title: Processes of psoriasis health care in Germany--long-term analysis of data from the statutory health insurances.
abstract: BACKGROUND
  To evaluate health care provision for psoriasis patients, and to better allocate resources, precise knowledge of the health care situation is essential. The goal of this study is to analyze prescription behavior and resource utilization for psoriasis patients in Germany.
  
  
  METHODS
  We performed a secondary analysis of routinely collected psoriasis data from 2004-2007 from members of a nationwide statutory health insurance company (Gmünder Ersatzkasse). A descriptive analysis was done on physician care, hospitalizations, and medications and related costs.
  
  
  RESULTS
  34,728 of the 913,145 continuously insured patients were diagnosed with psoriasis (one-year prevalence: 2.3-2.5%). At the time of the initial diagnosis, 68% of patients were treated by a dermatologist and 28% by a general practitioner (GP). Over the next 21 months, the proportion of patients seen by a dermatologist decreased to 22% and the proportion seen by a GP increased to around 70%. 15.2% of patients were absent at least once from work. 79.5% received prescriptions with an average cost of € 135 per patient per year. 97.5% of patients received topical therapy; 11% got systemic therapies. Biologics were given to about 0.1% of patients. Significant differences in prescription behavior were seen between regions and physician groups.
  
  
  CONCLUSIONS
  Psoriasis is an important economic and medical issue. The majority of insured patients take prescription therapies. Dermatologists are most often the first health care provider.
authors.affiliation: CVderm - Competence Center for Health Care Research in Dermatology, University Hospital of Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany. m.augustin@uke.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
authors.forename: Gerd
authors.initials: G
authors.lastname: Glaeske
authors.forename: Ines
authors.initials: I
authors.lastname: Schäfer
authors.forename: Stephan Jeff
authors.initials: SJ
authors.lastname: Rustenbach
authors.forename: Ariane
authors.initials: A
authors.lastname: Hoer
authors.forename: Marc Alexander
authors.initials: MA
authors.lastname: Radtke
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000191:economics* / Q000706:statistics & numerical data; D003879:Dermatologic Agents / Q000191:economics* / Q000627:therapeutic use*; D003880:Dermatology; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D015276:Health Care Rationing / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D055656:Prescriptions; D015995:Prevalence; D017064:Process Assessment, Health Care; D011565:Psoriasis / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents