西班牙不存在发病压缩现象：一项基于国家住院记录的时间序列研究。
No evidence of morbidity compression in Spain: a time series study based on national hospitalization records.
作者信息
Walter Stefan, Beltrán-Sánchez Hiram, Regidor Enrique, Gomez-Martin Carlos, Del-Barrio Jose Luis, Gil-de-Miguel Angel, Subramanian S V, Gil-Prieto Ruth
机构信息
Department of Epidemiology and Biostatics, University of California San Francisco, 550 16th Street, 2nd Floor, Campus Mail Box 0560, San Francisco, CA, 94158-2549, USA.
Department of Community Health Sciences, Fielding School of Public Health, and California Center for Population Research, University of California, Los Angeles, USA.
出版信息
Int J Public Health. 2016 Sep;61(7):729-38. doi: 10.1007/s00038-016-0829-5. Epub 2016 May 27.
OBJECTIVES
Compression of morbidity postulates that as the populations age, the age of onset of disease is postponed. The objective of this study is to test for evidence of compression of morbidity in Spain.
METHODS
We calculated the age and sex-specific incidence of myocardial infarction, heart failure, cerebrovascular disease, as well as bladder, prostate, breast, lung, and colon cancer among hospital discharges covering 99.5 % of the Spanish population, approximately 40 million inhabitants for two non-overlapping periods, 1997-2000 and 2007-2010, and estimated the length of life spent with disease using the Sullivan method.
RESULTS
We found that expansion of morbidity due to an earlier age-specific onset of incident disease and increase in life expectancy was the norm in Spain. Notable exceptions were cardiovascular disease in women (-0.2 % time spent with disease) and lung cancer for men (-0.9 % time spent with disease) from 1997-2000 to 2007-2010.
CONCLUSIONS
Compression of morbidity is often cited by policy makers when discussing adjustments to the health-care system. If morbidity is measured by age at onset of disease, the burden of morbidity has increased in Spain.
目的
发病压缩假说认为，随着人口老龄化，疾病的发病年龄会推迟。本研究的目的是检验西班牙是否存在发病压缩的证据。
方法
我们计算了1997 - 2000年和2007 - 2010年这两个不重叠时期西班牙医院出院病例中心肌梗死、心力衰竭、脑血管疾病以及膀胱癌、前列腺癌、乳腺癌、肺癌和结肠癌的年龄和性别特异性发病率，这两个时期覆盖了西班牙99.5%的人口，约4000万居民，并使用沙利文方法估计了带病生存时间。
结果
我们发现，在西班牙，由于特定年龄发病年龄提前导致的发病扩张和预期寿命增加是常态。1997 - 2000年至2007 - 2010年期间，显著的例外情况是女性心血管疾病（带病生存时间减少0.2%）和男性肺癌（带病生存时间减少0.9%）。
结论
政策制定者在讨论医疗保健系统调整时经常提及发病压缩。如果以疾病发病年龄来衡量发病率，西班牙的发病负担有所增加。
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