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01-12-2021 | Septicemia | Research article

Association between sepsis incidence and regional socioeconomic deprivation and health care capacity in Germany – an ecological study

Authors: Norman Rose, Claudia Matthäus-Krämer, Daniel Schwarzkopf, André Scherag, Sebastian Born, Konrad Reinhart, Carolin Fleischmann-Struzek

Published in: BMC Public Health | Issue 1/2021

Abstract

Background

Sepsis is a substantial health care burden. Data on regional variation in sepsis incidence in Germany and any possible associations with regional socioeconomic deprivation and health care capacity is lacking.

Methods

Ecological study based on the nationwide hospital Diagnosis-related Groups (DRG) statistics data of 2016. We identified sepsis by ICD-10-codes and calculated crude and age-standardized incidence proportions in the 401 administrative German districts. Associations between socioeconomic and health care capacity indicators and crude and age-adjusted sepsis incidence were investigated by simple and multiple negative binomial (NB) regressions.

Results

In 2016, sepsis incidence was 178 per 100,000 inhabitants and varied 10-fold between districts. We found that the rate of students leaving school without certificate was significantly associated with crude and age-standardized explicit sepsis incidence in the simple and multiple NB regressions. While we observed no evidence for an association to the capacity of hospital beds and general practitioners, the distance to the nearest pharmacy was associated with crude- and age-standardized sepsis incidence. In the multiple regression analyses, an increase of the mean distance + 1000 m was associated with an expected increase by 21.6 [95% CI, 10.1, 33.0] (p < 0.001), and 11.1 [95% CI, 1.0, 21.2]/100,000 population (p = .026) after adjusting for age differences between districts.

Conclusions

Residence in districts with lower socioeconomic status (e.g., less education) and further distance to pharmacies are both associated with an increased sepsis incidence. This warrants further research with individual-level patient data to better model and understand such dependencies and to ultimately design public health interventions to address the burden of sepsis in Germany.

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Title: Association between sepsis incidence and regional socioeconomic deprivation and health care capacity in Germany – an ecological study
Authors: Norman Rose
Claudia Matthäus-Krämer
Daniel Schwarzkopf
André Scherag
Sebastian Born
Konrad Reinhart
Carolin Fleischmann-Struzek
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Septicemia
Septicemia
Care
Published in: BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-021-11629-4

2024 ASCO Annual Meeting

Springer Medicine

Association between sepsis incidence and regional socioeconomic deprivation and health care capacity in Germany – an ecological study

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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