Paul Wiesheu, Anne-Lisa Heye, Judith Tillmann, Nessia Rachma Dianti, Klaus Völkel, Klaus Weckbecker, Eva Münster
{"title":"[Impact of Non-Pharmacological Measures during COVID-19 Pandemic in Adolescents - A Cross-sectional Study of 649 10th Grade Pupils in the City of Witten, Germany (GeWIT-Study)].","authors":"Paul Wiesheu, Anne-Lisa Heye, Judith Tillmann, Nessia Rachma Dianti, Klaus Völkel, Klaus Weckbecker, Eva Münster","doi":"10.1055/a-2335-2251","DOIUrl":"https://doi.org/10.1055/a-2335-2251","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to examine the impact of the COVID-19 pandemic and non-pharmacological interventions, with a particular focus on the subjective experiences of pupils in relation to the measures, the extent to which quarantine and illness with COVID-19 influenced their perception of the disease, the protective measures taken and the groups that were particularly affected.</p><p><strong>Methods: </strong>From November 2021 to February 2022, a written survey of tenth grade pupils from all nine secondary municipal schools in the city of Witten, Germany was conducted. Descriptive statistics were used to analyze and evaluate the data.</p><p><strong>Results: </strong>98.3% of the pupils present in class (n=649) were included in the survey. Of the study population, 12.9% stated that they had already had COVID-19 and 43.6% had been quarantined. 27.3% of the pupils reported that mask-wearing was not easy for them, while 65.2% found wearing a mask easy. Furthermore, 33.4% reported that distance learning had negatively impacted their well-being, and 6.9% of the pupils reported that they had experienced more violence during the pandemic. Fear of COVID-19 was reported by 10% of the pupils, and was less frequently reported if pupils had already been infected with COVID-19 or had been quarantined. 75.7% reported no fear of COVID-19.</p><p><strong>Discussion: </strong>The COVID-19 pandemic and the non-pharmacological measures to address it presented significant challenges and were a substantial burden on the pupils. The present study shows that the pandemic and/or the measures had a negative impact on the pupils. It is imperative to critically examine the measures, particularly in relation to vulnerable groups such as gender-diverse or socio-economically disadvantaged pupils. Education that is needs-based and target group-oriented can facilitate increased acceptance and perceptions of safety of implemented measures among pupils.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Antibiotic Prescription Rates For Respiratory Tract Infections Treated In The Outpatient Sector Based On Routine Data From A German Health Insurance Company].","authors":"Birgit Arens, Helmut L'Hoest, Alissa Wolf, Beata Hennig, Ursula Marschall, Irit Nachtigall","doi":"10.1055/a-2321-8275","DOIUrl":"10.1055/a-2321-8275","url":null,"abstract":"<p><strong>Background: </strong>Acute uncomplicated upper respiratory tract infections (RTIs) are common reasons for antibiotic prescriptions in the outpatient sector, although>90% are of viral origins and mostly self-limiting. Germany has a low antibiotic prescription rate compared to other European countries, but there are regional differences. Disease-specific quality indicators (QI) developed by the European Surveillance of Antimicrobial Consumption Network (ESAC-Net) address the prescription rates (target <20%) and choice of antibiotic (target>80%) in a general practitioner population. The aim of this analysis was to operationalise the ESAC-Net-QI using secondary data from a health insurance company at the level of diseases and healthcare facilities, as well as to analyse areas for improvement.</p><p><strong>Method: </strong>The underlying database comprises the panel physician billing, hospital and prescription data in accordance with German law (§§ 295, 300 and 301 SGB V) of the Barmer health insurance company for the year 2022. Categorical features are presented as frequency and percentage. Maximum specificity was aimed, hence potentially risky disease courses were excluded.</p><p><strong>Results: </strong>The overall RTI prescription rate of antibiotics was 25% in 2022 before applying inclusion and exclusion criteria (1,197,568/4,720,786). After applying the algorithm, the prescription rate for all RTI cases dropped to 6% (80,786/1,365,646). When specific RTI indications are considered, 35% (13,465/38,913) of acute bronchitis and acute sinusitis cases (4,971/14,051) received an antibiotic prescription each. At the facility level, 38% of practices (1,396/3,705) treating acute bronchitis and 41% of practices (539/1,300) treating acute sinusitis achieved the target of<20% antibiotic prescriptions. Only 29% of all RTI cases with antibiotic prescriptions (23,733/80,786) received a first-choice antibiotic.