Zhao Yuejen, Connors Christine, Wright Jo, Guthridge Steve, Bailie Ross
Health Gains Planning Branch, Department of Health and Families, Casuarina, Northern Territory.
Aust N Z J Public Health. 2008 Aug;32(4):307-13. doi: 10.1111/j.1753-6405.2008.00245.x.
To determine the prevalence rates of hypertension, diabetes, ischaemic heart disease (IHD), renal disease and chronic obstructive pulmonary disease (COPD), and their co-occurrence among the remote Aboriginal population of the Northern Territory (NT) in 2005.
Information from a primary care chronic disease register (CDR) and hospital inpatient database were linked to a population list by using a unique patient identifier. A capture-recapture method (CRM) and multivariate log-linear models were then applied to analyse the multiple datasets to estimate the prevalence rates for the selected diseases and case ascertainment in each data source.
The NT remote Aboriginal communities had considerably higher prevalence rates across all five chronic diseases than national health survey figures. At ages 50 years and over, the prevalence rates for hypertension and renal disease were above 50%, diabetes 40%, COPD 30% and IHD above 20%. In terms of data completeness, CDR and hospital sources were both relatively incomplete, generally around 20-60%. The most common co-occurrences for the five chronic diseases were between hypertension, diabetes, IHD and renal disease.
The prevalence rates calculated using this method are comparable to estimates from rigorous small area studies, but are markedly higher than those from single clinical data sources. The results indicate that there is a considerable under-diagnosis of preventable chronic diseases in the Aboriginal communities.
确定2005年北领地(NT)偏远原住民人群中高血压、糖尿病、缺血性心脏病(IHD)、肾病和慢性阻塞性肺疾病(COPD)的患病率及其共病情况。
通过使用唯一患者标识符,将初级保健慢性病登记册(CDR)和医院住院患者数据库中的信息与人口列表相链接。然后应用捕获-再捕获方法(CRM)和多变量对数线性模型分析多个数据集,以估计所选疾病的患病率以及每个数据源中的病例确诊情况。
NT偏远原住民社区所有五种慢性病的患病率均远高于全国健康调查数据。在50岁及以上人群中,高血压和肾病的患病率超过50%,糖尿病为40%,COPD为30%,IHD超过20%。在数据完整性方面,CDR和医院数据源都相对不完整,一般在20%-60%左右。五种慢性病最常见的共病情况发生在高血压、糖尿病、IHD和肾病之间。
使用该方法计算出的患病率与严格的小区域研究估计值相当,但明显高于单一临床数据源的估计值。结果表明,原住民社区中可预防的慢性病存在大量诊断不足的情况。