses a heavy burden for many caregivers.

Compression and Expansion of Morbidity—Secular Trends Among Cohorts of the Same Age.

Background: Morbidity is said to be compressed when the interval from the onset of a disease or disability to death becomes shorter over time, or when the incidence of the disease or disability declines over time. In the reverse situation, morbidity is said to be expanded.

Methods: This review is based on national and international studies retrieved by a selective literature search on secular trends in morbidity and mortality.

Willingness to provide informal care to older adults in Germany: a discrete choice experiment.

As the German population is continually aging and the majority of older adults still wish to 'age in place', the need for informal care provided by family and friends will correspondingly continue to increase. In addition, while the need for formal (professional) care services is also likely to increase, the supply already does not meet the demand in Germany today. The aim of our study is the elicitation of people's willingness to provide informal care by means of a discrete choice experiment.

The State of Care for Persons With a Diagnosis of Depression.

Background: Depression is one of the most common mental illnesses. There are well-known deficiencies in the care of patients with depression, particularly at the interfaces between health service areas or sectors. The aim of this study was to analyze the characteristics and state of care of persons with a diagnosis of depression.

[Completely Different or Quite Similar? The Sociodemographic Structure of the AOK Lower Saxony in Comparison to the General and Working Population in Lower Saxony and the Federal Republic of Germany].

Ziel Der Studie: Routinedaten von Krankenkassen sind als Datenquelle mittlerweile gut etabliert. Hinsichtlich der Verallgemeinerbarkeit der Ergebnisse bei Analysen mit Daten einer Krankenkasse treten Fragen der Repräsentativität der Versichertenpopulation auf, insbesondere da nicht alle Studien auf soziodemografische Merkmale adjustieren. Diese Arbeit untersucht mittels deskriptiver Analyse, ob und inwieweit sich die Sozialstruktur der Versichertenpopulation der AOK Niedersachsen von der Sozialstruktur der Allgemeinbevölkerung und der sozialversicherungspflichtig Beschäftigten in Niedersachsen (NDS) und in der Bundesrepublik (BRD) unterscheiden.

[Healthcare expenditure and the impact of age: a detailed analysis for survivors and decedents].

Background: Germany faces various socio-political challenges due to its ongoing ageing population. Significant increases in social security contributions are widely expected. The impact of ageing on healthcare expenditure is a controversial issue.

Effectiveness of Trainings of General Practitioners on Antibiotic Stewardship: Methods of a Pragmatic Quasi-Experimental Study in a Controlled Before-After Design in South-East-Lower Saxony, Germany (WASA).

Antibiotic resistance is a serious threat to global public health. It reduces the effectiveness of treatments for serious bacterial infections and thus increases the risk of fatal outcomes. Antibiotic prescriptions are often not in line with clinical evidence-based guidelines.

Willingness and preparedness to provide care: interviews with individuals of different ages and with different caregiving experiences.

Background: At present, the provision of informal care to older relatives is an essential pillar of the long-term care system in Germany. However, the impact of demographic and social changes on informal caregiving remains unclear.

Methods: Thirty-three semi-structured interviews were conducted with care consultants, informal caregivers and people without any caregiving experience to explore if people are willing to provide older adult care and how prepared these are with regard to the possibility of becoming care dependent themselves.

[Frequency of diagnosed non-alcololic fatty liver disease (NAFLD) in the German population - An analysis based on health insurance data].

Background:  Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases in Germany. In the long term, there is an increased risk of developing liver cirrhosis and subsequent diseases. Epidemiologic studies on NAFLD prevalence in Germany are scarce.

Quality indicators for the evaluation of end-of-life care in Germany - a retrospective cross-sectional analysis of statutory health insurance data.

Background: The provision and quality of end-of-life care (EoLC) in Germany is inconsistent. Therefore, an evaluation of current EoLC based on quality indicators is needed. This study aims to evaluate EoLC in Germany on the basis of quality indicators pertaining to curative overtreatment, palliative undertreatment and delayed palliative care (PC).

["But you often come unstuck on particularities" - Care consultants on legislation amendments and the challenges of their job: A qualitative investigation].

