Bachus Lena, Eberhard Sveja, Weißenborn Karin, Muschik Denise, Epping Jelena, Geyer Siegfried
Medizinische Soziologie, Medizinische Hochschule Hannover, Hannover.
Stabsbereich Gesundheitspolitik und Versorgungsforschung, AOK Niedersachsen, Hannover.
Gesundheitswesen. 2019 Apr;81(4):351-360. doi: 10.1055/s-0043-109860. Epub 2017 Jun 6.
According to Fries, morbidity compression occurs if age at onset of disease/disability and age at death increase. Morbidity compression is also present if disease/disability rates decrease to the same or to a larger extent than standardized death rates. In all cases, healthy lifetime is gained. Not many studies on morbidity compression are available, and only a small number of them refer to specific diseases. Stroke is used as an example for examining whether morbidity compression has occurred over an observation period of 9 years.
The study was based on pseudonymized data of a statutory health insurance covering 2006-2014 with 2 million insured per year. Analyses were performed for all types of stroke, separately for cerebral infarction, and for hemorrhages (ICD 10: I60-I62). Calculations were performed by means of survival analyses and with multiple regression.
In women and in men, rates decreased only for hemorrhagic strokes, while changes of onset age were difficult to interpret. Standardized death rates dropped only in males.
Evidence in favor of morbidity compression was found only for decreasing rates of hemorrhagic strokes. It has, however, to be kept in mind that the findings refer to a single disease occurring relatively late in the life course. Comprehensive assessments of morbidity compression are only possible taking into consideration a broader spectrum of diseases.
根据弗里斯的观点，如果疾病/残疾的发病年龄和死亡年龄增加，就会出现发病压缩。如果疾病/残疾率的下降幅度与标准化死亡率相同或更大，也会出现发病压缩。在所有情况下，都会延长健康寿命。关于发病压缩的研究并不多，其中只有少数涉及特定疾病。以中风为例，考察在9年的观察期内是否发生了发病压缩。
该研究基于2006 - 2014年法定医疗保险的匿名数据，每年有200万参保人。对所有类型的中风、脑梗死和出血性中风（国际疾病分类第十版：I60 - I62）分别进行分析。通过生存分析和多元回归进行计算。
在女性和男性中，仅出血性中风的发病率下降，而发病年龄的变化难以解释。标准化死亡率仅在男性中下降。
仅在出血性中风发病率下降方面发现了支持发病压缩的证据。然而，必须记住，这些发现仅涉及生命过程中相对较晚发生的单一疾病。只有考虑更广泛的疾病谱，才有可能对发病压缩进行全面评估。
