Fleming Douglas M, Cross Kenneth W, Barley Michele A
Birmingham Research Unit of the Royal College of General Practitioners, Birmingham, UK.
Br J Gen Pract. 2005 Aug;55(517):589-95.
Practice-based morbidity surveys inform on the prevalence of diseases presenting for health care. The last major survey in England and Wales was conducted in 1991.
To reveal changes in disease prevalence between 1991 and 2001.
Population-based analysis of persons presenting to GPs. Annual prevalence of diseases reported in the Weekly Returns Service (WRS) of the Royal College of General Practitioners in 2001 was compared with prevalence reported in Morbidity Statistics from General Practice, Fourth National Study (MSGP4).
Thirty-eight general practices contributing to the WRS, monitoring a population of 326,000 in 2001.
Prevalence was determined from Read codes for morbidity entered in the respective survey years. Diseases and disease groups were defined from Read codes mapping to the chapters, major sub-groups and 3-digit codes of the International Classification of Disease version 9 (ICD9). Age-standardised prevalence rates per 10,000 registered persons and 99% confidence intervals (CIs) were calculated using the national census population for 2001 as the standard. Survey differences in prevalence were identified from non-overlapping CIs.
There was a general reduction in the prevalence of disease caused by infection and an increase of degenerative disorders. The prevalence of mental disorders, skin disease and musculoskeletal disorders showed little change. Particular increases were noted for other malignant and benign neoplasms of the skin, hypothyroidism and diabetes. There were marked reductions for disorders of the conjunctiva, ear infections, acute myocardial infarction and heart failure, respiratory infections and injuries.
The role of the GP continues to change. These results confirm the importance of the management of chronic diseases as the dominant (though not the sole) role of the GP. The results demonstrate the use of the WRS as a source of data on disease prevalence.
基于实践的发病率调查可了解到寻求医疗保健的疾病患病率情况。英格兰和威尔士上一次的主要调查是在1991年进行的。
揭示1991年至2001年间疾病患病率的变化。
对向全科医生求诊的人群进行基于人群的分析。将2001年皇家全科医师学院每周回报服务（WRS）中报告的疾病年患病率与第四次全国全科医疗发病率统计研究（MSGP4）中报告的患病率进行比较。
38家参与WRS的全科诊所，2001年监测人群为326,000人。
根据各调查年份输入的发病情况的Read编码确定患病率。根据与《国际疾病分类》第9版（ICD9）的章节、主要亚组和三位编码相对应的Read编码来定义疾病和疾病组。以2001年全国人口普查人口为标准，计算每10,000名登记人口的年龄标准化患病率及99%置信区间（CI）。通过非重叠的CI来确定患病率的调查差异。
由感染引起的疾病患病率普遍下降，退行性疾病患病率上升。精神障碍、皮肤病和肌肉骨骼疾病的患病率变化不大。皮肤的其他恶性和良性肿瘤、甲状腺功能减退症和糖尿病的患病率尤其有所增加。结膜疾病、耳部感染、急性心肌梗死和心力衰竭、呼吸道感染及损伤的患病率显著下降。
全科医生的角色在持续变化。这些结果证实了管理慢性病作为全科医生主要（尽管不是唯一）角色的重要性。结果表明WRS可作为疾病患病率数据的来源。
