Category II: Routine Data
Abbreviations used:
AU = Incapacity for work; EBM = Uniform value scale for billing statutory health insurance services, IRR = Incidence Rate Ratio; PEPP = fixed rate remuneration system in psychiatry and psychosomatics (PEPP); AMDP = Working Group for Methodology and Documentation in Psychiatry; Information on Coded Diagnoses (FXX.X) according to the International Statistical Classification of Diseases and Related Health Problems (ICD-10)
| ROUTINE DATA [46–69] | ||||
|---|---|---|---|---|
| Study or data basis and publications (including observation period etc.) | Results | |||
| Outcome | Outcome | |||
|
Data basis: Outpatient care data from the National Association of Statutory Health Insurance Physicians
Data from persons with statutory health insurance who use SHI-accredited medical care; first to second quarter 2020 data from 16 of the 17 SHI-accredited medical associations (excluding Bremen), third to fourth quarter 2020 from 15 (excluding Bremen and Mecklenburg-Western Pomerania). [68] Mangiapane S, Zhu L, Czihal T et al. (2020): 14 defined observation periods in 2020: t0: 01.01.–03.03.; t1: 04.03.–10.03.; t2: 11.03.–17.03.; t3: 18.03.–24.03.; t4: 25.03.–31.03.; t5: 01.04.–28.04.; t6: 29.04.–26.05.; t7: 27.05.–30.06.; t8: 01.07.–28.07.; t9: 29.07.–25.08.; t10: 26.08.–30.09.; t11: 01.10.–04.11.; t12: 05.11.–02.12.; t13: 03.12.–31.12. compared to the corresponding comparison periods in 2019 |
e | Utilisation of outpatient care by medical and psychological psychotherapists and specialists in psychosomatic medicine and psychotherapy | Number of treatment cases |
Decrease compared to the same period of the previous year in the periods t2 to t6 with the strongest decrease at t4 with 36.5% and 39.8%, one-time increase at t7 by 24.4% and 17.8%;at t8-t11 fluctuations around the level of the previous year, t12–t13 decrease by 14.9% and 12.4% compared to the same period of 2019;
Changes over time roughly comparable to other doctor groups with the exception of the comparatively strong increase at t7 [68] |
| e | Utilisation of outpatient psychotherapy | Number of treatment cases for psychotherapeutic services for individual therapy (section 35.2.1 EBM) and group therapy (section 35.2.2 EBM) | Individual therapy: decrease compared to previous year’s period from t2 to t6 with strongest decrease at t3 by 23.3%, then increase compared to previous year’s periods until t11 with strongest increase at t11 (3.8%), then decrease again in t13 by 3,0% [68]
Group therapies decrease compared to previous year’s periods from t2 to t8 with strongest decrease at t5 by 59.8%, in t9 to t11 roughly unchanged at previous year’s level, decrease again at t12 and t13 by up to 16.4% [68] |
|
| e | Utilisation of outpatient substitution treatment | Number of treatment cases for substitution treatment for drug dependence (section 1.8 EBM) | Decrease compared to previous year’s period from t3 to t8 with strongest decrease at t4 by 13.0%, from t9 to t13 fluctuating below previous year’s level with decrease between 1.1% and 3.2% [68] | |
|
Data basis: Outpatient care data from the Disease Analyzer-Database (IQVIA)
Data from people with use of medical practices that are part of the panel of the Disease Analyzer Database (IQVIA) [54] Jacob L, Smith L, Koyanagi A et al. (2020): 03–06/2020 vs. 03–06/2019 (n=1,140 GP practices, n=1,854,742 people with treatment cases in 01–06/2020). [55] Michalowsky B, Hoffmann W, Bohlken J et al. (2020): 02–05/2020 compared to 02–05/2019 (n=1,095 GP or internal medicine practices and n=960 specialist practices, of which n=155 neurological and psychiatric practices; n=2,447,356 persons aged ≥65 years with treatment cases) |
e | Outpatient diagnostic incidence and prevalence of anxiety disorders in GP practices | Number of persons with (first) diagnosis of F41.0–3 or F41.8–9 | Increase in diagnoses by 19% in 2020 compared to 2019, increase in first diagnoses by 21% [54] |
