Hvidberg Michael F, Johnsen Søren P, Glümer Charlotte, Petersen Karin D, Olesen Anne V, Ehlers Lars
Danish Center for Healthcare Improvements, Aalborg University, Aalborg, Denmark
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Scand J Public Health. 2016 Jul;44(5):462-79. doi: 10.1177/1403494816641553. Epub 2016 Apr 20.
The aim of the current study was to present and discuss a broad range of register-based definitions of chronic conditions for use in register research, as well as the challenges and pitfalls when defining chronic conditions by the use of registers.
The definitions were defined based on information from nationwide Danish public healthcare registers. Medical and epidemiological specialists identified and grouped relevant diagnosis codes that covered chronic conditions, using the International Classification System version 10 (ICD-10). Where relevant, prescription and other healthcare data were also used to define the chronic conditions.
We identified 199 chronic conditions and subgroups, which were divided into four groups according to a medical judgment of the expected duration of the conditions, as follows. Category I: Stationary to progressive conditions (maximum register inclusion time of diagnosis since the start of the register in 1994). Category II: Stationary to diminishing conditions (10 years of register inclusion after time of diagnosis). Category III: Diminishing conditions (5 years of register inclusion after time of diagnosis). Category IV: Borderline conditions (2 years of register inclusion time following diagnosis). The conditions were primarily defined using hospital discharge diagnoses; however, for 35 conditions, including common conditions such as diabetes, chronic obstructive lung disease and allergy, more complex definitions were proposed based on record linkage between multiple registers, including registers of prescribed drugs and use of general practitioners' services. CONCLUSIONS THIS STUDY PROVIDED A CATALOG OF REGISTER-BASED DEFINITIONS FOR CHRONIC CONDITIONS FOR USE IN HEALTHCARE PLANNING AND RESEARCH, WHICH IS, TO THE AUTHORS' KNOWLEDGE, THE LARGEST CURRENTLY COMPILED IN A SINGLE STUDY.
本研究的目的是提出并讨论一系列基于登记册的慢性病定义，以供登记册研究使用，以及在使用登记册定义慢性病时所面临的挑战和陷阱。
这些定义是根据丹麦全国公共医疗登记册中的信息确定的。医学和流行病学专家使用国际疾病分类第10版（ICD - 10）识别并对涵盖慢性病的相关诊断代码进行分组。在相关情况下，还使用处方和其他医疗数据来定义慢性病。
我们识别出199种慢性病及其亚组，根据对病情预期持续时间的医学判断将其分为四组，如下所示。第一类：病情稳定至进展型（自1994年登记册开始以来诊断的最长登记册纳入时间）。第二类：病情稳定至衰退型（诊断后10年的登记册纳入时间）。第三类：衰退型病情（诊断后5年的登记册纳入时间）。第四类：临界病情（诊断后2年的登记册纳入时间）。这些病情主要通过医院出院诊断来定义；然而，对于35种病情，包括糖尿病、慢性阻塞性肺疾病和过敏等常见病情，基于多个登记册之间的记录链接，包括处方药登记册和全科医生服务使用情况登记册，提出了更复杂的定义。结论：本研究提供了一份基于登记册的慢性病定义目录，用于医疗保健规划和研究，据作者所知，这是目前在一项单一研究中编制的最大的目录。
