Federal Statistical Office Of Germany Research Articles

The Development of the Berliner as a Political Person under the Influence of the Urban Cultural Environment

Introduction. The article explores the reasons for the emergence of ethnic diversity in the city of Berlin, encompassing political, historical, geographical, anthropological, and sociological aspects of the urban environment. It also outlines the current issues in German society that shape the political culture of its people. The relevance of the topic is driven by the political radicalization of migrants in Germany, particularly in Berlin, resulting from cultural globalization that impacts traditional political institutions and behavioral models of the city's residents. The crisis of the liberal-democratic model and the increase in the number of Eurosceptics also play a significant role in the transformation of the political culture of contemporary Berliners. Solving the problem of political radicalization of migrants is equally important for the Russian Federation, especially in St. Petersburg, combining characteristics of the European urban environment and the polyethnic Russian state, whose residents consider themselves Russians despite national and cultural differences. Methodology and sources. The research is grounded in Ernest Burgess's model of concentric zones. The study relies on research methods such as synthesis, comparison, analysis, and sociological approaches. Data from the Federal Statistical Office of Germany, the results of the 2016 elections to the Berlin House of Deputies, the 2021 elections, and the subsequent 2023 elections, historical data, and findings from other researchers on the topic served as sources for the study. Results and discussion. The study identifies features of urban culture shaping the polyethnic Berlin society, including the ethnic diversity of residents, unique self-identification of Berliners, the presence of distinct urban districts, squatter movements, and the influence of architectural and spatial characteristics on the formation of human social behavior. Some city problems were also highlighted, such as the crisis of formation of a distorted perception of right and left currents among Berliners, the failure of multiculturalism policies, the migration crisis, and housing shortages. Conclusion. The development of a Berliner as a political being is influenced by the characteristics of the urban environment and certain issues facing the city, where the residential district, properties of the city's political culture, and ethnic background impact the political views of its inhabitants

The projected increase of vertebral osteomyelitis in Germany implies a demanding challenge for future healthcare management of aging populations.

Since an increase in the occurrence of native vertebral osteomyelitis (VO) is expected and reliable projections are missing, it is urgent to provide a reliable forecast model and make it a part of future health care considerations. Comprehensive nationwide data provided by the Federal Statistical Office of Germany were used to forecast total numbers and incidence rates (IR) of VO as a function of age and gender until 2040. Projections were done using autoregressive integrated moving average model on historical data from 2005 to 2019 in relation to official population projections from 2020 to 2040. The IR of VO is expected to increase from 12.4 in 2019 to 21.5 per 100,000 inhabitants [95% CI 20.9-22.1] in 2040. The highest increase is predicted in patients over 75years of age for both men and women leading to a steep increase in absolute numbers, which is fourfold higher compared to patients younger than 75years. While the IR per age group will not increase any further after 2035, the subsequent increase is due to a higher number of individuals aged 75years or older. Our data suggest that increasing IR of VO will seriously challenge healthcare systems, particularly due to demographic change and increasing proportions of populations turning 75years and older. With respect to globally fast aging populations, future health care policies need to address this burden by anticipating limitations in financial and human resources and developing high-level evidence-based guidelines for prevention and interdisciplinary treatment.

Combined International Trade and Investment Data “CITID” – A New Innovative and Comprehensive Data Landscape for Germany

Abstract The Combined International Trade and Investment Data (CITID) represents a new innovative and comprehensive data landscape that combines firm-level data focused on international trade and investment. The datasets are sourced from both the Deutsche Bundesbank and the Federal Statistical Office of Germany, ensuring a reliable and robust data landscape. Within the CITID, multiple individual datasets seamlessly merge, encompassing a wide range of information. These include data on trade in goods, trade in services, inward and outward foreign direct investment (FDI), as well as information on international financial and capital transactions along with additional firm-level data. The data enables a holistic understanding of firms’ international integration, previously unattainable, and offers new opportunities for analyzing global trade dynamics. The data will be accessible for research. This paper provides a comprehensive description of the individual datasets, including information about their combinability, the methodology for matching them, the data’s content, and its potential for further research.

Epidemiological Analysis of Traumatic Compartment Syndromes in Germany.

