Sozialepidemiologie einer neuen Einsatzkategorie

Psychiatric and psychosocial problems have become more and more important for German Emergency Medical Services. Investigating prevalence of psychiatric and psychosocial emergencies and their potential dependence from demographic and socioeconomic factors, this study intends to present socioepidemiologic data referring to this development in Germany. To this end, 2691 calls performed by a physician staffed mobile intensive care unit at Kaiserslautern/Germany (25 jobs/1000 inhabitants) in 1999 were analyzed in a retrospective and anonymous manner. Considering socioeconomic factors such as unemployment, social care and proportion of migrants, a socioeconomic index was calculated for each district. This index was used to stratify the 18 districts of Kaiserslautern into 3 socioeconomic regions. The socioeconomic index of each region was correlated with the referring prevalence of psychiatric and psychosocial emergencies. In contrast to the fact that older patients (>60 years) are responsible for 56% of all emergency calls, the majority of psychosocial and psychiatric emergencies were caused by patients of the lower age group between 30 and 50 years. Improved socioeconomic situation in 1999 (reduction of the unemployment rate from 16,1% to 14,2% and of the social care dependence rate from 4,9% to 3,9% compared with 1997) was paralleled by a decrease of psychosocial and psychiatric emergencies (3,4 to 2,6/1000 inhabitants). For verification of these retrospective data prospective studies are necessary.