[Use of health insurance data to analyse pain management practices in the nursing-home setting].
Pain is the most common health-related complaint in older persons. International estimations mention up to 80% of nursing home residents suffering from pain. In the meantime, no reliable epidemiological data on pain in nursing home residents are available for Germany, because of restricted access to the nursing-home population. This pilot study aimed to evaluate whether routine data from a German statutory health insurance fund can be used to generate data on pain prevalence and analgesic therapy in nursing home residents. To this end, data of all insured persons of Deutsche BKK who received long-term care insurance benefits for nursing-home care between April and June 2007 were selected anonymously. These data were combined with data on diagnoses and analgesic prescriptions. 3 pain-related diagnoses were selected: R 52 (pain, not elsewhere classified), M 16 (coxarthrosis) and G 53.0 (postherpetic neuralgia) and analysed for corresponding prescriptions. The study sample shows similar characteristics regarding age distribution and care needs in terms of long-term care insurance benefits compared to the official data on nursing-home residents for Germany in 2007. The rate of dementia was within the expected range, too. Therefore, external validity of the sample is assumed. One of the 3 selected diagnoses had been documented in 15% of the sample. About 58% of those received an analgesic prescription. Deficits were discovered regarding the documentation of postherpetic neuralgia, the combination of different analgesics and prescriptions for adjuvant drugs. Prevalence rate and numbers of prescriptions were as frequent as expected. The routine method for this analysis proved to be practicable and reliable. Data quality is deemed sufficient so that the main study will proceed to include a longer period of time and additional data.
Kopke
K
K
Charité-Universitätsmedizin Berlin, Institut für Medizinische Soziologie, Luisenstraße 13, Berlin. kirsten.kopke@charite.de
Fischer
Th
T
Kölzsch
M
M
Hofmann
W
W
Kuhlmey
A
A
Kreutz
R
R
Dräger
D
D
D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy* / Q000453:epidemiology; D015897:Comorbidity; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D007353:Insurance, Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D009313:National Health Programs / Q000706:statistics & numerical data*; D051474:Neuralgia, Postherpetic / Q000188:drug therapy / Q000453:epidemiology; D009735:Nursing Homes / Q000706:statistics & numerical data*; D015207:Osteoarthritis, Hip / Q000188:drug therapy / Q000453:epidemiology; D059408:Pain Management / Q000706:statistics & numerical data*; D014600:Utilization Review / Q000706:statistics & numerical data
D000700:Analgesics