title: [Management of patients with the cardinal symptom dizziness or vertigo].
abstract: BACKGROUND
  Vertigo and dizziness are common symptoms leading patients to consult a physician. The nationally representative "2003 Health Survey" depicts the epidemiology of the symptoms vertigo and dizziness across all of Germany. A breakdown of the data by region is not available.
  
  
  METHODS
  Routine data of the Bavarian Association of Statutory Health Insurance Physicians accounting centre ("Kassenärztliche Vereinigung Bayerns", KVB) from 2008 were analysed using multilevel models to investigate individual and regional factors and the relevance of nonspecific regional heterogeneity.
  
  
  RESULTS
  Altogether, 866,086 of 9,269,729 (9.34%) inhabitants received an ambulatory diagnosis of vertigo or dizziness, including 1.77 times as many women as men. Visits to the doctor because of vertigo or dizziness increased with age. After adjustments for age and sex, a North-South divide and a higher prevalence in the urban centres were apparent within Bavaria. The majority of patients were seen by their GP and nearby doctors. This held especially true for women. Also older patients were less likely to go to specialists further afield.
  
  
  CONCLUSIONS
  This analysis of the KVB data of patients with vertigo or dizziness underlines the central role that is played by GPs in diagnosis and treatment. In order to correctly diagnose the underlying causes, treat patients or send them to specialists effectively, all doctors need to be trained about this relevant clinical symptom. The insufficient representation of clinically established vertigo disorders by the ICD-10 was problematic. The most frequently coded diagnosis was N95.1 "postmenopausal dizziness".
authors.affiliation: Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Medizinische Fakultät der Ludwig-Maximilians-Universität München.
authors.forename: A
authors.initials: A
authors.lastname: Rieger
authors.affiliation: Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Medizinische Fakultät der Ludwig-Maximilians-Universität München.
authors.forename: U
authors.initials: U
authors.lastname: Mansmann
authors.affiliation: Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), Neuherberg.
authors.forename: W
authors.initials: W
authors.lastname: Maier
authors.affiliation: Kassenärztliche Vereinigung Bayerns.
authors.forename: L
authors.initials: L
authors.lastname: Seitz
authors.affiliation: Deutsches Schwindelzentrum - Integriertes Forschungs- und Behandlungszentrum für Schwindel, Gleichgewichts- und Augenbewegungsstörungen (IFB LMU).
authors.forename: T
authors.initials: T
authors.lastname: Brandt
authors.affiliation: Deutsches Schwindelzentrum - Integriertes Forschungs- und Behandlungszentrum für Schwindel, Gleichgewichts- und Augenbewegungsstörungen (IFB LMU).
authors.forename: M
authors.initials: M
authors.lastname: Strupp
authors.affiliation: Deutsches Schwindelzentrum - Integriertes Forschungs- und Behandlungszentrum für Schwindel, Gleichgewichts- und Augenbewegungsstörungen (IFB LMU).
authors.forename: O
authors.initials: O
authors.lastname: Bayer
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015897:Comorbidity; D004244:Dizziness / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D062211:Spatio-Temporal Analysis; D063189:Symptom Assessment / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data*; D014717:Vertigo / Q000175:diagnosis* / Q000473:pathology*; D055815:Young Adult