Centers for Disease Control and Prevention, Mailstop K-40, 4770 Buford Hwy NE, Atlanta, GA 30341, USA.
Prev Chronic Dis. 2013 Apr 25;10:E66. doi: 10.5888/pcd10.120239.
Current trends in US population growth, age distribution, and disease dynamics foretell rises in the prevalence of chronic diseases and other chronic conditions. These trends include the rapidly growing population of older adults, the increasing life expectancy associated with advances in public health and clinical medicine, the persistently high prevalence of some risk factors, and the emerging high prevalence of multiple chronic conditions. Although preventing and mitigating the effect of chronic conditions requires sufficient measurement capacities, such measurement has been constrained by lack of consistency in definitions and diagnostic classification schemes and by heterogeneity in data systems and methods of data collection. We outline a conceptual model for improving understanding of and standardizing approaches to defining, identifying, and using information about chronic conditions in the United States. We illustrate this model's operation by applying a standard classification scheme for chronic conditions to 5 national-level data systems. Although the literature does not support a single uniform definition for chronic disease, recurrent themes include the non-self-limited nature, the association with persistent and recurring health problems, and a duration measured in months and years, not days and weeks--Thrall. So far, many different approaches have been used to measure the prevalence and consequences of chronic diseases and health conditions in children, resulting in a wide variability of prevalence estimates that cannot be readily compared--van der Lee et al.
当前美国人口增长、年龄分布和疾病动态的趋势预示着慢性病和其他慢性病的患病率将会上升。这些趋势包括老年人口的迅速增长、公共卫生和临床医学进步带来的预期寿命的延长、一些风险因素的持续高发以及多种慢性病的新兴高发。尽管预防和减轻慢性病的影响需要足够的衡量能力，但由于定义和诊断分类方案缺乏一致性，以及数据系统和数据收集方法的异质性，这种衡量受到了限制。我们概述了一个概念模型，以提高对美国定义、识别和使用慢性病信息的方法的理解和标准化。我们通过将慢性疾病的标准分类方案应用于 5 个国家级数据系统来说明该模型的运作。尽管文献不支持对慢性病采用单一统一的定义，但反复出现的主题包括非自限性、与持续和反复出现的健康问题的关联，以及以月和年而不是天和周来衡量的持续时间——Thrall。到目前为止，已经使用了许多不同的方法来衡量儿童慢性病和健康状况的患病率和后果，导致患病率估计值差异很大，无法直接比较——van der Lee 等人。
