Use of Mental Health Care Services by People with Depression in Germany: a Secondary Data Analysis

Introduction According toepidemiologic studies, depression is one of the most frequentmental disorders in Germany. Based on the secondary data of three statutoryhealth insurers and the German Pension Fund, the utilization of mental healthcare services of people with depression was analyzed. Objectives The analysesdescribe the utilization of in- and outpatient mental health care services ofpeople with depression by different disciplines and utilization patterns overtime (pathways of care). Aim The main aim was to analyze mental healthcareutilization of people with depression in Germany in 2005–2007 in order toidentify areas of potential optimization of mental health care. Methods Secondary data of three statutory health insurancecompanies and of the German Pension Funds of the years 2005-2007 were used forthese analyses. The analyses are based on 1,435,133 persons with at least onediagnosis of a depression (F32/F33) in 2005-2007. Results The majority (73 %) of depression diagnoses wereclassified as ‘‘unspecified’’. For both inpatients and outpatients, aconsiderable proportion of care for mental illnesses was provided by primarycare physicians/other specialists in somatic medicine. Analyses of the pathwaysof care of people with severe depression revealed low levels of collaborationbetween primary and specialized care as well as outpatient and inpatienttreatment. Conclusions Setting aside boundaries between different disciplines and sectors, theuse of secondary data can, despite its limitations, contributes to thedetection of under- and overdiagnosis, mistaken allocation, and intersectoralinterface problems.