Dominitz J A, Provenzale D
Department of Medicine, Veterans Affairs Puget Sound Health Care System and the University of Washington School of Medicine, Seattle 98108, USA.
Am J Gastroenterol. 1999 Aug;94(8):2086-93. doi: 10.1111/j.1572-0241.1999.01282.x.
Medications used to treat gastrointestinal symptoms account for a substantial share of pharmacy expenses for veterans affairs medical centers. Prior studies have shown that the prevalence of peptic ulcer disease is higher in veterans than in nonveterans. Our aim was to determine the prevalence of upper gastrointestinal symptoms among patients seeking health care in the Department of Veterans Affairs outpatient clinics.
A total of 1582 veterans completed a previously validated bowel symptom questionnaire in the following clinics: gastroenterology (n = 693), walk-in (n = 403), general medicine (n = 379), and women's health (n = 107).
Overall response was 78%. Dyspepsia was reported in 30%, 37%, 44%, and 53% of patients in general medicine, walk-in, women's health, and gastroenterology clinics, respectively. Heartburn, at least weekly, was reported in 21%, 21%, 28%, and 40% of patients in general medicine, walk-in, women's health, and gastroenterology clinics, respectively. Prior peptic ulcer disease (PUD) was reported in 29%, 26%, 22%, and 44% of patients in general medicine, walk-in, women's health, and gastroenterology clinics, respectively. Dyspepsia, heartburn, and PUD were significantly associated with increased physician visits and lower general health.
Dyspepsia and heartburn are common symptoms among veterans. Lifetime prevalence of PUD is high among veterans. Gastrointestinal symptoms have a significant impact on health care utilization and general health. These prevalence estimates provide a basis for studies of resource utilization and for cost-effectiveness analyses of the treatment of gastrointestinal disorders in the veteran population. Moreover, the high prevalence of symptoms helps to explain the high utilization of gastrointestinal medications.
用于治疗胃肠道症状的药物在退伍军人事务医疗中心的药房费用中占很大比例。先前的研究表明,消化性溃疡疾病在退伍军人中的患病率高于非退伍军人。我们的目的是确定在退伍军人事务部门诊诊所寻求医疗服务的患者中上胃肠道症状的患病率。
共有1582名退伍军人在以下诊所完成了一份先前经过验证的肠道症状问卷:胃肠病科(n = 693)、即诊部(n = 403)、普通内科(n = 379)和妇女健康科(n = 107)。
总体回复率为78%。普通内科、即诊部、妇女健康科和胃肠病科诊所分别有30%、37%、44%和53%的患者报告有消化不良症状。普通内科、即诊部、妇女健康科和胃肠病科诊所分别有21%、21%、28%和40%的患者报告至少每周出现一次烧心症状。普通内科、即诊部、妇女健康科和胃肠病科诊所分别有29%、26%、22%和44%的患者报告有既往消化性溃疡疾病(PUD)。消化不良、烧心和PUD与就诊次数增加和总体健康状况较差显著相关。
消化不良和烧心是退伍军人中的常见症状。退伍军人中PUD的终生患病率很高。胃肠道症状对医疗服务利用和总体健康有重大影响。这些患病率估计为资源利用研究以及退伍军人人群胃肠道疾病治疗的成本效益分析提供了基础。此外,症状的高患病率有助于解释胃肠道药物的高使用率。