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Kristina Hagenström,1 Kristin Sauer,1 Nicole Mohr,1 Marleen Dettmann,1 Gerd Glaeske,2 Jana Petersen,1 Claudia Garbe,1 Tim Steimle,3 Matthias Augustin1 1German 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; 2Research Center on Inequality and Social Policy, University of Bremen, Bremen, Germany; 3Techniker Krankenkasse, Hamburg, GermanyCorrespondence: Kristina HagenströmGerman Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg, 20246, GermanyTel +49 (0) 40 7410 554 28Fax +49 (0) 40 7410 553 48Email k.hagenstroem@uke.deBackground: Information on the prevalence of atopic dermatitis (AD) varies greatly, and so far, only a few studies describe the healthcare of patients with AD in Germany.Objective: The aim of the study is to describe the prevalence and medications of people with AD in Germany.Methods: Health insurance data for the year 2019 were examined. Prevalence rates, the severity of disease, comorbidities and pharmaceutical supply were analyzed. Insured persons with AD were identified with at least one outpatient or inpatient International Classification Code of Diseases (L20).Results: In 2019, 4.21% [95% CI 4.21− 4.22%] of insured persons had AD (3.6 million). Women were affected slightly more frequently than men (4.74% [95% CI 4.73− 4.74%] and 3.64% [95% CI 3.64− 3.65%]). Adolescents and children under the age of 15 had the highest prevalence of AD compared to other age groups (9.44% [95% CI 9.42− 9.46%]). Majority of the insured persons with AD were affected by a mild to moderate form of the disease. The most common co-morbidity was infections of the skin (RR 5.00 [95% CI 4.97− 5.02%]). Some patients were treated by a dermatologist, whil

The current thesis elucidates the state of the art of interdisciplinary teamwork and so called multimodal therapy for chronic conditions in children and adolescents. Specifically, it covers cystic fibrosis (CF) and mental health problems, conditions of high relevance for public health. First, two analyses of a) survey data of a nationwide representative German sample and b) claims data of a statutory health insurance fund present frequencies of children and adolescents with common mental health problems and CF. Survey analyses show results depending on statistical and clinical case definition strategies on the one hand and differences between parent- and self-report on the other hand. Estimates on the incidence of CF based on claims data analyses are in line with the existing literature. Second, two systematic guideline reviews synthesize recommendations on multimodal therapy for concerned children and adolescents and discuss the results against the background of social legislation in the statutory health care system. Results show defi-cits in statutory conditions for interdisciplinary teamwork in the outpatient health care setting, revealing a need for change in the general conditions for multimodal therapy. Third, a) a survey on the health care utilization in a sample of patients of a CF-centre indicates high rates of children and adolescents with CF who do not receive multimodal therapy despite of a below average health related quality of life and a clear need for treatment. b) A claims data analysis presents important insight into the current utilization patterns of children and adolescents with common mental health problems. Against guideline recommendations for later pharmacological treatment, age is hardly ever associated with drug prescription in the common mental health problems. Fourth, emphasizing the need of scientific pilot projects, an action plan is suggested to improve the structural and process quality of multimodal therapy. A theoretical concept il

The current thesis elucidates the state of the art of interdisciplinary teamwork and so called multimodal therapy for chronic conditions in children and adolescents. Specifically, it covers cystic fibrosis (CF) and mental health problems, conditions of high relevance for public health. First, two analyses of a) survey data of a nationwide representative German sample and b) claims data of a statutory health insurance fund present frequencies of children and adolescents with common mental health problems and CF. Survey analyses show results depending on statistical and clinical case definition strategies on the one hand and differences between parent- and self-report on the other hand. Estimates on the incidence of CF based on claims data analyses are in line with the existing literature. Second, two systematic guideline reviews synthesize recommendations on multimodal therapy for concerned children and adolescents and discuss the results against the background of social legislation in the statutory health care system. Results show defi-cits in statutory conditions for interdisciplinary teamwork in the outpatient health care setting, revealing a need for change in the general conditions for multimodal therapy. Third, a) a survey on the health care utilization in a sample of patients of a CF-centre indicates high rates of children and adolescents with CF who do not receive multimodal therapy despite of a below average health related quality of life and a clear need for treatment. b) A claims data analysis presents important insight into the current utilization patterns of children and adolescents with common mental health problems. Against guideline recommendations for later pharmacological treatment, age is hardly ever associated with drug prescription in the common mental health problems. Fourth, emphasizing the need of scientific pilot projects, an action plan is suggested to improve the structural and process quality of multimodal therapy. A theoretical concept il