Einfluss des sozioökonomischen Status auf Gesundheitskosten für Kinder und Jugendliche mit Störungen des Sozialverhaltens

König, Udo; Heinzel‐Gutenbrunner, Monika; Meinlschmidt, Gerhard; Maier, Werner; Bachmann, Christian

doi:10.1007/s00103-019-02991-1

Cited by 3 publications

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References 41 publications

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“…Die Verteilung der Krankheitskosten stellt eine Mischung aus diskreter und stetiger Verteilung dar und sie ist dementsprechend rechtsschief. Diese Form der Mischverteilung wird als Tweedie-oder Poisson-Gamma-Verteilung bezeichnet [20,21]. Als Modell wurde dementsprechend ein generalisiertes lineares Modell mit der Log-Verknüpfungsfunktion für Tweedie-verteilte abhängige Variablen gerechnet mit den direkten Krankheitskosten als abhängige Variable, psychische Belastungen (HADS) als unabhängige Variable und den Kontrollvariablen Geschlecht, Beziehungsstatus, Alter, Bildung und Beschäftigungsstatus.…”

Section: Statistische Analysenunclassified

Psychische Belastung und ihre Folgen für die Krankheitskosten – eine Längsschnittstudie in Deutschland

2022

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Zusammenfassung Ziel der Studie Die Studie verfolgt das Ziel, die Effekte der psychischen Belastung auf die Höhe und die Zusammensetzung der Krankheitskosten (ambulante Kosten, Krankenhauskosten, Rehabilitationskosten, Arzneimittelkosten) im Zeitverlauf zu überprüfen. Methodik Im Längsschnittdesign untersuchten wir die psychische Belastung von 3.287 Studienteilnehmern der erwachsenen Allgemeinbevölkerung anhand der Hospital Anxiety and Depression Scale (HADS) und ihren Effekt auf die Höhe und die Zusammensetzung der Krankheitskosten aufgrund von psychischen Erkrankungen im Jahr der Befragung t0 und den beiden Folgejahren [t1] {t2}. Ergebnisse Im Vergleich zur Referenzgruppe, die keine psychischen Belastungen aufweist, waren die Krankheitskosten in der Gruppe mit geringen psychischen Belastungen um den Faktor 2,0 [2,2] {1,5}, bei jenen mit moderater psychischer Belastung um den Faktor 3,7 [4,2] {3,1} und bei jenen mit schweren psychischen Belastungen um den Faktor 7,5 [9,0] {5,2} signifikant erhöht. Im Zeitverlauf zeigten sich signifikante Effekte auf die Krankheitskosten nur an den beiden äußeren Rändern der psychischen Belastungsgrade (keine und schwere psychische Belastungen) mit einer Tendenz zur Mitte. Mit zunehmendem Grad psychischer Belastung dominierten Krankenhauskosten die Gesamtkosten aufgrund psychischer Belastung und der Anteil der ambulanten Krankheitskosten an den Gesamtkosten nahm ab. Schlussfolgerung Mit dem Grad psychischer Belastung steigen die Krankheitskosten steil an. Die Progredienz psychischer Erkrankungen zu verhindern, ist deshalb nicht nur aus individueller, sondern auch aus gesundheitsökonomischer Perspektive bedeutsam.

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Section: Statistische Analysenunclassified

Psychische Belastung und ihre Folgen für die Krankheitskosten – eine Längsschnittstudie in Deutschland

2022

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“…The DIW and the cost data represent a mixture of a discrete distribution with positive probability mass at zero (many participants do not have any DIW) and a continuous distribution for data > 0 and represent a left-skewed distribution. This form of mixed distribution is known as the Tweedie or Poisson-gamma distribution [28,29]. Accordingly, a generalized linear model with a Tweedie distribution with log link function was calculated with mental distress (HADS) as an independent variable and the speci c and non-speci c DIW in the rst and second year after the HADS assessment as dependent variables.…”

Section: Statistical Analysesmentioning

confidence: 99%

Socio-Economic Consequences of Mental Distress: Quantifying the Impact of Self-Reported Mental Distress on the Days of Incapacity to Work and Medical Costs in the Following 2 years: A Longitudinal Study in Germany

