Epidemiology and use of compression treatment in venous leg ulcers: nationwide claims data analysis in Germany |
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| Authors: | Kristina Heyer Kerstin Protz Gerd Glaeske Matthias Augustin |
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| Affiliation: | 1. German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg‐Eppendorf (UKE), Hamburg, Germany;2. Centre for Social Policy Research, University of Bremen, Bremen, Germany |
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| Abstract: | Chronic venous diseases are the most common causes of leg ulcers. Compression treatment (CT) is a central component of venous leg ulcer (VLU) therapy along with prevention based on guidelines and clinical evidence. However, large‐scale data on the use of CT are rare. In particular, there have not yet been published nationwide data for Germany. We analysed data from a large German statutory health insurance (SHI) on incident VLU between 2010 and 2012. VLUs were identified by ICD‐10 diagnoses. The status of active disease was defined by wound‐specific treatments. Compression stockings and bandages were identified by SHI medical device codes. The overall estimated incident rate of active VLU of all insured persons was 0·34% from 2010 to 2012. Adapted to the overall German population, n = 229 369 persons nationwide had an incident VLU in 2010–2012. Among all VLU patients, only 40·6% received CT within 1 year, including 83·3% stockings, 31·8% bandages and 3·1% multi‐component compression systems. Compression rates showed significant differences by gender and age. Large regional variations were observed. Validity of data is suggested by high concordance with a primary cohort study. Although recommended by guidelines, there is still a marked under‐provision of care, with CT in incident VLUs in Germany requiring active measures. |
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| Keywords: | Compression treatment Leg ulcers Statutory health insurance Regional variations Wound care, health care research |
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