[Research Data Center on Health - Vision for Further Development from the Research Perspective]. / Forschungsdatenzentrum Gesundheit ­ Vision für eine Weiterentwicklung aus Sicht der Forschung.

The German research data center for health will provide claims data of statutory health insurances. The data center was set up at the medical regulatory body BfArM pursuant to the German data transparency regulation (DaTraV). The data provided by the center will cover about 90% of the German population, supporting research on healthcare issues, including questions of care supply, demand and the (mis-)match of both. These data support the development of recommendations for evidence-based healthcare. The legal framework for the center (including §§ 303a-f of Book V of the Social Security Code and two subsequent ordinances) leaves a considerable degree of freedom when it comes to organisational and procedural aspects of the center's operation. The present paper addresses these degrees of freedom. From the point of view of researchers, ten statements show the potential of the data center and provide ideas for its further and sustainable development.

[Prevalence Rates of Mild Cognitive Impairment and of Dementia in the German Outpatient Health Care Sector 2009-2016]. / Prävalenz von leichten kognitiven Störungen und Demenzen in der ambulanten Routineversorgung in Deutschland 2009­2016.

OBJECTIVE: In Germany, the number of patients with dementia is expected to increase from 1.7 (2017) to more than 3 million people (2050). Preventive and therapeutic measures target at early stages of dementia such as mild cognitive impairment (MCI). Aim of the study is to compare prevalence rates of MCI and dementia over time. METHODS: The study was based on the complete nation-wide outpatient claims data of the panel doctors services according to §â€Š295 SGB V. We identified prevalent patients with MCI (PwMCI) and with dementia (PwD) in the years 2009 to 2016 treated by general practitioners or neuropsychiatric specialists. RESULTS: The number of prevalent PwMCI/PwD increased from 50,760/1,014,381 (2009) to 166,919/1,416,319 (2016) and the corresponding prevalence rates from 0.13 % to 0.42 % (MCI) and from 2.52 % to 3.55 % (dementia), resp. CONCLUSION: Despite the significant prevalence gain, the number of PwMCI identified in outpatient health claims data is much lower than the expected number of 2,8 to 3,7 million people at the population level. Therefore, we anticipate a further increase in the number of PwMCI being treated in the outpatient sector over the coming years.

Outpatient Antibiotic Prescription.

BACKGROUND: In view of the rise in antibiotic resistance and Clostridium difficile superinfection, close monitoring of antibiotic prescribing practices is essential so that targeted quality assurance measures can be taken. METHODS: We analyzed nationwide data from multiple statutory health insurance carriers on prescriptions of systemic antibiotics in the years 2008-2014, with special attention to cephalosporins and fluoroqinolones. Prescribing rates were characterized in terms of defined daily doses (DDD) per 1000 statutory insurees per year and were analyzed separately for each age group and each federal state in Germany. Trends were analyzed with joinpoint regression. RESULTS: Antibiotic prescribing rates for persons aged 15 to 69 increased slightly overall during the period of observation. On the other hand, there was a significant decline in antibiotic prescribing rates for persons under age 15 in all of the German states, with a mean annual decrease of 6.8%. There was also a slight decline in antibiotic prescribing rates for persons aged 70 and above, mainly accounted for by fluoroquinolones. Cephalosporin prescribing rates rose significantly in all states, by an overall average of 7.6% per annum. Cephalo - sporin prescribing rates rose significantly in all age groups except persons under age 15, for whom there was a decline that did not reach statistical significance. CONCLUSION: This study revealed an overall decline in outpatient antibiotic prescriptions for persons under age 15 as well as other major changes in prescribing practices for the types of antibiotics studied. The observed marked rise in cephalosporin prescribing rates in all German states demands special attention because of the associated danger of increased antibiotic resistance and C. difficile superinfection. Oral cephalosporins are not recommended as drugs of first choice in current guidelines.