Background: Traumatic compartment syndrome is a critical condition that can lead to severe, lifelong disability. Methods: This retrospective study analyzed hospital billing data from 2015 to 2022, provided by the Federal Statistical Office of Germany, to examine the demographics and trends of traumatic compartment syndrome in Germany. The analysis included cases coded with ICD-10 codes T79.60 to T79.69 and any therapeutic OPS code starting with 5-79, focusing on diagnosis year, gender, ICD-10 code, and patient age. Results: The results showed that out of 13,305 cases, the majority were in the lower leg (44.4%), with males having a significantly higher incidence than females (2.3:1 ratio). A bimodal age distribution was observed, with peaks at 22-23 and 55 years. A notable annual decline of 43.87 cases in compartment syndrome was observed, with significant decreases across different genders and age groups, particularly in males under 40 (23.68 cases per year) and in the "foot" and "lower leg" categories (16.67 and 32.87 cases per year, respectively). Conclusions: The study highlights a declining trend in traumatic CS cases in Germany, with distinct demographic patterns. Through these findings, hospitals can adjust their therapeutic regimens, and it could increase awareness among healthcare professionals about this disease.

Trends of mortality rate in patients with congenital heart defects in Germany—analysis of nationwide data of the Federal Statistical Office of Germany

BackgroundCongenital heart defects (CHD) are still associated with an increased morbidity and mortality. The aim of this study was to analyze trends of mortality rates in patients with CHD between 1998 and 2018 in Germany.MethodsData of registered deaths with an underlying diagnosis of CHD were used to evaluate annual mortality between 1998 and 2018. Polynomial regressions were performed to assess annual changes in CHD-associated mortality rates by age groups.ResultsDuring the 21-year study period, a total of 11,314 deaths were attributed to CHD with 50.9% of deaths in infants (age < 1 year) and 28.2% in neonates (age ≤ 28 days). The most frequent underlying CHDs associated with death were hypoplastic left heart syndrome (n = 1498, 13.2%), left ventricular outflow tract obstruction (n = 1009, 8.9%), atrial septal defects (n = 771, 6.8%), ventricular septal defects (n = 697, 6.2%), and tetralogy of Fallot (n = 673, 5.9%), and others (n = 6666, 58.9%). Among all patients, annual CHD-related mortality rates declined significantly between 1998 and 2010 (p < 0.0001), followed by a significant annual increase until 2018 (p < 0.0001). However, mortality rates in 2018 in all ages were significantly lower than in 1998.ConclusionMortality in CHD patients decreased significantly between 1998 and 2010, but a substantial number of deaths still occurred and even significantly increased in the last 3 years of the observation period particularly in neonates and infants. This renewed slight increase in mortality rate during the last years was influenced mainly by high-risk neonates and infants. Assessment of factors influencing the mortality rate trends in association with CHD in Germany is urgently needed. Obligatory nationwide registration of death cases in relation to surgical and catheter interventions in CHD patients is necessary to provide additional valuable data on the outcome of CHD.Graphical abstract

Results from 237 extracorporeal membrane oxygenation runs with drowned patients: a nationwide retrospective study

BackgroundDrowning is one of the leading causes of death worldwide and presents with a wide range of symptoms, from simple coughing to cardiac or pulmonary failure. In severe cases, extracorporeal membrane oxygenation (ECMO) should be considered as a rescue therapy. Therefore, we sought to analyse ECMO usage, outcomes and predictive factors in drowned patients.MethodsThe Federal Statistical Office of Germany provided the study data. The patients included experienced drowning (ICD T75.1) and ECMO (OPS 8–852.0, 8–852.3) between 2007 and 2020. All age groups were included. Mortality was calculated for the total population and for ECMO patients. A multiple logistic regression model for ECMO patients was applied to account for predefined patient characteristics and complications.ResultsOf 12,354 patients who were hospitalised due to drowning, 237 patients (1.9%) received ECMO. Hospital mortality was 14.1% (n = 1741) overall and 74.7% (n = 177) for ECMO patients. In-hospital mortality was positively associated with cardiopulmonary resuscitation (CPR) before admission (odds ratio [OR] 4.49, 1.31–15.39) and in-hospital CPR (OR 6.28, 2.76–14.31). Stroke (OR 0.14, 0.02–0.96) and drug abuse (OR 0.05, 0.01–0.45) were negatively associated with in-hospital mortality. Neither the ECMO mode nor the patient’s age and sex had statistically significant effects on survival.ConclusionThis study indicates that survival in drowned patients who receive ECMO is lower than previously reported. The proportion of paediatric patients was also smaller than expected. As the effects of different ECMO modes on mortality remain unclear, the need for further study remains great.