</p><p><strong>Conclusion: </strong>Our analysis indicates that the ESAC-Net-QI for RTIs can be calculated at case and facility levels using routine health insurance data. For specific RTIs, there were indications of improvement potential in the frequency and selection of prescribed antibiotics.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluating the Usefulness of Population-Wide COVID-19 Testing in the Omicron Era: Insights from a German Model.","authors":"Afschin Gandjour","doi":"10.1055/a-2328-4165","DOIUrl":"https://doi.org/10.1055/a-2328-4165","url":null,"abstract":"<p><strong>Background: </strong>The Omicron variant of SARS-CoV-2, which has become dominant worldwide since late 2021, presents a unique challenge due to its high rate of asymptomatic transmission. This study evaluates the efficacy and value of population-wide testing, including self-testing, in the context of COVID-19, particularly under the Omicron variant, using data from Germany.</p><p><strong>Methods: </strong>A decision-analytical model and secondary data was used for assessing the impact of systematic screening and testing for COVID-19. Various scenarios were taken into consideration including seasonal patterns of COVID-19 transmission and the potential for annual waves. The model assessed the clinical benefits of testing against the backdrop of vaccine effectiveness, transmission rates, and the potential to prevent severe clinical events, including death, ICU admission, and long COVID syndrome.</p><p><strong>Results: </strong>The study found that the value of mass testing and self-testing for private use was highly contingent on the transmission rate and the scenario of COVID-19 waves (seasonal vs. continuous). For winter waves, a very high incidence rate was required to justify testing, while for continuous waves, testing could be valuable for those in contact with individuals in their last decade of life. The analysis highlighted the limitations of mass testing when community transmission rates were low and the potential value of testing in high-risk contacts or amidst new outbreaks.</p><p><strong>Discussion: </strong>The findings suggest that the resumption of testing during winter waves is unlikely to provide significant clinical benefits given the current understanding of Omicron's transmission and immunity waning. This study underscores the need for a nuanced approach to COVID-19 testing policies, considering both the epidemiological context and the practical implications of testing strategies.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lars Gabrys, Andrea Schaller, Stefan Peters, Anne Barzel, Susanne Berrisch-Rahmel, Karsten E Dreinhöfer, Katharina Eckert, Wiebke Göhner, Wolfgang Geidl, Sonja Krupp, Martin Lange, Roland Nebel, Klaus Pfeifer, Andrea Reusch, Matthias Schmidt-Ohlemann, Semrau Jana, Philipp Sewerin, Karen Steindorf, Andreas Ströhle, Gorden Sudeck, Hagen Wäsche, Sebastian Wolf, Bettina Wollesen, Christian Thiel
{"title":"[DNVF Memorandum: Objectives and Methods of Physical Activity-Related Health Services Research].","authors":"Lars Gabrys, Andrea Schaller, Stefan Peters, Anne Barzel, Susanne Berrisch-Rahmel, Karsten E Dreinhöfer, Katharina Eckert, Wiebke Göhner, Wolfgang Geidl, Sonja Krupp, Martin Lange, Roland Nebel, Klaus Pfeifer, Andrea Reusch, Matthias Schmidt-Ohlemann, Semrau Jana, Philipp Sewerin, Karen Steindorf, Andreas Ströhle, Gorden Sudeck, Hagen Wäsche, Sebastian Wolf, Bettina Wollesen, Christian Thiel","doi":"10.1055/a-2340-1669","DOIUrl":"10.1055/a-2340-1669","url":null,"abstract":"<p><p>The DNVF Memorandum: Objectives and Methods of Physical Activity-Related Health Services Research summarizes, for the first time, the highly interdisciplinary and interprofessional field of physical activity-based health care in the German healthcare system. In addition to providing a conceptual framework and definition of key measures and concepts in physical activity-related health care research, existing research gaps and needs are identified, and methods for advancing this relatively young field of research are described. A particular focus of this study is the relevant outcome parameters and their standardized assessment using established and valid measurement tools. The memorandum aims to establish a general understanding of the complex subject of promoting physical activity and sports therapy in the context of healthcare, to give an impulse to new research initiatives, and to integrate the currently available strong evidence on the effectiveness of physical activity and exercise into healthcare.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sophie Gigou, Laura Corazza, Sandra Fett, Martin Tauscher, Roman Gerlach, Ewan Donnachie, Antonius Schneider
