利用出院数据和关联实验室数据评估香港儿童呼吸系统疾病的疾病负担。

Assessing disease burden of respiratory disorders in Hong Kong children with hospital discharge data and linked laboratory data.

作者信息

Nelson Edmund A S, Tam J S, Yu L M, Li A M, Chan Paul K S, Sung Rita Y T

机构信息

Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.

出版信息

Hong Kong Med J. 2007 Apr;13(2):114-21.

PMID:17406038

Abstract

OBJECTIVES

To describe the pattern of respiratory disorders in the Hong Kong paediatric population admitted to government hospitals, and to assess the reliability of the diagnoses by linkage with laboratory data.

METHODS

Discharge diagnoses for all admissions are recorded in a central computerised database, the Clinical Management System. These data were analysed for the inclusive period July 1997 to June 1999. Virology laboratory results from a single hospital were linked to the Clinical Management System diagnostic codes to examine discrepancies in coding specific viral aetiologies.

RESULTS

A primary diagnosis of a respiratory disorder was noted in 37.5% (upper respiratory 30.1%, tonsillitis/pharyngitis 10.5%, croup/laryngitis 2.3%, acute otitis media 2.7%, bronchitis/chest infection 2.6%, bronchiolitis 10.2%, pneumonia 20.9%, influenza 4%, asthma and allergic rhinitis 16.5%), and a primary or secondary diagnosis in 42.5% of children younger than 15 years. The incidence rates of respiratory illness coded as bronchiolitis and influenza were respectively estimated to be 887-979 and 222-381 per 100,000 children under 5 years and 3551-3949 and 415-528 per 100,000 children under the age of 1 year. The percentage of respiratory-associated admissions varied significantly by hospital and detailed analysis of data at one hospital highlighted important discrepancies between discharge diagnosis and laboratory results.

CONCLUSIONS

These passive surveillance data provide general estimates of the disease burden for respiratory disorders in Hong Kong children. Active surveillance studies are required to provide more accurate estimates of the disease burden. Consideration should be given to enhance the Clinical Management System by routinely linking all laboratory data with discharge diagnosis information, by establishing sentinel surveillance hospitals and by assessing new strategies to standardise coding.

摘要

目的

描述入住政府医院的香港儿童人群中的呼吸系统疾病模式，并通过与实验室数据关联来评估诊断的可靠性。

方法

所有住院病例的出院诊断记录在中央计算机化数据库“临床管理系统”中。对1997年7月至1999年6月这一时间段的数据进行分析。将一家医院的病毒学实验室结果与临床管理系统诊断编码相联系，以检查特定病毒病因编码中的差异。

结果

37.5%的病例主要诊断为呼吸系统疾病（上呼吸道疾病占30.1%，扁桃体炎/咽炎占10.5%，哮吼/喉炎占2.3%，急性中耳炎占2.7%，支气管炎/肺部感染占2.6%，细支气管炎占10.2%，肺炎占20.9%，流感占4%，哮喘和变应性鼻炎占16.5%），15岁以下儿童中42.5%有主要或次要诊断。编码为细支气管炎和流感的呼吸系统疾病发病率估计分别为每10万名5岁以下儿童887 - 979例和222 - 381例，每10万名1岁以下儿童3551 - 3949例和415 - 528例。与呼吸系统相关的住院病例百分比因医院而异，对一家医院的数据详细分析突出了出院诊断与实验室结果之间的重要差异。