Healthcare costs of Type 2 diabetes in Germany

AIM

To describe for the first time the direct costs of Type 2 diabetes treatment by analysing nationwide routine data from statutory health insurance in Germany.

METHODS

This cost-of-illness-study was based on a 6.8% random sample of all German people with statutory health insurance (4.3 out of 70 million people). The healthcare expenses show direct per capita costs from the payer perspective. Healthcare expenses for physicians, dentists, pharmacies, hospitals, sick benefits and other healthcare costs were considered. Per capita costs, cost ratios for people with Type 2 diabetes and without diabetes as well as diabetes-attributable costs were calculated.

RESULTS

Per capita costs for people with Type 2 diabetes amounted to €4,957 in 2009 and €5,146 in 2010. People with Type 2 diabetes had 1.7-fold higher health expenses than people without diabetes. The largest differences in health expenses were found for prescribed medication from pharmacies (cost ratio diabetes/no diabetes: 2.2) and inpatient treatment (1.8). Ten percent of the total statutory health insurance expense, in total €16.1 billion, was attributable to the medical care of people with Type 2 diabetes.

CONCLUSIONS

This nationwide study indicates that one in 10 Euros of healthcare expenses is spent on people with Type 2 diabetes in Germany. In the future, national statutory health insurance data can be used to quantify time trends of costs in the healthcare system.

[Validity of a complex soccer-specific field test and a non-specific sprint test-assessments for test and match performance]

BACKGROUND

Soccer assessments often lack specificity and complexity. Examinations of validity for soccer assessments, based on the relation between test and match performance, are available although they are scarce. A complex soccer-specific field test which is validated cannot be found in the literature at all.

OBJECTIVE

The aim of this follow-up study was to assess the validity of a soccer-specific complexity test (FBKT) and a repeated non-specific sprint test (ST) based on three gold standards: match performance, coach ranking, and league affiliation.

MATERIALS AND METHODS

A German fourth league soccer team (n = 14) was assessed using FBKT and ST in the pre-season for the second half of the 2010/2011 season. Afterwards, their performance in 17 matches was evaluated using video analysis in order to compare them with the test parameters (e. g., pass/assist ratio, goals, duelling behaviour). Eighteen months later, the league affiliation of all players was identified and the coach evaluated the tested players.

RESULTS

With regard to match performance, playing time was proved to be the most suitable parameter for validating the test performance (FBKT, ST). The total and minimum times of ST were the most powerful parameters in relation to playing time and explained 50 % and 46 % of the variance, respectively. Concerning the FBKT, the parameters "sum of all linear sprints" (24 %) and "total time of all activity series with penalty time in round two" (22 %) explained the highest amount of variance. Coach ranking generated significant odds ratios for the minimum time of ST (OR = 6.5; CI: 3.2 - 5.2 × 1015; p = 0.037), and total time of speed dribbling of the FBKT (OR = 1.3; CI: 1.2 - 199.5; p = 0.036) based on a proportional-odds model. With regard to league affiliation, significant odds ratios occurred with the following parameters: minimum time of ST (OR = 15.8; CI: 2.16 - 115.4; p = 0.007); total time of ST (OR = 3.28; CI: 1.31 - 8.21; p = 0.011); and, total time of speed dribbling for the FBKT (OR = 1.3; CI: 1.01 - 1.61; p = 0.044).

CONCLUSIONS

This study showed that the larger logical validity of soccer-specific complex tests does not necessarily translate to a larger construct validity, as compared to non-specific tests. However, their value is not limited to performance evaluation. The FBKT provides valuable information concerning training process control. It is possible that its low validity is caused by the poor performance of the players in soccer-specific consequences of actions (centres, goals) due to the restricted differentiation of players.