{"title":"[Physician Numbers and Employment in Bavaria: Trends in statistics of the Bavarian Medical Association and the Association of Statutory Health Insurance Physicians of Bavaria].","authors":"Sophie Gigou, Laura Corazza, Sandra Fett, Martin Tauscher, Roman Gerlach, Ewan Donnachie, Antonius Schneider","doi":"10.1055/a-2328-4088","DOIUrl":"https://doi.org/10.1055/a-2328-4088","url":null,"abstract":"<p><strong>Background: </strong>Although the number of places at medical schools and physicians in Germany has increased continuously over the past 25 years, there is a threat of a shortage of physicians. Based on data from the Bavarian Medical Association (BLÄK) and the Association of Statutory Health Insurance Physicians of Bavaria (KVB), an analysis of the number of physicians in Bavaria over a longer period of time was carried out in order to understand current developments and possible starting points for the future organization of medical care. The figures were analyzed with regard to the distribution of physicians by outpatient and inpatient sector as well as with regard to the development of the number of employees, the scope of employment and the gender distribution in the outpatient sector.</p><p><strong>Methods: </strong>Data were taken from the annually published and systematically compiled numbers of physicians from the BLÄK (2000 to 2022) as well as the outpatient billing data of practicing and employed physicians in Bavaria (2010 to 2022), processed by the KVB. Descriptive analyses were performed.</p><p><strong>Results: </strong>Since 2000, the number of physicians in Bavaria has risen by 83% in the inpatient setting and by 35% in the outpatient setting. As a result, more physicians have been working in hospitals than in outpatient care since 2010. In the outpatient setting the trend is moving away from establishing one's own practice and full-time work towards salaried and part-time employment. Employed physicians have lower average working hours than self-employed physicians. The proportion of women among physicians has steadily increased, with female physicians more likely to be employed and working part-time compared with male physicians. Nevertheless, part-time employment is also prominent among male physicians in some specialties today.</p><p><strong>Conclusion: </strong>The trend towards practicing in salaried and part-time positions continues unabated and is represented across all specialties, suggesting that more physicians are needed to maintain the number of working hours over time. In addition to incentives and subsidies, this reality must be taken into account when planning care. At the same time, it is questionable whether increasing medical school places without managing them according to need is the right way to address the shortage of physicians in outpatient care when an ever-increasing proportion of physicians is working in inpatient care.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141628075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GesundheitswesenPub Date : 2024-07-01Epub Date: 2023-10-20DOI: 10.1055/a-2098-3039
Peter Ihle, Udo Schneider, Verena Vogt
{"title":"[Five Key Questions for Health Services Research: are SHI Claims Data Suitable for Your Research Project?]","authors":"Peter Ihle, Udo Schneider, Verena Vogt","doi":"10.1055/a-2098-3039","DOIUrl":"10.1055/a-2098-3039","url":null,"abstract":"<p><p>Health services research examines the structures and processes of health care under everyday conditions. Routine data of the statutory health insurance (SHI) - the so-called routine practice data - represent real health care and are therefore an important data source for health services research. This paper presents 5 key questions that researchers and data-holding institutions can use to assess the suitability of this data source for answering their health services research question. The aim of these guiding questions is to generate a common understanding between researchers and data-holding institutions of the research project, the research objective, and the feasibility of implementation in health services research. The five guiding questions cover the formulation of the research question, the planned method, the target population, the relevant study periods, and the required information from SHI data. These methodologically oriented guiding questions are supplemented by the question of how the results of the research project could improve care. Thus, for researchers, the five guiding questions provide an initial structuring for data requests; for data-holding institutions, they provide a framework for considering possible involvement in or support of a research idea in health services research.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GesundheitswesenPub Date : 2024-07-01Epub Date: 2024-07-29DOI: 10.1055/a-2312-4993