Impact of the COVID pandemic on major abdominal cancer resections in Germany: a retrospective population-based cohort study.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is estimated to have claimed more than 6 million lives globally since it started in 2019. Germany was exposed to two waves of coronavirus disease 2019 in 2020, one starting in April and the other in October. To ensure sufficient capacity for coronavirus disease 2019 patients in intensive care units, elective medical procedures were postponed. The fraction of major abdominal cancer resections affected by these measures remains unknown, and the most affected patient cohort has yet to be identified. This is a register-based, retrospective, nationwide cohort study of anonymized 'diagnosis-related group' billing data provided by the Federal Statistical Office in Germany. Cases were identified using diagnostic and procedural codes for major cancer resections. Population-adjusted cancer resection rates as the primary endpoint were compared at baseline (2012-2019) to those in 2020. A change in resection rates for all analyzed entities (esophageal, gastric, liver, pancreatic, colon, rectum, and lung cancer) was observed from baseline to 2020. Total monthly oncological resections dropped by 7.4% (8.7% normalized to the annual German population, P =0.011). Changes ranged from +3.7% for pancreatic resections ( P =0.277) to -19.4% for rectal resections ( P <0.001). Reductions were higher during lockdown periods. During the first lockdown period (April-June), the overall drop was 14.3% (8.58 per 100 000 vs. 7.35 per 100 000, P <0.001). There was no catch-up effect during the summer months except for pancreatic cancer resections. In the second lockdown period, there was an overall drop of 17.3%. In subgroup analyses, the elderly were most affected by the reduction in resection rates. There was a significant negative correlation between regional SARS-CoV-2 incidences and resections rates. This correlation was strongest for rectal cancer resections (Spearman's r : -0.425, P <0.001). The pandemic lockdowns had a major impact on the oncological surgical caseload in Germany in 2020. The elderly were most affected by the reduction. There was a clear correlation between SARS-CoV-2 incidences regionally and the reduction of surgical resection rates. In future pandemic circumstances, oncological surgery has to be prioritized with an extra focus on the most vulnerable patients.

Who seeks psychodynamic psychotherapy in community-based practices? Patient characteristics examined in a large sample of applications for reimbursement of psychotherapy in Germany

This study examined the demographic characteristics of patients using outpatient psychodynamic psychotherapy and compared them to the general population. A second aim was to explore clinical and biographical features of the users. We extracted data from a random sample of 983 applications for reimbursement of psychodynamic psychotherapy in community-based practices in Germany. These applications contain information for the health insurer but also additional written reports for an expert reviewer. Census data for comparison were obtained from the Federal Statistical Office of Germany. Men, older people, and migrants were underrepresented, while the unemployed were overrepresented compared to the general population. A third of the reports described a patient’s experience of physical and/or sexual violence. Twenty-six percent of the reports mentioned that the parents had separated, and a third of these patients were younger than 5 years at that time. Suicidal ideation was reported for a fifth of the patients. About 5% were reported to present with self-harming behaviour and 14% with violence towards others. It was mentioned that the patients were consuming dangerous amounts of alcohol in 9%. The most frequent diagnosis group was affective disorders, followed by neurotic disorders, whereas only few had a substance use diagnosis or a psychotic disorder. In summary, men, migrants, older people, and patients with substance abuse and psychotic disorders are likely underrepresented in outpatient psychotherapy in Germany, indicating unequal access to mental health care despite the universal coverage of its costs. Patients in outpatient psychodynamic psychotherapy often present with severe clinical problems.

