Patient-relevant endpoints in inflammatory bowel diseases--have changes occurred in Germany over the past twelve years?
OBJECTIVE
Inflammatory bowel diseases (IBDs) are gaining increasing medical as well as economic significance. Improving medical treatment options can have a positive effect on number of hospitalized patients, necessary operations and the inability to work.


METHODS
To understand patient-relevant endpoints in IBDs, the data for 2000-12 published by the Federal Statistical Office and the data for 2012 according to Article 21 of the Hospital Reimbursement Act in Germany were assessed. In addition, data records held by a public health insurance company on the medication of IBD patients were evaluated.


RESULTS
During 2000-12, the number of hospitalized IBD patients (ICD 10 K50, K51) rose from 38533 to 43452 (+12.7%). The necessity of surgical intervention increased during the period under review. The number of people unable to work increased differently for Crohn's disease (CD) and ulcerative colitis (UC), by 2.1 and 9.5%, respectively. Entry of persons into the statutory pension insurance system did not decline from 2000 to 2012. The number of potential years of life lost (PYLL) in patients with IBD also remained constant during the period under review (2017 in 2000-02 versus 2011 in 2010-012). From 2009 to 2013 the percentage of patients treated with an anti-TNF-antibodies rose (2009, 4.3% for CD and 1.4% for UC; 2013, 8.4% for CD and 3.2% for UC).


CONCLUSIONS
An improvement in patient-relevant endpoints was not observed between 2000 and 2012 in IBD patients in Germany. Improvements can only be achieved through structured and interdisciplinary treatment concepts involving all healthcare providers.
Klinik für Innere Medizin IV, Universitätsklinikum Jena, Jena, Germany andreas.stallmach@med.uni-jena.de.
Andreas
A
Stallmach
Geschäftsbereich Medizincontrolling, Universitätsklinikum Jena, Jena, Germany.
Ulf
U
Dennler
BARMER GEK Hauptverwaltung1100 - Kompetenzzentrum Medizin und Versorgungsforschung, Berlin, Germany.
Ursula
U
Marschall
Klinik für Innere Medizin IV, Universitätsklinikum Jena, Jena, Germany.
Carsten
C
Schmidt
D000293:Adolescent; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D003424:Crohn Disease / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000639:trends; D023381:Endpoint Determination; D005260:Female; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008017:Life Expectancy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D012179:Retirement / Q000639:trends*; D018582:Sick Leave / Q000639:trends; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014938:Work Capacity Evaluation; D055815:Young Adult
D014409:Tumor Necrosis Factor-alpha
Inflammatory bowel disease; antibodies; immunosuppression; morbidity; mortality; outcome