title: Epidemiology and inpatient treatment of vascular diseases in Germany: English Version.
abstract: BACKGROUND
  Non-cardiac vascular diseases account for approximately 10 % of the total burden of disease in the German population as measured in disability-adjusted life years (DALY). Thus, from the social perspective, much attention should be paid to optimization of the provision of vascular services especially in elderly people.
  
  
  OBJECTIVE
  This article describes the structure of inpatient care and the provision of vascular treatment as well as age- and gender-specific hospital incidence rates of vascular diseases in Germany between 2005 and 2013.
  
  
  METHODS
  Secondary data analysis is based on basic data from German hospitals as well as nationwide aggregated data from the diagnosis-related groups' statistics from the Federal Statistical Office.
  
  
  RESULTS
  Since 2005, the incidence of non-cardiac vascular diseases has increased and showed a significant dependency on sex and age. In general, men were affected consistently more frequently by vascular diseases. In contrast, hospital admission rates due to varicose veins or acute ischemia of the legs were higher in women. Treatment of arterial diseases was performed predominantly in general surgery units or departments for vascular surgery. From 1991 to 2013, the number of hospitals employing specialists for vascular surgery almost doubled, and the number of vascular surgeons working full-time in German hospitals was nearly tripled. Endovascular approaches were used particularly for revascularization of peripheral arteries as well as aortic aneurysm repair. In contrast, carotid surgery as well as peripheral embolectomy were predominately performed using open surgical techniques.
  
  
  CONCLUSIONS
  Since 1991, the increasing need for vascular services for patients has been met by continuously growing structures for the provision of vascular surgical treatment; however, the suitability and efficiency of provision of vascular services could only be assessed in an appropriate way by using more differentiated and disaggregated data.
  Additional information is available in the online version of this article (doi:10.1007/s00772-015-0095-5).
authors.affiliation: Klinik und Poliklinik für Vaskuläre und Endovaskuläre Chirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675 Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kühnl
authors.affiliation: Klinik und Poliklinik für Vaskuläre und Endovaskuläre Chirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675 Munich, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Söllner
authors.affiliation: Klinik und Poliklinik für Vaskuläre und Endovaskuläre Chirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675 Munich, Germany.
authors.forename: H-H
authors.initials: HH
authors.lastname: Eckstein
keywords: Administrative incidence; Provision of vascular services; Vascular epidemiology; Vascular medicine; Vascular surgery