title: Evaluating frequency, diagnostic quality, and cost of Lyme borreliosis testing in Germany: a retrospective model analysis.
abstract: BACKGROUND
  Data on the economic impact of Lyme borreliosis (LB) on European health care systems is scarce. This project focused on the epidemiology and costs for laboratory testing in LB patients in Germany.
  
  
  METHODS
  We performed a sentinel analysis of epidemiological and medicoeconomic data for 2007 and 2008. Data was provided by a German statutory health insurance (DAK) company covering approx. 6.04 million members. In addition, the quality of diagnostic testing for LB in Germany was studied.
  
  
  RESULTS
  In 2007 and 2008, the incident diagnosis LB was coded on average for 15,742 out of 6.04 million insured members (0.26%). 20,986 EIAs and 12,558 immunoblots were ordered annually for these patients. For all insured members in the outpatient sector, a total of 174,820 EIAs and 52,280 immunoblots were reimbursed annually to health care providers (cost: 2,600,850€). For Germany, the overall expected cost is estimated at 51,215,105€. However, proficiency testing data questioned test quality and standardization of diagnostic assays used.
  
  
  CONCLUSIONS
  Findings from this study suggest ongoing issues related to care for LB and may help to improve future LB disease management.
authors.affiliation: Bacteriologic Infection Serology Study Group of Germany (BISSGG), Central Laboratory, Institute for Laboratory Medicine, Northwest Medical Centre, Academic Teaching Hospital, Medical Faculty, Johann Wolfgang Goethe-University, Steinbacher Hohl 2-26, 60488 Frankfurt am Main, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Müller
authors.forename: M H
authors.initials: MH
authors.lastname: Freitag
authors.forename: G
authors.initials: G
authors.lastname: Poggensee
authors.forename: E
authors.initials: E
authors.lastname: Scharnetzky
authors.forename: E
authors.initials: E
authors.lastname: Straube
authors.forename: Ch
authors.initials: Ch
authors.lastname: Schoerner
authors.forename: H
authors.initials: H
authors.lastname: Hlobil
authors.forename: H-J
authors.initials: HJ
authors.lastname: Hagedorn
authors.forename: G
authors.initials: G
authors.lastname: Stanek
authors.forename: A
authors.initials: A
authors.lastname: Schubert-Unkmeir
authors.forename: D E
authors.initials: DE
authors.lastname: Norris
authors.forename: J
authors.initials: J
authors.lastname: Gensichen
authors.forename: K-P
authors.initials: KP
authors.lastname: Hunfeld
mesh_terms: D001898:Borrelia / Q000276:immunology; D019411:Clinical Laboratory Techniques / Q000191:economics / Q000592:standards; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D007348:Insurance, Health / Q000191:economics; D008193:Lyme Disease / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology; D015233:Models, Statistical; D010045:Outpatients; D015995:Prevalence; D011933:Reagent Kits, Diagnostic / Q000592:standards; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D011933:Reagent Kits, Diagnostic