To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
According toepidemiologic studies, depression is one of the most frequentmental disorders in Germany. Based on the secondary data of three statutoryhealth insurers and the German Pension Fund, the utilization of mental healthcare services of people with depression was analyzed.
The analysesdescribe the utilization of in- and outpatient mental health care services ofpeople with depression by different disciplines and utilization patterns overtime (pathways of care).
The main aim was to analyze mental healthcareutilization of people with depression in Germany in 2005–2007 in order toidentify areas of potential optimization of mental health care.
Secondary data of three statutory health insurancecompanies and of the German Pension Funds of the years 2005-2007 were used forthese analyses. The analyses are based on 1,435,133 persons with at least onediagnosis of a depression (F32/F33) in 2005-2007.
The majority (73 %) of depression diagnoses wereclassified as ‘‘unspecified’’. For both inpatients and outpatients, aconsiderable proportion of care for mental illnesses was provided by primarycare physicians/other specialists in somatic medicine. Analyses of the pathwaysof care of people with severe depression revealed low levels of collaborationbetween primary and specialized care as well as outpatient and inpatienttreatment.
Setting aside boundaries between different disciplines and sectors, theuse of secondary data can, despite its limitations, contributes to thedetection of under- and overdiagnosis, mistaken allocation, and intersectoralinterface problems.
Anxiety disorders are among the most common mental disorders in Germany. Different sectors and disciplines participate in mental healthcare of these patients, but there is a lack of empirical evidence of the treatment outcomes in different settings.
The study focuses on analyzing the care pathways of patients with anxiety disorders and the effects of such pathways on critical events like sick leave, early retirement and mortality.
The analysis aims at developing recommendations for optimizing treatment with a view to minimize the rate of occurrence of critical events during the care pathway.
Secondary data of three statutory health insurance companies and of the German Pension Funds of the years 2005–2007. The analyses are based on 744,742 persons with at least one diagnosis of an anxiety disorder.
The analyses reveal a low rate of changes between primary and specialized care. There was a high number of care pathways (n = 2.608).The most common type was care by primary care physicians/somatic specialists only (60.5% of patients), followed by a treatment by a psychiatrist only (9.5%). Patients, who were only treated by general practitioners/somatic specialists, had significantly lower rates of sick leave and early retirement. This may indicate that cases with more favourable prognoses are found with this care pathway.
Analyses of care pathways using secondary data can contribute to identify potential for optimizing mental health care services and provide information about intersectoral interface problems, which should be considered in the quality management of mental healthcare.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Email your librarian or administrator to recommend adding this to your organisation's collection.