Müller

Bombana

Heinzel-Gutenbrenner³

et al. 2020

Preprint

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Background: Mental disorders are related to high individual suffering and significant socio-economic burdens. However, it remains unclear to what extent self-reported mental distress is related to individuals’ days of incapacity to work and their medical costs. This study aims to investigate the impact of self-reported mental distress for specific and non-specific days of incapacity to work and specific and non-specific medical costs over a two-year span.Method: Within a longitudinal research design, 2,287 study participants' mental distress was assessed using the Hospital Anxiety and Depression Scale (HADS). Days of incapacity to work and medical costs were retrieved from a German health insurance’s routine data during the following two-year period.Results: Current mental distress was found to be significantly related to the number of specific days absent from work and medical costs. Compared to participants classified as no cases by the HADS (2.6 days), severe case participants showed 27.3-times as many specific days of incapacity to work in the first year (72 days) and 10.3-times as many days in the second year (44 days), and resulted in 11.4-times more medical costs in the first year (2272 EUR) and 6.2-times more in the second year (1319 EUR). The relationship of mental distress to non-specific days of incapacity to work and non-specific medical costs is also significant, but mainly driven from specific absent days and specific medical costs. Our results also indicate that the prevalence of presenteeism is considerably high: 42% of individuals continued to go to work despite severe mental distress. Conclusions: Our results show that self-reported mental distress, assessed by the HADS, is highly related to the days of incapacity to work and medical costs in the two-year period. Reducing mental distress by improving preventive structures for at-risk populations and increasing access to evidence-based treatments for individuals with mental disorders might, therefore, pay for itself and could help to reduce public costs.

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Socio-economic consequences of mental distress: quantifying the impact of self-reported mental distress on the days of incapacity to work and medical costs in a two-year period: a longitudinal study in Germany

Müller

Bombana

Heinzel-Gutenbrenner³

et al. 2021

BMC Public Health

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Background Mental disorders are related to high individual suffering and significant socio-economic burdens. However, it remains unclear to what extent self-reported mental distress is related to individuals’ days of incapacity to work and their medical costs. This study aims to investigate the impact of self-reported mental distress for specific and non-specific days of incapacity to work and specific and non-specific medical costs over a two-year span. Method Within a longitudinal research design, 2287 study participants’ mental distress was assessed using the Hospital Anxiety and Depression Scale (HADS). HADS scores were included as predictors in generalized linear models with a Tweedie distribution with log link function to predict participants’ days of incapacity to work and medical costs retrieved from their health insurance routine data during the following two-year period. Results Current mental distress was found to be significantly related to the number of specific days absent from work and medical costs. Compared to participants classified as no cases by the HADS (2.6 days), severe case participants showed 27.3-times as many specific days of incapacity to work in the first year (72 days) and 10.3-times as many days in the second year (44 days), and resulted in 11.4-times more medical costs in the first year (2272 EUR) and 6.2-times more in the second year (1319 EUR). The relationship of mental distress to non-specific days of incapacity to work and non-specific medical costs was also significant, but mainly driven from specific absent days and specific medical costs. Our results also indicate that the prevalence of presenteeism is considerably high: 42% of individuals continued to go to work despite severe mental distress. Conclusions Our results show that self-reported mental distress, assessed by the HADS, is highly related to the days of incapacity to work and medical costs in the two-year period. Reducing mental distress by improving preventive structures for at-risk populations and increasing access to evidence-based treatments for individuals with mental disorders might, therefore, pay for itself and could help to reduce public costs.

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Einfluss des sozioökonomischen Status auf Gesundheitskosten für Kinder und Jugendliche mit Störungen des Sozialverhaltens

Cited by 3 publications

References 41 publications

Psychische Belastung und ihre Folgen für die Krankheitskosten – eine Längsschnittstudie in Deutschland

Psychische Belastung und ihre Folgen für die Krankheitskosten – eine Längsschnittstudie in Deutschland

Socio-Economic Consequences of Mental Distress: Quantifying the Impact of Self-Reported Mental Distress on the Days of Incapacity to Work and Medical Costs in the Following 2 years: A Longitudinal Study in Germany

Socio-economic consequences of mental distress: quantifying the impact of self-reported mental distress on the days of incapacity to work and medical costs in a two-year period: a longitudinal study in Germany

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