Harlan W R, Parsons P E, Thomas J W, Murt H A, Lepkowski J M, Guire K E, Berki S E, Landis J R
Natl Med Care Util Expend Surv C. 1989 Nov(7):iii-iv, 1-71.
Cardiovascular conditions have a major economic as well as health impact on adults in the United States. In the National Medical Care Utilization and Expenditure Survey, conducted during 1980, health service data were obtained from a national sample of 17,123 civilian noninstitutionalized individuals. These data have been analyzed to define the impact and demographic patterns of health care utilization and costs attributable to adult cardiovascular conditions. Approximately 28 million persons in the United States, or 17.3 percent of the total civilian noninstitutionalized population 17 years of age and over, had a cardiovascular condition during 1980. Cardiovascular conditions were reported with increasing frequency in successively older age groups and were reported most frequently by black persons. The prevalence and economic impact differed by specific type of cardiovascular condition and whether the condition was complicated by another disease. To examine these differences, persons reporting cardiovascular conditions were categorized into four mutually exclusive groups: persons with hypertension alone, persons with arteriosclerotic cardiovascular and cerebrovascular disease associated with hypertension, persons with arteriosclerotic cardiovascular disease alone, and persons with cardiovascular disease associated with other conditions that might alter medical care utilization and disability. The disability, service utilization, and health care charges were compared among these groups, and data for each group were compared with those for the overall U.S. population. Survey participants were asked to rate their health relative to that of other people their age. The self-rating of persons reporting hypertension alone was lower than the national average. Only 17 percent of the general population rated their health as "fair" or "poor," but 27 percent of persons with hypertension alone used these descriptions. Overall, persons with hypertension alone were much less likely to be employed than the general population (52.2 percent versus 71.6 percent). However, when controlling for age, it was found that persons with hypertension alone were about as likely to be employed as the general population. On the average, persons with hypertension reported only slightly more work-loss days than did the general population (6.5 versus 4.9 days). A modest restriction of activity was reported by those with hypertension alone (20.1 days per year on the average compared with 15.6 for the general population). The mean number of ambulatory visits per year for those with hypertension alone was 7.9, only slightly greater than the 5.7 average for the overall population.(ABSTRACT TRUNCATED AT 400 WORDS)
心血管疾病对美国成年人的经济和健康都有重大影响。在1980年进行的全国医疗保健利用与支出调查中,健康服务数据取自全国17123名非机构化平民的样本。这些数据经过分析,以确定成人心血管疾病导致的医疗保健利用和成本的影响及人口模式。1980年,美国约有2800万人患有心血管疾病,占17岁及以上非机构化平民总人口的17.3%。心血管疾病在年龄较大的人群中报告频率越来越高,黑人报告的频率最高。心血管疾病的患病率和经济影响因具体类型以及是否并发其他疾病而有所不同。为了研究这些差异,报告患有心血管疾病的人被分为四个相互排斥的组:仅患有高血压的人、患有与高血压相关的动脉硬化性心血管和脑血管疾病的人、仅患有动脉硬化性心血管疾病的人,以及患有与其他可能改变医疗保健利用和残疾状况的疾病相关的心血管疾病的人。对这些组之间的残疾、服务利用和医疗保健费用进行了比较,并将每组数据与美国总体人口的数据进行了比较。调查参与者被要求将自己的健康状况与同年龄的其他人进行比较。仅患有高血压的人的自我评估低于全国平均水平。只有17%的普通人群将自己的健康状况评为“一般”或“差”,但仅患有高血压的人中有27%使用了这些描述。总体而言,仅患有高血压的人就业的可能性比普通人群低得多(分别为52.2%和71.6%)。然而,在控制年龄后发现,仅患有高血压的人与普通人群就业的可能性大致相同。平均而言,仅患有高血压的人报告的误工天数仅比普通人群略多(分别为6.5天和4.9天)。仅患有高血压的人报告活动有适度限制(平均每年20.1天,而普通人群为15.6天)。仅患有高血压的人每年的门诊就诊平均次数为7.9次,仅略高于总体人口的平均5.7次。(摘要截取自400字)