| e | Outpatient diagnostic incidence of anxiety disorders in GP practices by age | Number of persons with first diagnosis of F41.0–3 or F41.8–9 by age | Decrease in the proportion of 18–30 year olds to 16.8% in 2020 compared to 20.3% in 2019 [54] | |
| e | Comorbidity of outpatient incident diagnoses in general practitioners of anxiety disorders | Number of persons with first diagnosis of F41.0–3 or F41.8–9 and diagnosis of nine somatic disorders | Increase in people with comorbid COPD in 2020 to 9.4% compared to 7.9% in 2019 and with comorbid asthma to 11.3% in 2020 compared to 9.7% in 2019 [54] | |
| e | Utilisation of outpatient care by psychiatric/neurological practices among persons aged ≥65 years | Number of physician contacts in psychiatric/neurological practices | Increase of 13% in March, decrease of 18% in April and 12% in May compared to 2019; rather small decrease compared to 7 other doctor groups with a mean of 5% (rank 3) [55] | |
| e | Referral or admission to outpatient or inpatient care by psychiatric/neurological practices among persons aged ≥65 years | Number of referrals or admissions in outpatient or inpatient care by psychiatric/neurological practices | Decrease of 22% in referrals and 40% in admissions in March to May 2020 compared to 2019 [55] | |
| e | Outpatient diagnosis of depression for persons aged ≥65 years | Number of Persons with first diagnosis F32–33 | Decrease of 13% in 2020 compared to 2019 [55] | |
|
Data basis: Work incapacity data for KKH
Data of those compulsorily and voluntarily insured with the KKH (excluding the unemployed and pensioners), n=812,000 [57] [56] KKH Kaufmännische Krankenkasse (2020): 01–06/2020 compared to 01–06/2019 [58] KKH Kaufmännische Krankenkasse (2021): 2020 compared to 2019 [57] KKH Kaufmännische Krankenkasse (2021): 2020 compared to 2019 and 2019 compared to 2018 |
e | Incapacity to work cases | Number of cases with incapacity to work due to F-diagnosis | Increase of approx. 80% compared to 2019 [56] |
| e | Duration of incapacity to work by gender | Number of days per case of incapacity to work due to F-diagnosis | Increase for women by ‘just under 4 days’, for men by ‘almost five days’ in 2020 compared to 2019 [58] | |
| e | Duration of incapacity to work | Number of days per case of incapacity to work due to F-diagnosis | Increase of 4.2 days in 2020 compared to 2019, larger increase than from 2018 to 2019 of 3.9 days [57] | |
|
Data basis: Incapacity to work for BARMER
Data from working people aged 15–64 who are insured with BARMER [49] BARMER (2020): 01–06/2020 compared to 2019 |
e | Number of work days lost due to sickness | Proportion of days with incapacity to work due to F-diagnosis in all insured days | Decrease of 5.5% in the period April–June 2020 compared to April–June 2019 [49] |
|
Data basis: Incapacity to work data for BKK
Data from employees insured with participating BKKs [51] BBK (2021): 01/2020 –04/2021 |
e | Number of work days lost due to sickness | Proportion of days with incapacity to work due to F-diagnosis in all insured days | Decrease from March (0.83%) to May 2020 (0.70%), renewed increase as of November 2020 (0.78%) and February/March 2021 (0.80%) [51] |
|
Data basis: Incapacity to work data for DAK
Data from employed persons insured with the DAK [52] DAK Gesundheit (2021): 01–12/2020 compared to 01–12/2019 |
e | Incapacity to work cases | Number of cases of incapacity to work due to F-diagnosis per 100 insured persons | Decrease in 2020 compared to 2019 for women from 9.3 to 8.8 and for men from 5.7 to 5.1 [52] |
| e | Duration of incapacity to work | Number of days per case of incapacity to work due to F-diagnosis | Decrease in short case durations (1–7 days) by 20% in 2020 compared to 2019, increase in long case durations (>6 weeks) by 6% in 2020 compared to 2019 [52] | |
