[Regional analysis of drug treatment prevalence and medication of diabetes mellitus in Germany]. / Regionale Analyse der medikamentösen Behandlungsprävalenz und Arzneimitteltherapie von Diabetes mellitus in Deutschland.

BACKGROUND AND AIM: Diabetes mellitus is a widespread chronic disease. Diabetes prevalence was already analyzed in multiple complex studies. The goal of this analysis was the determination of the regional drug treatment prevalence and medication of diabetes mellitus in Germany. Simultaneously, we examined and validated the applicability of prescription data of the German statutory health insurance (SHI) as the basis for reliable and comparable prevalence estimations. PATIENTS AND METHODS: For the analysis, we used anonymized data from a prescription database as well as the member statistics of the German federal Ministry of Health. By using defined prescription profiles with anti-diabetic medication, we determined the diabetic patients and treatment schemes per Association of SHI Physicians. Subsequently, we calculated and described the drug treatment prevalence and medication. A differentiation between type 1 and type 2 diabetes was not possible. RESULTS: The total prevalence of drug-treated patients in Germany was 7.77%. The regional values ranged from 6.40% in Schleswig-Holstein until 11.37% in Saxony-Anhalt. The highest numbers of drug treatment prevalence were found in the East of Germany. Insulin treatment was frequent in Hamburg, but rare in Bavaria. Insulin combined with oral anti-diabetic medication was mainly dispensed in Saxony-Anhalt and Brandenburg, least in Hamburg. A treatment with one or more oral anti-diabetics was most common in Bavaria and Bremen, lowest in Rhineland-Palatinate and Mecklenburg-West Pomerania. CONCLUSION: We developed an easy to use evaluation algorithm for prescription data to estimate the drug treatment prevalence of a chronic disease. The estimated prevalence confirms the increasing trend reported from other studies and appears to be plausible in comparison. More research is required to validate and enhance the method.

Costing out nursing services based on acuity.

Since nursing is a personnel intensive, high-budget department, nursing managers have recognized the need to monitor costs and identify potential areas for change in order to decrease expenditures. An effective acuity system can be used to not only efficiently determine appropriate staffing, but also to estimate direct nursing costs under diagnosis related group (DRG) reimbursement. This article describes a method for using patient acuity to determine direct nursing care costs in a DRG.