Ovarian cancer prevention by opportunistic salpingectomy is a new de facto standard in Germany

PurposeThe most prevalent and aggressive subtype of epithelial ovarian carcinoma (EOC), high-grade serous carcinoma (HGSC), originates in many cases from the fallopian tubes. Because of poor prognosis and lack of effective screening for early detection, opportunistic salpingectomy (OS) for prevention of EOC is being implemented into clinical routine in several countries worldwide. Taking the opportunity of a gynecological surgery in women at average cancer risk, extramural fallopian tubes are completely resected preserving the ovaries with their infundibulopelvic blood supply. Until recently, only 13 of the 130 national partner societies of the International Federation of Obstetrics and Gynecology (FIGO) have published a statement on OS. This study aimed to analyze the acceptance of OS in Germany.Methods(1) Survey of German gynecologists in 2015 and 2022 by the Department of Gynecology of the Jena University Hospital in co-operation with the Department of Gynecology at Charité-University Medicine Berlin with support of NOGGO e. V. and AGO e. V. (2) Salpingectomy numbers in Germany for years 2005–2020 as retrieved from the Federal Statistical Office of Germany (Destatis).Results(1) Survey: Number of participants was 203 in 2015 and 166 in 2022, respectively. Nearly all respondents (2015: 92%, 2022: 98%) have already performed bilateral salpingectomy without oophorectomy in combination with benign hysterectomy with the intention to reduce the risk for malignant (2015: 96%, 2022: 97%) and benign (2015: 47%, 2022: 38%) disorders. Compared to 2015 (56.6%), considerably more survey participants performed OS in > 50% or in all cases in 2022 (89.0%). Recommendation of OS for all women with completed family planning at benign pelvic surgery was approved by 68% in 2015 and 74% in 2022. (2) Case number analysis: In 2020, four times more cases of salpingectomy were reported by German public hospitals compared to 2005 (n = 50,398 vs. n = 12,286). Of all inpatient hysterectomies in German hospitals in 2020, 45% were combined with salpingectomy, and more than 65% in women at the age of 35 to 49 years.ConclusionMounting scientific plausibility regarding involvement of fallopian tubes in the pathogenesis of EOC led to change of clinical acceptance of OS in many countries including in Germany. Case number data and widespread expert judgment demonstrate that OS has become a routine procedure in Germany and a de facto standard for primary prevention of EOC.

Trends in Computer-Assisted Surgery for Total Knee Arthroplasty in Germany: An Analysis Based on the Operative Procedure Classification System between 2010 to 2021.

Alignment strategies for primary total knee arthroplasty (TKA) have changed significantly over time with a shift towards a more individualized alignment goal. At the same time, computer-assisted surgery (CAS) has gained interest for intraoperative control and accuracy in implant positioning and limb alignment. Despite the often discussed benefits and drawbacks of robotics and navigation for TKA, the routine use of these new devices on a day-to-day basis remains obscure. Therefore, nationwide hospital billing data based on the Operation Procedure Classification System (OPS) were retrieved from the Federal Statistical Office of Germany for the period from 2010 to 2021. OPS codes for primary total knee arthroplasty (OPS code: 5-822*) were further analyzed regarding the usage of computer navigation (additional OPS code: 5-988) or robotic devices (additional OPS code: 5-987). Gender and age at the time of surgery were also assessed. The results show a total of 2,226,559 primary TKAs were implanted between 2010 and 2021, of which 2,044,914 were performed conventionally (91.84% of all TKAs). A total of 170,276 TKAs were performed using navigation technique (7.65% of all TKAs) and another 11,369 TKAs were performed using robotics (0.51% of all TKAs). For the period from 2018 to 2021, a substantial increase in robot-assisted TKA (R-TKA) was observed, with an average increase rate of 84.74% per year, while the number of navigated TKAs declined (-3.67% per year). Computer-assisted surgery, and particularly robotics for TKA, are seeing growing popularity and stepwise translation into routine clinical use in Germany, with a steep increase rate of more than 80% per year since 2018. Nevertheless, the majority of TKAs are still performed using manual instrumentation, rendering conventional TKA the currently unchanged gold standard.