Ingo Meyer
{"title":"AGENS Methodenworkshop und Career Day 2023 – face2face in Köln.","authors":"Ingo Meyer","doi":"10.1055/a-2312-4993","DOIUrl":"10.1055/a-2312-4993","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GesundheitswesenPub Date : 2024-07-01Epub Date: 2023-05-30DOI: 10.1055/a-2061-6954
Lukas Reitzle, Ingrid Köster, Oktay Tuncer, Christian Schmidt, Ingo Meyer
{"title":"[Development and Internal Validation of Case Definitions for Prevalence Estimation of Microvascular Complications of Diabetes in Routine Data].","authors":"Lukas Reitzle, Ingrid Köster, Oktay Tuncer, Christian Schmidt, Ingo Meyer","doi":"10.1055/a-2061-6954","DOIUrl":"10.1055/a-2061-6954","url":null,"abstract":"<p><strong>Background: </strong>Surveillance of diabetes requires up-to-date information on the prevalence of diabetes and its complications over time. For this purpose, statutory health insurance (SHI) data is being increasingly used, as the data is available in a timely fashion and case numbers enable detailed estimates also of diabetes complications. The aim of the present study was the development and internal validation of case definitions for the prevalence estimation of diabetic retinopathy (DRP), diabetic polyneuropathy (DPN) and diabetic foot syndrome (DFS).</p><p><strong>Methods: </strong>Persons with diabetes differentiated by type 1, type 2, and other diabetes in an age- and sex-stratified sample of persons insured by Barmer SHI in 2018 (n=72,744) comprised the study popuation. Based on the central ICD codes for microvascular complications (DRP: H36.0; DPN: G63.2; DFS: E1X.74/.75), case definitions were developed including additional ICD codes for complications without direct diabetes reference. Subsequently, the case definitions were internally validated. For the validation, coding in the inpatient setting (m1S) or repeatedly in the outpatient setting (m2Q) as well as coding of specific procedures (EBM, OPS) and drug prescriptions or by relevant specialists were considered. Additionally, we analysed the documentation of the diagnoses in the previous years.</p><p><strong>Results: </strong>In 2018, the prevalence of the central ICD codes was 8.4% for DRP (H36.0), 18.9% for DPN (G63.2) and 13.4% for DFS (E1X.74/.75). After inclusion of additional ICD codes in the case definition, prevalence increased significantly for DRP (9.6%) and DPN (20.7%), and barely for DFS (13.5%). Internal validation confirmed the majority of diagnoses (DRP: 96.7%; DPN: 96.5% DFS: 95.8%) and m2Q represented the most relevant criterion. When up to four previous years were considered, prevalences were up to 30% higher for DPN and DFS and up to 64% higher for DRP.</p><p><strong>Conclusion: </strong>The inclusion of additional ICD codes in the case definition of microvascular complications of diabetes appears meaningful, as this increases the sensitivity of the prevalence estimate. Internal validation suggests that the documented diagnoses are plausible. However, not all diagnoses are documented annually, leading to an underestimation of the prevalence using a cross-sectional study design of one year.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9548514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GesundheitswesenPub Date : 2024-07-01Epub Date: 2024-07-16DOI: 10.1055/a-2308-7319
Judith Gartmann, Christoph Egen, Christian Sturm, Andrea Bökel
{"title":"[Personal and Environmental Contextual Factors in Socio-Medical Orthopedic Evaluation Reports].","authors":"Judith Gartmann, Christoph Egen, Christian Sturm, Andrea Bökel","doi":"10.1055/a-2308-7319","DOIUrl":"https://doi.org/10.1055/a-2308-7319","url":null,"abstract":"<p><strong>Introduction: </strong>The personal and environmental contextual factors of the ICF describe not only physical and mental health but also (occupational) participation. So far, the extent to which these contextual factors are taken into account in the socio-medical evaluation has not been clarified. Contextual factors can guide allocation to disability pension or rehabilitative interventions in an individualized and targeted manner. The aim of this study was to determine the frequency of ICF contextual factors in socio-medical evaluation.