| e | Work incapacity cases according to diagnosis | Number of days of incapacity to work due to F-diagnosis per 100 insured persons according to individual diagnoses | Changes in 2020 vs. 2019: decrease in somatoform disorder (F45) by 6%, almost unchanged in depression (F32+33) with an increase of 0.3%; increase in other anxiety disorders (F41) by 5%, reactions to severe stress and adjustment disorders (F43) by 8% and other neurotic disorders (F48) by 7% [52] | |
|
Data basis: Incapacity to work data for AOK
Data from employees insured with the AOK, n=approx. 13 million [47] Wissenschaftliches Institut der AOK (WIdO) (2020): 01.01.–31.08.2020 compared to 01.01.–31.08.2019 |
e | Incapacity to work cases | Number of cases of incapacity to work due to F-diagnosis per 100 insured persons | Decrease to 11.1 in the period January to August 2020 from 12.0 in the comparison period in 2019 [47] |
| e | Duration of incapacity to work | Number of days per case of incapacity to work due to F-diagnosis | Increase to 29.3 in the period January to August 2020 from 25.9 days in the same period in 2019 [47] | |
|
Data basis: Work incapacity data for TK
Data from persons insured with TK who are subject to social insurance or registered as unemployed, n=5.4 million [67] Techniker Krankenkasse (2021): 2020 compared to 2019 [66] Techniker Krankenkasse (2021): 01–12/2020 com-pared to 2019/ 2018 |
e | Days of incapacity to work | Number of days of incapacity to work due to F-diagnosis per 100 years insured | Increase of 5.1 days for men and 14.4 days for women in 2020 compared to 2019 [67] |
| e | Change in sick leave from 2019 to 2020 compared to 2018 to 2019 | Change in number of days with incapacity to work due to F-diagnosis | Increase of 0.11 days from 2019 to 2020 (2.98) compared to increase from 2018 to 2019 (2.89) [66] | |
|
Data basis: Emergency admission of the psychiatric clinic of the Hannover Medical School
Data of persons aged ≥18 years who presented at the psychiatric emergency admission of Hannover Medical School and had medical contact with psychiatrists [62] Seifert J, Meissner C, Birkenstock A et al. (2021): 16.03.–24.05.2020 compared to 16.03.–24.05.2019, n=374 presentings |
e | Psychiatric emergencies according to clinical characteristics | Number of cases with F-diagnosis, after repeated presentations within one month and suicide attempts before presentation | Decrease in case numbers of 21.4% in the period 16.03.–24.05.2020 compared to the same period in 2019, at the same time increase in the number of repeated presentations within one month to 30.2% compared to 20.4% in 2019; unchanged proportion of suicide attempts [62] |
| e | Psychiatric emergencies according to diagnoses | Number of diagnoses of mental disorders in the main diagnostic groups F1–F4 and F6, as well as ‘other’ (F0, F5, and F7–9) | Decrease to 15.2% in the period 16.03–24.05.2020 from 22.2% in the same period in 2019 for affective disorders (F32–33), at the same time increase for personality and behavioural disorders (F6) to 12.3% from 7.8%, unchanged proportion for F1, F2, F4 and ‘other’ [62] | |
| e | Aspects of the psycho-pathological findings | Documentation of 65 selected symptoms of psychopathological findings according to AMDP system | Increase in the period 16.03.–24.05.2020 compared to the same period in 2019 for formal thinking disorder (75.7% compared to 65.1%), hopelessness (13.9% compared to 5.3%) and social withdrawal (14.4% compared to 8.0%), all others unchanged (including suicidality) [62] | |
| e | Relation between psychiatric emergencies and the COVID-19-pandemic | Explicit documentation of the association of the case with the COVID-19-pandemic by the treating psychiatrist | A relation between the presentation and the COVID-19-pandemic was documented for 20.1% of all persons; among these, the proportion of persons with suicide attempts increased 3-fold compared to cases without a connection to the COVID-19-pandemic [62] | |
|
Data basis: Emergency admission of the Central Institute of Mental Health Mannheim