Estimation of R0 for the spread of SARS-CoV-2 in Germany from excess mortality

For SARS-CoV-2, R0 calculations in the range of 2–3 dominate the literature, but much higher estimates have also been published. Because capacity for RT-PCR testing increased greatly in the early phase of the Covid-19 pandemic, R0 determinations based on these incidence values are subject to strong bias. We propose to use Covid-19-induced excess mortality to determine R0 regardless of RT-PCR testing capacity. We used data from the Robert Koch Institute (RKI) on the incidence of Covid cases, Covid-related deaths, number of RT-PCR tests performed, and excess mortality calculated from data from the Federal Statistical Office in Germany. We determined R0 using exponential growth estimates with a serial interval of 4.7 days. We used only datasets that were not yet under the influence of policy measures (e.g., lockdowns or school closures). The uncorrected R0 value for the spread of SARS-CoV-2 based on RT-PCR incidence data was 2.56 (95% CI 2.52–2.60) for Covid-19 cases and 2.03 (95% CI 1.96–2.10) for Covid-19-related deaths. However, because the number of RT-PCR tests increased by a growth factor of 1.381 during the same period, these R0 values must be corrected accordingly (R0corrected = R0uncorrected/1.381), yielding 1.86 for Covid-19 cases and 1.47 for Covid-19 deaths. The R0 value based on excess deaths was calculated to be 1.34 (95% CI 1.32–1.37). A sine-function-based adjustment for seasonal effects of 40% corresponds to a maximum value of R0January = 1.68 and a minimum value of R0July = 1.01. Our calculations show an R0 that is much lower than previously thought. This relatively low range of R0 fits very well with the observed seasonal pattern of infection across Europe in 2020 and 2021, including the emergence of more contagious escape variants such as delta or omicron. In general, our study shows that excess mortality can be used as a reliable surrogate to determine the R0 in pandemic situations.

Local socio-structural predictors of COVID-19 incidence in Germany.

Socio-economic conditions and social attitudes are known to represent epidemiological determinants. Credible knowledge on socio-economic driving factors of the COVID-19 epidemic is still incomplete. Based on linear random effects regression, an ecological model is derived to estimate COVID-19 incidence in German rural/urban districts from local socio-economic factors and popularity of political parties in terms of their share of vote. Thereby, records provided by Germany's public health institute (Robert Koch Institute) of weekly notified 7-day incidences per 100,000 inhabitants per district from the outset of the epidemic in 2020 up to December 1, 2021, are used to construct the dependent variable. Local socio-economic conditions including share of votes, retrieved from the Federal Statistical Office of Germany, have been used as potential risk factors. Socio-economic parameters like per capita income, proportions of protection seekers and social benefit claimants, and educational level have negligible impact on incidence. To the contrary, incidence significantly increases with population density and we observe a strong association with vote shares. Popularity of the right-wing party Alternative for Germany (AfD) bears a considerable risk of increasing COVID-19 incidence both in terms of predicting the maximum incidences during three epidemic periods (alternatively, cumulative incidences over the periods are used to quantify the dependent variable) and in a time-continuous sense. Thus, districts with high AfD popularity rank on top in the time-average regarding COVID-19 incidence. The impact of the popularity of the Free Democrats (FDP) is markedly intermittent in the course of time showing two pronounced peaks in incidence but also occasional drops. A moderate risk emanates from popularities of the Green Party (GRÜNE) and the Christian Democratic Union (CDU/CSU) compared to the other parties with lowest risk level. In order to effectively combat the COVID-19 epidemic, public health policymakers are well-advised to account for social attitudes and behavioral patterns reflected in local popularities of political parties, which are conceived as proper surrogates for these attitudes. Whilst causal relations between social attitudes and the presence of parties remain obscure, the political landscape in terms of share of votes constitutes at least viable predictive “markers” relevant for public health policy making.

Evaluation of Comorbidities as Risk Factors for Fracture-Related Infection and Periprosthetic Joint Infection in Germany.

