Fehlkodierungen von HIV/AIDS-Diagnosen und deren Bedeutung für den morbiditätsorientierten Risikostrukturausgleich
- Autor(en)
- J. Tomeczkowski, J. Mahlich, M. Stoll
- Abstrakt
Background: The objective of this study is to determine the number and costs of patients with HIV-diagnoses and their dependence on age and gender by evaluating German statutory health insurance data. Methods: We analyzed various databases of several million customers of various statutory sickness funds operating independently nationwide and extrapolated the results to the overall population. Results: The number of HIV-positive patients varied considerably between the particular statutory sickness funds analyzed. The prevalence of HIV diagnoses in the year 2008 was significantly higher than reported by the governmental Robert Koch-Institute. After elimination of a coding error in the administration software of German ophthalmologists the number of HIV-diagnosis decreased from 2008 to 2010. In the year 2011 no further decline was notable. At that time 60.7% of documented HIV-positive patients had prescriptions for antiretroviral medications. 38.7% patients without prescriptions for ARM had a diagnosis by the B23.8 ICD-code only. Unexpectedly for Germany women had a higher proportion of B23.8 diagnoses than men (56.2% with B23.8 versus 38.4% all other HIV-codes). Conclusions: False coded HIV-diagnosis presumably triggered financing the statutory sickness funds in Germany. Even after the decline of false coded diagnoses, our results show a high prevalence of HIV diagnoses. The disproportional high numbers of ICD-10 B23.8 for women in the year 2011 are notes for remaining false coded B23.8 diagnoses in the statutory health care system.
- Organisation(en)
- Institut für Volkswirtschaftslehre
- Externe Organisation(en)
- Janssen-Cilag GmbH, Medizinische Hochschule Hannover (MHH)
- Journal
- Gesundheitsokonomie und Qualitatsmanagement
- Band
- 20
- Seiten
- 132-139
- Anzahl der Seiten
- 8
- ISSN
- 1432-2625
- DOI
- https://doi.org/10.1055/s-0034-1385779
- Publikationsdatum
- 06-2015
- Peer-reviewed
- Ja
- ÖFOS 2012
- 303010 Gesundheitsökonomie
- Schlagwörter
- ASJC Scopus Sachgebiete
- Health policy
- Sustainable Development Goals
- SDG 3 – Gesundheit und Wohlergehen
- Link zum Portal
- https://ucrisportal.univie.ac.at/de/publications/aec5239f-f491-4a4c-a55f-3f7b076b9535