title: Healthcare utilization of people with type 2 diabetes in Germany: an analysis based on health insurance data.
abstract: OBJECTIVE
  This population-based study assesses the healthcare utilization of people with Type 2 diabetes by analysing routine data from Allgemeine Orts-Krankenkasse (AOK), the largest statutory health insurance provider in Germany.
  
  
  METHODS
  Anonymized billing data from all AOK-insured persons with at least one day of insurance during the evaluation year 2010 were analysed. Treatment and cost data from all areas of inpatient and outpatient care were available, as was information regarding patient age and sex. International Classification of Diseases (ICD-10) diagnosis and Anatomical Therapeutic Chemical (ATC) classification were used to identify 2.7 million insured persons with diabetes.
  
  
  RESULTS
  The age- and sex-standardized prevalence of Type 2 diabetes was 9.8%. Of those patients identified, 33.9% had at least one diabetes-related complication and 83.0% had a diagnosis of hypertension. Almost two-thirds (63.1%) received antihyperglycaemic medication. Metformin and sulfonylurea were prescribed most often; medications without proof of benefit in endpoint studies were prescribed much less frequently. People without diabetes were admitted to hospital only half as often as those with Type 2 diabetes. The projected total expenditure in Germany for all people with Type 2 diabetes amounted to approximately €33.3 billion in 2010.
  
  
  CONCLUSIONS
  This study shows an increase in both the prevalence of diabetes and treatment costs. The majority of people with Type 2 diabetes were aged 70 years or older. One third of this group has diabetes-related complications. Antihyperglycaemic medications without proof of benefit in endpoint studies were prescribed much less frequently than drugs with proof of benefit.
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Jena, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Müller
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Jena, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Heller
authors.affiliation: Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany.
authors.forename: M H
authors.initials: MH
authors.lastname: Freitag
authors.affiliation: Wissenschaftliches Institut der AOK (WIdO), Berlin, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Gerste
authors.affiliation: Wissenschaftliches Institut der AOK (WIdO), Berlin, Germany.|Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA), Berlin, Germany.
authors.forename: C M
authors.initials: CM
authors.lastname: Haupt
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Jena, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Wolf
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Jena, Germany.
authors.forename: U A
authors.initials: UA
authors.lastname: Müller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D000068240:Data Anonymization; D016208:Databases, Factual; D048909:Diabetes Complications / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs; D006801:Humans; D006973:Hypertension / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D015994:Incidence; D016247:Information Storage and Retrieval; D007348:Insurance, Health; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012189:Retrospective Studies