Introduction: Fracture-related infections (FRI) and periprosthetic joint infections (PJI) represent a major challenge in orthopedic surgery. Incidence of both entities is annually growing. Comorbidities play an important role as an influencing factor for infection and thus, for prevention and treatment strategies. The aims of this study were (1) to analyze the frequency of comorbidities in FRI and PJI patients and (2) to evaluate comorbidities as causative risk factor for PJI and FRI. Methods: This retrospective cohort study analysed all ICD-10 codes, which were coded as secondary diagnosis in all in hospital-treated FRI and PJI in the year 2019 in Germany provided by the Federal Statistical Office of Germany (Destatis). Prevalence of comorbidities was compared with the prevalence in the general population. Results: In the year 2019, 7158 FRIs and 16,174 PJIs were registered in Germany, with 68,304 comorbidities in FRI (mean: 9.5 per case) and 188,684 in PJI (mean: 11.7 per case). Major localization for FRI were infections in the lower leg (55.4%) and forearm (9.2%), while PJI were located mostly at hip (47.4%) and knee joints (45.5%). Mainly arterial hypertension (FRI: n = 3645; 50.9%—PJI: n = 11360; 70.2%), diabetes mellitus type II (FRI: n = 1483; 20.7%—PJI: n = 3999; 24.7%), obesity (FRI: n = 749; 10.5%—PJI: n = 3434; 21.2%) and chronic kidney failure (FRI: n = 877; 12.3%—PJI: n = 3341; 20.7%) were documented. Compared with the general population, an increased risk for PJI and FRI was reported in patients with diabetes mellitus (PJI: 2.988; FRI: 2.339), arterial hypertension (PJI: 5.059; FRI: 2.116) and heart failure (PJI: 6.513; FRI: 3.801). Conclusion: Patients with endocrinological and cardiovascular diseases, in particular associated with the metabolic syndrome, demonstrate an increased risk for orthopedic implant related infections. Based on the present results, further infection prevention and treatment strategies should be evaluated.

The epidemiology and direct healthcare costs of aseptic nonunions in Germany - a descriptive report.

AimsThis observational cross-sectional study aimed to answer the following questions: 1) how has nonunion incidence developed from 2009 to 2019 in a nationwide cohort; 2) what is the age and sex distribution of nonunions for distinct anatomical nonunion localizations; and 3) how high were the costs for surgical nonunion treatment in a level 1 trauma centre in Germany?MethodsData consisting of annual International Classification of Diseases (ICD)-10 diagnosis codes from German medical institutions from 2009 to 2019, provided by the Federal Statistical Office of Germany (Destatis), were analyzed. Nonunion incidence was calculated for anatomical localization, sex, and age groups. Incidence rate ratios (IRRs) were determined and compared with a two-sample z-test. Diagnosis-related group (DRG)-reimbursement and length of hospital stay were retrospectively retrieved for each anatomical localization, considering 210 patients.ResultsIn 2019, a total of 11,840 nonunion cases (17.4/100,000 inhabitants) were treated. In comparison to 2018, the incidence of nonunion increased by 3% (IRR 1.03, 95% confidence interval (CI) 0.53 to 1.99, p = 0.935). The incidence was higher for male cases (IRR female/male: 0.79, 95% CI 0.76 to 0.82, p = 0.484). Most nonunions occurred at the pelvic and hip region (3.6/100,000 inhabitants, 95% CI 3.5 to 3.8), followed by the ankle and foot as well as the hand (2.9/100,000 inhabitants each). Mean estimated DRG reimbursement for in-hospital treatment of nonunions was highest for nonunions at the pelvic and hip region (€8,319 (SD 2,410), p < 0.001).ConclusionDespite attempts to improve fracture treatment in recent years, nonunions remain a problem for orthopaedic and trauma surgery, with a stable incidence throughout the last decade.Cite this article: Bone Joint Res 2022;11(8):541–547.

Impact of the SARS-CoV-2 Pandemic on Liver Surgery and Liver Transplantations in Germany

