García-Palmieri Mario R, Pérez-Perdomo Rosa, Colón Samira Rosa
School of Medicine and Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
Bol Asoc Med P R. 2005 Oct-Dec;97(4):259-68.
OBJECTIVE To study the prevalence of cardiovascular conditions and health services utilization in Puerto Rico, 2001. METHODS All medical claims for coronary heart disease (ICD-9 410-414), hypertension (ICD-9 401-405), congestive heart failure (ICD-9 428) and cerebrovascular accidents and transient ischemia (ICD-9:430-438.9) submitted for reimbursement purposes to an insurance company (private and public sector) in Puerto Rico in 2001 were identified. Prevalence and medical care utilization concerning cardiovascular conditions was estimated with 95% confidence. RESULTS Overall prevalence of cardiovascular conditions was 13.5% (95% CI: 11.68%-15.44%), being larger in the private sector (16.0%; 95% CI: 15.98%-16.08% vs. 11.7%; 95% CI: 11.62%-11.77%). Although in both sectors prevalence increased with age, at same age groups was two times higher in the private sector. Hypertension was the most prevalent condition (9.7; 95% CI: 8.14%-11.41%) being higher in females (10.4; 95% CI: 10.37%-10.51%) than in males (8.9; 95% CI: 8.81%-8.96%). The health service utilization (physician's office visits, emergency room visits, and hospital admissions) was higher in males. However, it varies by sectors. CONCLUSIONS Significant difference exists in the prevalence of cardiovascular conditions and health services utilization among private and public sectors in Puerto Rico. The observed differences among the private and public populations imply that there are factors such as socioeconomic status, education, lifestyles, environmental hazards in neighborhoods, and health habits that could be involved in the differences.
目的 研究2001年波多黎各心血管疾病的患病率及医疗服务利用情况。方法 确定2001年提交给波多黎各一家保险公司(私营和公共部门)用于报销目的的所有冠心病(国际疾病分类第九版410 - 414)、高血压(国际疾病分类第九版401 - 405)、充血性心力衰竭(国际疾病分类第九版428)以及脑血管意外和短暂性脑缺血(国际疾病分类第九版:430 - 438.9)的医疗索赔。对心血管疾病的患病率和医疗服务利用情况进行95%置信度的估计。结果 心血管疾病的总体患病率为13.5%(95%置信区间:11.68% - 15.44%),私营部门的患病率更高(16.0%;95%置信区间:15.98% - 16.08%,相比之下公共部门为11.7%;95%置信区间:11.62% - 11.77%)。虽然在两个部门患病率均随年龄增长而升高,但在同一年龄组中私营部门的患病率是公共部门的两倍。高血压是最常见的疾病(9.7;95%置信区间:8.14% - 11.41%),女性患病率(10.4;95%置信区间:10.37% - 10.51%)高于男性(8.9;95%置信区间:8.81% - 8.96%)。男性的医疗服务利用率(看医生、急诊就诊和住院)更高。然而,这因部门而异。结论 波多黎各私营和公共部门在心血管疾病患病率及医疗服务利用方面存在显著差异。在私营和公共人群中观察到的差异意味着社会经济地位、教育程度、生活方式、社区环境危害以及健康习惯等因素可能与这些差异有关。