Hudson Toni-Marie L, Klekamp Benjamin G, Matthews Sarah D
1 Florida Department of Health in Orange County, Orlando, FL, USA.
Public Health Rep. 2017 Jul/Aug;132(1_suppl):80S-87S. doi: 10.1177/0033354917709783.
Heroin-related deaths have increased substantially in the past 10 years in the United States, particularly in Florida. Our objectives were to measure heroin-related morbidity and mortality rates in Orange County, Florida, and to assess trends in those rates during 2010-2014.
We used 3 heroin surveillance methods, based on data from the Florida Medical Examiner, the Florida Agency for Health Care Administration (AHCA), and the Electronic Surveillance System for the Early Notification of Community-Based Epidemics-Florida (ESSENCE-FL). We conducted descriptive and geographic spatial analyses of all 3 data sets, determined heroin-related mortality and morbidity (emergency department [ED] visit) rates, and compared the timeliness of data availability from the 3 data sources.
Heroin-related deaths in Orange County increased by 590%, from 10 in 2010 to 69 in 2014. Heroin-related ED visits during the same period increased 12-fold (from 13 to 154) and 6-fold (from 49 to 307) when based on AHCA and ESSENCE-FL data, respectively. ESSENCE-FL identified 140% more heroin-related visits than did AHCA. Spatial analysis found geographic clustering of heroin-related morbidity and mortality. Hospitals facing the greatest burden of heroin-related ED visits were close to communities with the highest crude heroin-related ED visit rates. Of the 3 data sources, ESSENCE-FL provided the timeliest data availability.
These 3 data sources can be considered acceptable surveillance systems for monitoring heroin-related events in Orange County. The timely availability of data from ESSENCE-FL makes it the most useful source for obtaining near-real-time data about the heroin epidemic, potentially leading to improved identification of populations most in need of interventions to reduce morbidity and mortality.
在过去10年中，美国与海洛因相关的死亡人数大幅增加，尤其是在佛罗里达州。我们的目的是衡量佛罗里达州奥兰治县与海洛因相关的发病率和死亡率，并评估2010 - 2014年期间这些比率的趋势。
我们基于佛罗里达州法医、佛罗里达州医疗保健管理局（AHCA）以及佛罗里达州社区流行病早期预警电子监测系统（ESSENCE - FL）的数据，采用了3种海洛因监测方法。我们对所有3个数据集进行了描述性和地理空间分析，确定了与海洛因相关的死亡率和发病率（急诊就诊），并比较了这3个数据来源的数据可得及时性。
奥兰治县与海洛因相关的死亡人数增加了590%，从2010年的10例增至2014年的69例。同期，基于AHCA和ESSENCE - FL数据，与海洛因相关的急诊就诊人数分别增加了12倍（从13例增至154例）和6倍（从49例增至307例）。ESSENCE - FL识别出的与海洛因相关的就诊人数比AHCA多140%。空间分析发现与海洛因相关的发病率和死亡率存在地理聚集现象。面临与海洛因相关急诊就诊负担最重的医院靠近粗海洛因相关急诊就诊率最高的社区。在这3个数据来源中，ESSENCE - FL提供的数据可得及时性最高。
这3个数据来源可被视为监测奥兰治县与海洛因相关事件的可接受监测系统。ESSENCE - FL数据的及时可得性使其成为获取有关海洛因流行情况近实时数据的最有用来源，这可能有助于更好地识别最需要干预措施以降低发病率和死亡率的人群。