Data of persons that presented in the emergency admission of the Central Institute of Mental Health Mannheim [61] Hoyer C, Ebert A, Szabo K et al. (2020): 01.01.–19.04.2020 compared to 01.01.–21.04.2019 |
e | Presentations in psychiatric emergency admission | Number of presentations in psychiatric emergency admission | Decrease of 26.6% in presentation rates 18.03.–14.04./01.01.–17.03 in 2020 compared to 2019 [61] |
| e | Presentations in psychiatric emergency admission according to diagnosis | Number of presentations in psychiatric emergency admission by main diagnosis group | Decrease of 42.3% in showcase rates 18.03.–14.04./01.01.–17.03 in 2020 compared to 2019 for affective disorders [61] | |
|
Data basis: Emergency admission and consultation requirements of the Klinikum rechts der Isar, Technische Universität München
Data from people who presented at the central interdisciplinary emergency admission of the Klinikum rechts der Isar, Technische Universität München [60] Aly L, Sondergeld R, Holzle P et al. (2020): 21.03.–01.05.2020 vs 23.03.–03.05.2019 (n=3,549 total number of all presentations in emergency admission) |
e | Psychiatric emergencies | Number of cases with corresponding coding according to Manchester-Triage-System or ICD-10 | Unchanged absolute number of psychiatric emergencies as well as distribution among ICD main diagnosis groups, but increase in the share of all presentations to 5% compared to 3% in the previous year [60] |
| e | Psychiatric consultation requirements, connection with the COVID-19-pandemic | Proportion of cases with psychiatric consultation requests with content related to the COVID-19-pandemic and with suicide attempts | A substantive link to the COVID-19-pandemic was found in 21%; among these, an increased proportion of suicide attempts (22%) was observed compared to those without a COVID-19 link (6%) [60] | |
|
Data basis: Emergency admission and inpatient care in HELIOS-Clinics
Persons admitted as psychiatric emergencies to one of n=67 hospitals of the HELIOS Group with main diagnosis F00–F69 [59] Fasshauer JM, Bollmann A, Hohenstein S et al. (2021): 13.03.–21.05.2020 vs. 01.01.–12.03.2020; 13.03.–21.05.2019 (n=13,151 total number of all psychiatric emergency admissions) |
e | Psychiatric Emergencies | Number of cases with main diagnosis F00–F69 | Decrease in 13.03.–21.05.2020 compared to the previous months in 2020 (IRR 0.68) and the comparative period in 2019 (IRR 0.70), affected all main diagnosis groups [59] |
| e | Length of stay for psychiatric diagnosis | Number of days of inpatient treatment for cases with main diagnosis F00–F69 | Decrease in length of stay to 9.8 in 13.03.–21.05.2020 compared to 14.7 in the previous months in 2020 and 16.4 in the comparative period in 2019, respectively [59] | |
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Data basis: AOK inpatient care data
Data of inpatient treatment among insured persons of the AOK, n=27 million [46] Wissenschaftliches Institut der AOK (WIdO) (2020): 16.03.–05.04.2020 compared to 16.03.2019–05.04.2019 [48] Wissenschaftliches Institut der AOK (WIdO) (2021): 01/2020–02/2021 compared to 01–12/2019 |
e | Inpatient treatment cases | Number of inpatient treatment cases for F-diagnoses | Decrease of 49% in 16.03.–05.04.2020 compared to the same period in 2019, thus comparatively strong decrease (rank 6) among the 21 treatment events considered [46] |
| e | Inpatient cases in psychiatric, psychotherapeutic and psychosomatic clinics and departments | Number of treatment cases in specialised hospitals or departments for psychiatry and psychotherapy, child and adolescent psychiatry and psychotherapy and psychosomatic medicine and psychotherapy that bill according to the PEPP system | Decrease compared to 2019 in the entire observation period, most pronounced in April 2020 by 31% as well as in January 2021 by 21%, least pronounced in September 2020 by 5% [48] | |
|
Data basis: LVR clinics inpatient care data