</p><p><strong>Methodology: </strong>A frequency analysis of contextual factors in socio-medical reports for musculoskeletal disorders was performed. Contextual factors mentioned several times were coded once in the report. In the frequency ranking, each environmental and personal factor was categorized as \"frequent,\" \"moderate,\" and \"rare.\"</p><p><strong>Results: </strong>215 socio-medical reports with musculoskeletal diagnoses starting from 2017 were retrospectively analyzed. All socio medical reports were analyzed for the occurence of personal contextual and environmental factors. In particular, personal factors were identified, which provide information about general personal characteristics or the general state of health. Almost half of the environmental factors were rarely identified.</p><p><strong>Conclusion: </strong>Many ICF contextual factors are constantly recorded in the analyzed reports. The important influence of these factors on return to work is well known. Thus, the absence or low presence of the ICF contextual factors from the chapters Attitudes (i4), Basic Skills (i4) and Support & Relationships (e3), which are also contextual to the assessed person's experience of the world of work, was surprising. The relevance of the frequently and rarely identified contextual factors for the socio-medical evaluation of musculoskeletal disability pension applicants must be questioned.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141628027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GesundheitswesenPub Date : 2024-07-01Epub Date: 2023-12-22DOI: 10.1055/a-2173-8160
Felix Wicke, Eva Lorenz, Roman Michael Pokora
{"title":"[Schätzung der Wirksamkeit der Grippeimpfung anhand von Sekundärdaten: Eine Kohortenstudie und Propensity-Score-Matching-Analyse von Leistungsdaten aus Baden-Württemberg].","authors":"Felix Wicke, Eva Lorenz, Roman Michael Pokora","doi":"10.1055/a-2173-8160","DOIUrl":"10.1055/a-2173-8160","url":null,"abstract":"<p><p>Ziel war es die Wirksamkeit der Influenza-Impfung (VE) für die Grippesaison 2014/2015 auf Grundlage von Routinedaten aus Krankenkassendatensatz zu schätzen und zu replizieren. Zusätzlich sollten methodische Aspekte untersucht werden. Es wurden Abrechnungsdaten von 2,64 Millionen Versicherten der AOK Baden-Württemberg mit dortigem Wohnsitz ab 15 Jahren analysiert. Basierend auf Abrechnungsdaten für die Influenza-Impfung 2014, wurden die Teilnehmer als ungeimpft oder geimpft klassifiziert. Kovariablen, die den Zusammenhang zwischen Impfung und Influenzainfektion beeinträchtigen könnten, wurden berücksichtigt. Hierzu gehörten Alter, Geschlecht, Wohnort sowie Kovariablen, die auf den Gesundheitszustand und die Inanspruchnahme von Gesundheitsdienstleistungen hinweisen. Der primäre Endpunkt war ein Krankenhausaufenthalt wegen Influenza während der Grippesaison 2015. Zu den sekundären Endpunkten gehörten unter anderem Krankenhausaufenthalte wegen Lungenentzündung und die Gesamtmortalität. Um eine vergleichbare Gruppe von geimpften und ungeimpften Teilnehmern zu ermitteln, wurde ein Propensity-Score-Matching (PSM) durchgeführt. Es wurde eine Bias-Analyse durchgeführt, bei der die VE vor und nach der Grippesaison geschätzt wurde, also zu Zeitpunkten, in denen angenommen wurde, dass die Influenza nicht in der Bevölkerung zirkulierte und die Impfung nicht wirken konnte. Insgesamt konnten 839.706 Teilnehmer 1:1 gematcht werden. Die geschätzte VE (basierend auf Influenza bedingten Krankenhausaufenthalten) betrug 27% [95%Konfidenzintervall (KI): 17%; 36%], was der Schätzung des RKI für dieselbe Saison (27% [95%KI: -1%; 47%]) entspricht. Die Bias-Analyse zeigte, dass das Ergebnis teilweise durch residuale Konfundierung erklärt werden kann, was zu einer potenziellen Überschätzung des zugrunde liegenden Effekts führt. Die Ergebnisse der sekundären Endpunkte zeigten ähnliche Ergebnisse, obwohl sie wahrscheinlich in höherem Maße durch residuale Konfundierung bedingt sind. Zusammenfassend zeigt sich, dass (1) sekundäre Daten der deutschen Krankenkassen verwendet werden können, um plausible VE-Schätzungen abzuleiten, und dass (2) das PSM eine nützliche und transparente Methode zur Ableitung dieser Schätzungen ist. Darüber hinaus ist (3) residuale Konfundierung ein relevantes Problem in Beobachtungsstudien zu VE und (4) Bias-Analysen vor- und nach der Grippesaison sind eine wesentliche Ergänzung für die Interpretation der Ergebnisse.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138886254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}