Introduction: Since the implementation of long-term care insurance in 1995, various reforms have contributed to the development of the German nursing care system in order to meet the structural and financial needs of the growing number of people in need of care. The aim of this paper is to present an assessment of care consultants on past legislation, challenges encountered during their work and suggestions to improve the current care system.

Methods: 14 semi-structured, face-to-face interviews were conducted with care consultants.

The Frequency and Timing of Recurrent Stroke: An Analysis of Routine Health Insurance Data.

Background: Stroke is among the leading causes of death in Germany and one of the main reasons for handicap and disability. The risk factors for stroke include hypertension, metabolic disorders, and diabetes. An estimated 250 000 persons sustain a stroke in Germany each year.

Claims Data Analysis on the Dispensing of Tricyclic Antidepressants Among Patients With Dementia in Germany.

A restrictive use of tricyclic antidepressants (TCA) in patients with dementia (PwD) is recommended due to the hazard of anticholinergic side effects. We evaluated the frequency of TCA dispensing in PwD over a period of 1 year and the use of TCA before and after the incident diagnosis of dementia. This analysis was based on administrative data from a German statutory health insurance for a period of 2 years.

Health inequalities in terms of myocardial infarction and all-cause mortality: a study with German claims data covering 2006 to 2015.

Objectives: International comparisons are suggesting that mortality inequalities may have changed in the last years, although not always into the same direction. Only a few studies examined myocardial infarction (MI). In our study, long-term developments of MI and all-cause mortality were considered by analysing social gradients by income.

Informal and formal care preferences and expected willingness of providing elderly care in Germany: protocol for a mixed-methods study.

Introduction: In Germany, the number of elderly people in need of care is expected to increase from 2.4 million in 2015 to 3.2 million in 2030.

Morbidity compression in myocardial infarction 2006 to 2015 in terms of changing rates and age at occurrence: A longitudinal study using claims data from Germany.

Background: According to James Fries morbidity compression is present if morbidity rates are decreasing to a larger extent than mortality rates. Compression also occurs if age at onset is increasing at a faster pace than age at death. These two variants of the compression hypothesis were formulated as a population concept.

Widening inequalities in multimorbidity? Time trends among the working population between 2005 and 2015 based on German health insurance data.

Background: Previous research has produced evidence for social inequalities in multimorbidity, but little is known on how these disparities change over time. Our study investigates the development of social inequalities in multimorbidity among the middle-aged and older working population. Special attention is paid to whether differing time trends between socio-economic status (SES) groups have taken place, increasing or decreasing inequalities in multimorbidity.

Continuity of treatment with benzodiazepines in dementia patients: an analysis of German health insurance claims data.

Long-term treatment with benzodiazepines (BZD) should be avoided in dementia patients because of an increased risk of adverse events. We evaluated how continuously dementia patients were prescribed BZD over 12 months. For this observational study, we used claims data from a large German public sickness fund for 2014 and 2015, including patients with an incident diagnosis of dementia in 2014.

[The Frequency of Depression Diagnoses in Different Groups of Insured Persons - A Routine Data Analysis of the Years 2006 to 2015].

Depressive disorders are one of the most common type of mental disorders and are associated with a significant loss of social functioning and decrease in quality of life. While survey data from the Robert Koch-Institute show no increase in the prevalence of depression during recent years, data from social insurance agencies demonstrate an increasing social significance. Many people argue that changes in working conditions are a major reason for increasing depression diagnoses.

[Healthcare expenditures and the role of demografic change : An analysis of statutory health insurance data].

The development of healthcare expenditures and the impact of demographic change are the subject of a controversial debate. Yearly healthcare expenditures have more than doubled between 1992 and 2015 and are often justified by the aging demographic. The majority of expenses are paid by the statutory health insurance (SHI).

[Mental disorders of working age : Evaluation of the administrative incidence and prevalence as well as regional differences in Lower Saxony on the basis of secondary data from a statutory health insurance provider].

Background: Mental disorder is the subject of ever-increasing attention in the field of public health. However, the actual number of such cases is difficult to determine owing to the lack of comprehensive longitudinal studies.

Objectives: The administrative incidence and prevalence of mental disorders were estimated on the basis of data from 2010 to 2013 provided by the health insurance company AOK, Lower Saxony, and were assessed according to age and gender.