Cox Brian, McBride David, Broughton John, Tong Darryl
Hugh Adam Cancer Epidemiology Unit, University of Otago, Dunedin, New Zealand.
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
BMJ Open. 2015 Dec 9;5(12):e008409. doi: 10.1136/bmjopen-2015-008409.
To inform the provision of support to veterans by analysing hospital discharge data, thereby identifying which conditions show an excess risk, require specific management strategies and deserve further investigation.
Tertiary level care, including all public and private New Zealand hospitals.
All New Zealand Vietnam veterans with service between 1964 and 1972.
Standardised hospitalisation ratios (SHRs) were calculated based on the number of first observed hospital admissions for a condition, those expected being based on New Zealand national hospitalisation rates.
The SHR for all causes of hospitalisation was 1.18, 95% CI 1.15 to 1.21, with modest increases for the major common causes, cardio and cerebrovascular disease. Admission rates for chronic renal failure and chronic obstructive pulmonary disease were highest in the 2006-2009 time period. The highest statistically significant hospitalisation risk was for alcohol-related mental disorder, SHR 1.91, 99% CI 1.39 to 2.43.
Chronic renal failure has limited attribution to veteran service but along with chronic obstructive pulmonary disease has the potential to have high costs both to the individual and the health system. We suggest that routine surveillance of veterans by way of a 'flag' in national and primary care databases would facilitate the recognition of service-related conditions and the appropriate provision of healthcare.
通过分析医院出院数据为退伍军人提供支持,从而确定哪些疾病存在额外风险、需要特定管理策略并值得进一步研究。
三级医疗护理,包括新西兰所有公立和私立医院。
所有在1964年至1972年期间服役的新西兰越战退伍军人。
标准化住院率(SHR)根据首次观察到的某种疾病的住院人数计算得出,预期住院人数基于新西兰全国住院率。
所有住院原因的标准化住院率为1.18,95%置信区间为1.15至1.21,主要常见病因(心血管和脑血管疾病)有适度增加。慢性肾衰竭和慢性阻塞性肺疾病的住院率在2006 - 2009年期间最高。统计学上住院风险最高的是酒精相关精神障碍,标准化住院率为1.91,99%置信区间为1.39至2.43。
慢性肾衰竭与退伍军人服役的关联有限,但与慢性阻塞性肺疾病一样,对个人和卫生系统都可能造成高昂成本。我们建议通过在国家和初级医疗数据库中设置“标记”对退伍军人进行常规监测,这将有助于识别与服役相关的疾病并适当提供医疗保健。