The SARS-CoV-2 pandemic has led to restrictions in surgical care worldwide and therefore also posed new challenges to liver surgery. The respective procedures often entail high perioperative risks and resource requirements. However, the indication for liver surgery is frequently without alternatives. To date, there is little knowledge about the impact of the pandemic on liver surgery in Germany. A retrospective data analysis of liver surgery procedures in Germany as well as transplantations was conducted. Evaluations were based on procedure codes recorded between 2010 and 2020 according to diagnosis-related groups (DRG) by the Federal Statistical Office of Germany (Destatis) and data from the German Organ Procurement Organization (Deutsche Stiftung Organtransplantation; DSO). According to DRG procedure codes relating to liver surgery recorded between 2010 and 2020 in Germany, the annual fluctuation for the first year of the pandemic 2020 remained comparable to previous years. Furthermore, the development of post-mortem liver transplantations as well as living liver donations remained stable in Germany in 2020 and 2021. The number of liver surgery procedures in Germany was subject to a dynamic development until 2020, without apparent changes in the first year of the SARS-CoV-2 pandemic. The most frequently performed liver procedures, as well as liver transplantations, remained stable with respect to their annually recorded numbers. Publication of data regarding procedures in liver surgery and transplantation in 2021 need to be awaited and analyzed to evaluate whether the observations presented in this article prove stable any further.

Illness-Death Model as a Framework for Chronic Disease Burden Projection: Application to Mental Health Epidemiology.

Estimates of future disease burden supports public health decision-making. Multistate modeling of chronic diseases is still limited despite a long history of mathematical modeling of diseases. We introduce a discrete time approach to the illness-death model and a recursion formula, which can be utilized to project chronic disease burden. We further illustrate an example of the technique applied to anxiety disorders in Germany. The illness-death model is a multistate model that relates prevalence, incidence, mortality, and remission. A basic recursion formula that considers prevalence, incidence, mortality among the susceptible, and mortality among the diseased can be applied to irreversible chronic diseases such as diabetes. Among several mental disorders, remission plays a key role and thus an extended recursion formula taking remission into account is derived. Using the Global Burden of Disease Study 2019 data and population projections from the Federal Statistical Office of Germany, a total number of individuals with anxiety disorders by sex in Germany from 2019 to 2030 was projected. Regression models were fitted to historical data for prevalence and incidence. Differential mortality risks were modeled based on empirical evidence. Remission was estimated from prevalence, incidence, and mortality, applying the extended recursion formula. Sex- and age-specific prevalence of 2019 was given as the initial value to estimate the total number of individuals with anxiety disorders for each year up to 2030. Projections were also made through simple extrapolation of prevalence for comparison. From 2019 to 2030, we estimated a decrease of 52,114 (-1.3%) individuals with anxiety disorders among women, and an increase of 166,870 (+8.5%) cases among men, through the illness-death model approach. With prevalence extrapolation, an increase of 381,770 (+9.7%) among women and an increase of 272,446 (+13.9%) among men were estimated. Application of the illness-death model with discrete time steps is possible for both irreversible chronic diseases and diseases with possible remissions, such as anxiety disorders. The technique provides a framework for disease burden prediction. The example provided here can form a basis for running simulations under varying transition probabilities.

Incidence and treatment of intracapsular femoral neck fractures in Germany

IntroductionIntracapsular femoral neck fractures are one of the most common fractures in Germany. Nevertheless, the epidemiology and treatment modalities are not described comprehensively. For this reason, this study highlights the epidemiology of femoral neck fractures in different age groups and summarizes treatment strategies within the period from 2009 to 2019 based on nationwide data.Materials and methodsIn this retrospective cohort study all cases of intracapsular femoral neck fractures (ICD-10: S72.0) between 2009 and 2019 in Germany were analyzed with regard to epidemiology, incidence and treatment. Operation and procedure classification system (OPS)- codes in combination with intracapsular femoral neck fracture as main diagnosis were taken to investigation. Data was provided by the Federal Statistical Office of Germany (Destatis).ResultsA total of 807,834 intracapsular femoral neck fractures with a mean incidence of 110.0 per 100,000 inhabitants annually was detected within eleven years. In 68.8% of all fractures patients were female. Most patients were older than 70 years (82.4%), and 56.7% were older than 80 years. The overall increase of fracture numbers between 2009 and 2019 was 23.2%. Joint replacement has been most often performed (80.4%). Hemiarthroplasty (56.8%) and total hip arthroplasty (22.8%) were the most common procedures with an increase of 27.1 and 38.6%, respectively. The proportion of cemented hemiarthroplasties was 86.2% while 51.3% of all total hip arthroplasties were totally or partially cemented. Osteosyntheses were mainly conducted using dynamic compression screws (34.0%), conventional screws (31.3%) and nails (22.2%).ConclusionThe incidence of intracapsular femoral neck fractures in Germany has been increasing continuously within the last decade. In particular, patients over 80 years suffered predominantly from this type of fracture. The majority was treated with a joint replacement procedure, mainly cemented hemiarthroplasty.