Data of persons who were admitted to one of n=9 psychiatric clinics of the Landschaftsverband Rheinland (LVR) as day-clinic patients or inpatients [50] Zielasek J, Vrinssen J, Gouzoulis-Mayfrank E (2021): 18.03.–31.05.2020 compared to 18.03.–31.05.2019 (n=10,545 treatment cases) |
Day-clinic and inpatient admissions per day | Number of admitted cases to day-clinic and inpatient care (planned admissions and emergencies) per day in clinics for psychiatry, child and adolescent psychiatry, psychosomatic medicine, geriatrics and addiction treatment | Decrease of 25% in the period 18.03.–31.05.2020 compared to the same period in 2019 [50] | |
| Day-clinic patient and inpatient cases by diagnosis | Discharge diagnosis according to main diagnosis groups | Decrease in the period 18.03.–31.05.2020 compared to the same period in 2019 for intelligence disorders (F7) with 51%, neurotic, stress and somato-form disorders (F4) with 35%, affective disorders (F3) with 34% and personality and behavioural disorders (F6) with 31%, organic mental disorders including Alzheimer’s (F0/G3) with 10% and schizophrenia, schizotypal and delusional disorders (F2) with 9% [50] | ||
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Data basis: Statistics on narcotics-related deaths from the Land Offices of Criminal Investigation
[53] The Federal Government Drug Commissioner (2021): 2020 compared to 2019 |
e | Deaths due to narcotics use | Total number of deaths in all federal states | Increase of 13% to 1,581 in 2020 compared to 1,398 in 2019 [53] |
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Data basis: Telephone counselling ‘Telefonseelsorge’
Data from persons who made contact with the nation-wide telephone counselling ‘Telefonseelsorge’ in one of n=91 counselling centres [64] Arendt F, Markiewitz A, Mestas M et al. (2020): 01.01.–31.03.2020 compared to 01.01.–31.03.2019 (contact via telephone) [65] Armbruster S, Klotzbücher V (2020): 01.01.2019–28.04.2020 (contact via telephone or online) |
e | Calls to telephone counselling | Number of calls to telephone counselling | Increase to approx. 700 calls more per day at the end of March 2020 compared to the same period in 2019 [64] |
| e | Contacts to telephone counselling | Number of contacts to telephone counselling per day (telephone and online) | Increase of approx. 20% around 22.03.2020, after approx. three weeks of decline, in April still increased compared to previous year’s level; stronger increase in federal states with stricter infection control measures [65] | |
| e | Reasons for contacting telephone counselling | Central counselling topics for each contact to telephone counselling | Increase in counselling topics ‘mental and physical health’, ‘relationship/social issues’ and ‘violence’ [65] | |
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Data basis: Cause of death statistics of the city of Leipzig
[63] Radeloff D, Papsdorf R, Uhlig K et al. (2020): 16.03.–24.05.2020 compared to 16.03.–24.05.2019 and previous years 2010–2019; 3 phases depending on the limitation of social contacts and mobility: No restriction (01.01.–16.03.2020), moderate restriction (17.–21.03., 06.06.–30.09.2020), severe restriction (22.03.–05.06.2020) compared to previous years as of 2010 |
e | Suicide rate | Number of suicides per 100,000 life years | Decrease in suicide rate from 16.8 (time without restrictions) to 7.2 (time of severe restraints) due to unexpectedly high suicide rates in 2019 and early 2020; unchanged values in comparison none vs. mild and mild vs. severe restraints; no differences between expected and observed trends based on previous year trends [63] |
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Data basis: Cause of death statistics of the Federal Statistical Office
[69] Federal Statistical Office (2021): 2020 vs. 2019 |
e | Suicide | Total number of suicides (cause of death X60–X84) | Decrease in suicides to n=8,565 in 2020 compared to n=9,041 in 2019 [69] |