Snijders Bianca, van der Hoek Wim, Stirbu Irina, van der Sande Marianne A B, van Gageldonk-Lafeber Arianne B
Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Prim Care Respir J. 2013 Dec;22(4):400-5. doi: 10.4104/pcrj.2013.00085.
Community-acquired pneumonia (CAP) is an important cause of hospital admission and death, but the extent of the problem of CAP at the primary healthcare level is largely unknown.
To investigate the contribution of general practitioners (GPs) to the management of patients with CAP in the Netherlands.
The study population consisted of all people enlisted in a GP network. We obtained information on CAP episodes from GP electronic records (using ICPC code R81) during the years 2002-2009. CAP registrations were also obtained from national hospital discharge data (ICD-9 codes) and cause of death statistics (ICD-10 codes). The three registration systems were linked at the individual level. We used descriptive analyses to estimate the annual number of CAP episodes (i.e. defined as a CAP diagnosis within 30 days).
From 2002 to 2009 the mean annual size of the study population was 395,039. For this population, 3,700 (0.9%) CAP episodes per year were registered in at least one of the registration systems, 2,933 (79%) of which were in the GP system only. Recovery within 30 days occurred on average in 95% (2,791/2,933) of the CAP episodes annually registered by a GP, while 2.3% (67/2,933) of patients with a GP-registered CAP episode were admitted to hospital within 30 days and 1% (26/2,933) had a fatal outcome within 30 days.
The vast majority of CAP episodes registered in the Netherlands are managed successfully at the GP level without hospitalisation.
社区获得性肺炎（CAP）是入院和死亡的重要原因，但在基层医疗保健层面CAP问题的严重程度很大程度上未知。
调查荷兰全科医生（GP）对CAP患者管理的贡献。
研究人群包括在一个全科医生网络登记的所有人。我们从2002年至2009年的全科医生电子记录（使用国际初级保健分类代码R81）中获取CAP发作的信息。CAP登记也从国家医院出院数据（国际疾病分类第九版代码）和死亡原因统计（国际疾病分类第十版代码）中获取。这三个登记系统在个体层面进行关联。我们使用描述性分析来估计每年CAP发作的数量（即定义为30天内的CAP诊断）。
2002年至2009年，研究人群的年平均规模为395,039人。对于该人群，每年至少在一个登记系统中登记了3,700例（0.9%）CAP发作，其中2,933例（79%）仅在全科医生系统中。全科医生每年登记的CAP发作中，平均95%（2,791/2,933）在30天内康复，而2.3%（67/2,933）的全科医生登记CAP发作患者在30天内入院，1%（26/2,933）在30天内有致命结局。
在荷兰登记的绝大多数CAP发作在全科医生层面得到成功管理，无需住院治疗。
