XXXX -related treatment and costs in Germany: Do they change with comorbidity? A claims data analysis.

@entity1 @entity308 @entity571 @entity146 @entity914 @entity7383 @entity1314 @entity731 @entity285 @entity309
BACKGROUND: Existing diverse bottom-up estimations of direct costs associated with @entity308 in Germany motivated a detailed @entity1 -level analysis of @entity308 -related treatment (DRT), -costs (DRC) and Comorbidity. METHODS: A large sickness fund's claims data was used to retrospectively identify @entity1 aged 18-65 years with new-onset @entity308 treatment between January 1st and February 15th 2010, and follow them until December 31st 2010, describe DRT, estimate associated DRC, and predict DRC with a generalised linear model. RESULTS: A total of 18,139 @entity1 were analysed. Mean direct DRC were    783. Predictors of DRC regarding @entity146 comorbidities were: "Delusion, @entity914 and @entity1314 " (DRC-ratio 1.72), " @entity285 /drug addiction" (1.82), "abuse of @entity285 /drugs" (1.57). Predictors of DRC regarding medical comorbidities were: " @entity309 " (0.77), " @entity731 " (0.65), "pregnancy" (0.66), and " @entity571 " (1.87). Of all @entity1 , 60.8% received their most intense/specialised DRT from a general practitioner, a medical specialist (23.7%), a psychotherapist (8.0%), a medical specialist and psychotherapist (2.9%), or in hospital (4.6%). Serious @entity146 comorbidity nearly tripled @entity308 -related hospitalisation rates. LIMITATIONS: @entity7383 and missing @entity146 outpatient clinic data must be considered. CONCLUSIONS: Estimated DRC are significantly below the assessment of the German national guideline. Differing definitions of observation period and cost attribution might explain differing German DRC results. Signs of @entity146 bias indicate overestimation of hospital DRC. Identified associations of DRC with certain medical diseases in older adults warrant further research. Up to one quarter of @entity1 with severe @entity308 diagnosis might lack specialist treatment.
