[Sustainable Infrastructure for Health Services Research: Development of a Regional SHI Routine Database]

Low vision aids provision in an urban setting in Germany between 2014 and 2017: a regional population based study with healthcare claims data

PURPOSE

Little is known about the utilization of low vision services (LVS) in Germany. To understand which persons and how often these services would be utilized, this study aimed to investigate low vision aids (LVAs) provision in an urban setting and to describe user characteristics and trends in their characteristics.

METHODS

A retrospective study based on a population-based healthcare claims database in Cologne (N = ~ 500,000), Germany. The study population comprised individuals, who were continuously insured at four large statutory health insurers and who redeemed a prescription for visual aids or aids for blindness between January 2014 and December 2017. We examined their socio-demographic and clinical characteristics. Trends in characteristics were examined with logistic and linear regression models over time.

RESULTS

Out of ~ 500,000 persons, 781 unique individuals (~ 0.2%) redeemed an LVA prescription. They were mainly female (68.7%), 60 years or older (75.3%) and had macular degeneration (50.6%) and/or glaucoma (25.9%). In the working-age subgroup, 33.8% were employed. Visual aids were most often prescribed (74.1%) and of all types of LVAs, individuals most commonly redeemed a prescription for magnifiers (35.8%), screen readers (34.3%) and/or canes (17.1%). Of the entire study population, 75.4% received their prescription from an ophthalmologist, 5.3% from a general practitioner and 7.1% from other medical specialists. Significant trends in characteristics of individuals who redeemed an LVA prescription were not found.

CONCLUSIONS

Between 2014 and 2017, 781 individuals in Cologne redeemed an LVA prescription. They had characteristics which mostly can be explained by the epidemiology of VI. Results indicate that individuals that redeemed LVAs have a magnification requirement of ≥ 1.5-fold and ≥ 6-fold. Furthermore, next to ophthalmologists, general practitioners and other medical specialists seem to play a role in LVA provision as well, which should be taken into account by policy makers when planning interventions for increasing LVS provision. Our findings provide a starting point to examine LVS provision in Germany.

[Diagnostic Prevalence of Dental Findings in Children, Adolescents and Young Adults with Mental Disorders Compared to Healthy People - an Analysis and Estimation Based on Claims Data from 2019]

AIM

To analyse oral health-related diagnostic prevalences in children, adolescents (KiJu), young adults with mental/behavioural disorders (PEVS) and those of the general population in Germany based on claims data.

METHOD

Anonymously provided ZI (Zentralinstitut)-data sets of GKV-insured persons (0-44 years) were i. e. stratified according to gender, age groups, ICD-K00-K14 diagnosis.

RESULT

No reliable oral or dental health-related information was generated from the requested data set. Regardless of the F diagnosis, according to the data set, 1.8% of all 11,854,384 KiJu-GKV-insured persons and 0.2% of 18-44-year-olds (23,348,399 GKV-insured persons) had a diagnosis related to the dental hard tissue (ICD-10 K02/K03.2). Based on available literature on the prevalence of caries in KiJu with PEVS, a mean unweighted prevalence of 51% can be assumed. According to the available literature on the prevalence of caries in KiJu with PEVS a mean unweighted prevalence of 51% can be calculated. Following this and the diagnosis prevalence of PEVS in 0- to 17-year-olds from 2017, an estimated 957.952 children with PEVS should also have a caries.

CONCLUSION

The nationwide data on the prevalence of oral health-related diagnoses made by physicians in the general population and in people of the same age with PEVS are very low. Apparently, dental diagnoses are only given very rarely by general practitioners and paediatricians, among others. The existing literature as well as the clinical experience of the authors indicate that this claim data is not suitable to realistically represent the dental and oral health of the examined group of people. Thus, for networking, the improvement of health care research and the care, e. g. of subgroups of the society, is an interprofessional dental/medical, data protection-compliant central database to be driven forward.

[The use of data for public health and healthcare-a shared goal of the EU member states]

Die Gesundheit der Bevölkerung – im Sinne von Prävention und Versorgung – braucht gute Daten. Daten unterstützen die Entscheidungsfindung auf der Systemebene ebenso wie konkrete Maßnahmen auf der Individualebene. Daten sind außerdem Voraussetzung für Forschung und die Entwicklung von Innovation. Gleichzeitig sind Daten Mangelware: Sie liegen nur in Ausschnitten oder für ganze Systemteile überhaupt nicht vor, sie decken Sachverhalte nur approximativ ab oder sind in Formaten gebunden, die eine automatisierte (bzw. skalierbare) Verarbeitung erschweren bis unmöglich machen. Zudem sind gerade Gesundheitsdaten höchst sensibel und entsprechend geschützt, was ihre Verwertung noch herausfordernder macht.

Mit diesen Herausforderungen steht Deutschland nicht allein da, sie finden sich in ähnlicher Form in allen anderen Mitgliedsstaaten der Europäischen Union (EU). Das Potenzial einer gemeinsamen Problemdefinition sowie der gemeinsamen Entwicklung von Lösungen wird in Deutschland bisher aber nur wenig genutzt. Der Artikel gibt einen Einblick in verschiedene EU-Initiativen rund um das Thema Gesundheitsdaten. Im Vordergrund steht dabei die Frage, wie deutsche Akteur:innen Zugang zu diesen Initiativen bekommen können, um so einerseits vom Wissen und den Erfahrungen in den Nachbarländern zu profitieren, aber auch um eigenes Wissen in diesen Kreis zurückgeben zu können.