Termination of Criminal Prosecution followed by the Imposition of Duties and Regulations on the Accused as an Alternative Way to Resolve a Criminal Law Conflict in the German Criminal Procedure

Given the Russian tendency to expand the scope of non-rehabilitating grounds for termination of criminal prosecution/case, the paper examines the legal regulation and law enforcement practice of termination of criminal prosecution with the imposition of various duties and regulations to the accused as one of the alternative ways to resolve a criminal conflict within the framework of the German criminal procedure. The German criminal procedure has a lot in common with the Russian one; both are formed on the principle of lawfulness, or legality. At present, both Russian and German legislators are looking for alternative ways, in addition to procedural coercion or the threat of its use, to resolve the conflict in the process, which contribute to the humanization of criminal legislation, reducing the number of convicts, procedural economy. One of such alternatives in the German criminal procedure is the termination of criminal prosecution followed by the imposition of duties and regulations on the accused. The possibility of termination of criminal prosecution on this basis is provided not only in the Criminal Procedure Code of the Federal Republic of Germany, but also in various sectoral laws, for example, the German Narcotics Law, the German Youth Court Law. An analysis of the statistical data of the Federal Statistical Office in Germany from 2016 to 2020 on the termination of criminal prosecution followed by the imposition of certain duties and regulations to the accused shows the priorities of the German law enforcement officer in terms of choosing individual duties assigned to the accused and, if properly performed, entailing the termination of criminal prosecution. Despite the wide choice of duties and regulations, the law enforcement officer mainly uses the few duties imposed on the accused in order to terminate criminal prosecution. However, the very possibility of a wide choice of potentially possible duties and regulations indicates an individualized approach to the participants of the criminal law conflict in the German criminal procedure, which makes it possible to take into account the interests of all parties to the conflict.

Combined Business Tax Statistics 2016 of the Federal Statistical Office of Germany – A Micro Data Set for Scientific Use

Abstract This article aims to give background information of the combined business tax statistics 2016 of the Federal Statistical Office of Germany. The micro data set includes the different German business tax statistics, which are linked together (i.e. trade tax statistics, corporate income tax statistics, turnover tax statistics, statistics on business partnerships and associations as well as additional information of the statistical business register). With more than three million businesses the micro data set provides linked information on the German business structure and is available in anonymised form for scientific use at the Research Data Centre of the Federal Statistical Office.

Increased aortic repair in Germany correlates with reduction of death caused by aortic aneurysms but not aortic dissections.

We asked if there is a significant correlation between the increasing trend in aortic repair (AR) and decreasing aortic aneurysm (AA) and aortic dissection (AD) mortality? Therefore, we retrospectively analyzed all aortic repairs in patients with AA and AD and its correlation with disease-specific death rates and hospitalizations for ruptured AA and AD in Germany. We retrieved the number of cases hospitalized for AA and AD as well as the procedures in these cases from the Federal Bureau of Statistics (DRG statistics) and death rates from the national mortality statistic published by the Federal Statistical Office in Germany for the years 2006-2017. From 2006 to 2017, the total number of hospitalized cases admitted with principal diagnosis of AA increased by 25.8% and that of AD by 56.7%. That of cases with the principal diagnosis of ruptured AA (rAA) remained unchanged (-2.5%) and that with rAD increased by 54.6%. The number of (open and endovascular) procedures in cases hospitalized for AA increased by 39.4% and for AD by 126.4%. The age-adjusted death rates in Germany for AA decreased from 4.0 to 2.9 per 100,000 inhabitants and that for AD increased from 1.0 to 1.4. The decrease in death attributed to AA cases can be described by linear regression as y = -0.0003*y + 6.7076 (p < 0.0001). Accepting this association between increased elective procedures and reduced AA mortality, each/all 1000 procedures save 0.3 lives per 100,000 inhabitants. Despite increasing numbers of AR for AA and AD, only the mortality rate for all AAs decreased, while we did not observe a decrease in overall mortality of AD in Germany.