In disease-related cost accounts, the data sources available in the health sector are combined to determine the costs caused by a specific disease. They provide information on the extent to which the German national economy is burdened by specific diseases and their consequences. Disease-related cost accounts do not involve separate surveys in the sense of primary statistics. In disease-related cost accounts, the consumption of resources in the health sector that is directly connected with some medical treatment, prevention, rehabilitation or long-term care measure is determined and allocated to the relevant diseases. The delimitation of diseases and diagnoses in disease-related cost accounts is based on the International Statistical Classification of Diseases and Related Health Problems (ICD). What is shown in addition to disease-related costs is the potential loss of resources caused in a national economy in the form of years of employment lost and years of life lost by incapacity for work, disability and premature death.
How are disease-related costs calculated?
The calculations are based on a top-down method where, in several stages, the national health expenditure data that are available from the health expenditure accounts in a breakdown by institution (e.g. medical practices, hospitals, prevention or rehabilitation facilities) are allocated to ICD chapters, groups or categories of diseases by means of suitable codes. The codes are determined not only by national surveys, covering the entire range of services of an institution, or major parts of it, but also by regional surveys. A specific problem in the context of codes is how to deal with multi-morbidities. These are multiple diseases occurring mainly among older patients. For each of those diseases, the relevant costs must be quantified and correctly allocated through the codes used. In disease-related cost accounts, there are certain limits to exactly representing multi-morbidities because the diagnosis data required for the calculation of codes are available in different forms in the underlying data sources. Therefore, when allocating costs to diagnoses, the following approach was chosen: Where data on main diagnoses were available, costs were allocated to specific diseases on the basis of the main diagnoses. Where several diagnoses were recorded on the same level in the data sources, the cost data available were allocated to them with equal weights.
When are disease-related cost accounts released?
Disease-related cost accounts are published at two-year intervals and are based on the current results of health expenditure accounts. The results of disease-related cost accounts are available via the website of the Federal Statistical Office and the information system of Health Monitoring of the Federation (GBE) at www.gbe-bund.de . On specific occasions, results of disease-related cost accounts are published through press releases.
How accurate are disease-related cost accounts?
Due to different accounting and remuneration procedures as well as legal provisions, the density and quality of diagnoses in the data sources available are subject to some variation. In addition, many cost data are available only with relation to cases or persons, which makes it more difficult to clearly combine service data with diagnosis data. By using specific allocation algorithms and calculation methods, however, the inaccuracies occurring in the basic data can largely be eliminated, so that the results of disease-related cost accounts meet the user requirements regarding up-to-date and informative data. Also, the accuracy of disease-related cost accounts is further improved by continuously integrating new data sources with detailed breakdowns.
