Wiréhn Ann-Britt E, Karlsson H Mikael, Carstensen John M
Department of Health and Society, Linköping University, Linköping, Sweden.
Scand J Public Health. 2007;35(4):424-31. doi: 10.1080/14034940701195230.
In Ostergötland County, Sweden, all data on hospital care and primary healthcare (PHC) have been entered in a diagnosis-related administrative database since 1999. This database was used to estimate the prevalence of four chronic diseases and to examine the capture of data in PHC, outpatient hospital care, and inpatient hospital care, considered in different time frames.
A case-finding algorithm identified patients with at least one healthcare contact involving a diagnosis of diabetes, hypertension, asthma, or chronic obstructive pulmonary disease (COPD) in 1999-2003. Prevalence rates were calculated as the ratio of the number of identified patients alive to the total number of inhabitants on 31 December 2003 (n approximately 415,000).
Prevalence rates were 4.4% for diabetes, 10.3% for hypertension, 4.5% for asthma, and 1.2% for COPD. For all four diagnoses, the proportions of patients identified on only one healthcare level were greatest for PHC, reaching rates of 23%, 68%, 53%, and 48%, respectively. The cases identified solely in PHC comprised larger proportions of women and patients over the age of 65 years. Considering the proportion of patients identified in 2003 in relation to the total five-year period gave values of 71%, 50%, 38%, and 58%, respectively, for the four diagnoses.
The administrative healthcare databases in Sweden today can be important tools in epidemiological research. However, data on several consecutive years and both PHC and hospital data are needed to achieve valid prevalence estimates.
在瑞典东约特兰省，自1999年起所有医院护理和初级卫生保健（PHC）数据都已录入一个与诊断相关的行政数据库。该数据库用于估计四种慢性病的患病率，并检查在不同时间框架内初级卫生保健、医院门诊护理和医院住院护理中的数据采集情况。
一种病例查找算法识别出在1999 - 2003年期间至少有一次医疗接触且诊断为糖尿病、高血压、哮喘或慢性阻塞性肺疾病（COPD）的患者。患病率计算为2003年12月31日存活的已识别患者数量与居民总数（约415,000人）的比率。
糖尿病患病率为4.4%，高血压为10.3%，哮喘为4.5%，COPD为1.2%。对于所有这四种诊断，仅在一个医疗层面识别出的患者比例在初级卫生保健中最高，分别达到23%、68%、53%和48%。仅在初级卫生保健中识别出的病例中女性和65岁以上患者所占比例更大。考虑到2003年识别出的患者占整个五年期的比例，这四种诊断分别为71%、50%、38%和58%。
如今瑞典的行政医疗保健数据库可能是流行病学研究中的重要工具。然而，需要连续数年的数据以及初级卫生保健和医院数据才能获得有效的患病率估计值。
