Fehlkodierungen von HIV/AIDS-Diagnosen und deren Bedeutung für den morbiditätsorientierten Risikostrukturausgleich

Author(s)
J. Tomeczkowski, J. Mahlich, M. Stoll
Abstract

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(s)
Department of Economics
External organisation(s)
Janssen-Cilag GmbH, Medizinische Hochschule Hannover (MHH)
Journal
Gesundheitsokonomie und Qualitatsmanagement
Volume
20
Pages
132-139
No. of pages
8
ISSN
1432-2625
DOI
https://doi.org/10.1055/s-0034-1385779
Publication date
06-2015
Peer reviewed
Yes
Austrian Fields of Science 2012
303010 Health economics
Keywords
ASJC Scopus subject areas
Health Policy
Sustainable Development Goals
SDG 3 - Good Health and Well-being
Portal url
https://ucrisportal.univie.ac.at/en/publications/aec5239f-f491-4a4c-a55f-3f7b076b9535