Schuster Fabian, Ostermann Thomas, Emcke Timo, Schuster Reinhard
European University Viadrina Frankfurt (Oder), Germany.
Witten/Herdecke University, Herdecke, Germany.
Stud Health Technol Inform. 2017;243:52-56.
Diagnostic diversity has been in the focus of several studies of health services research. As the fraction of people with statutory health insurance changes with age and gender it is assumed that diagnostic diversity may be influenced by these parameters.
We analyze fractions of patients in Schleswig-Holstein with respect to the chapters of the ICD-10 code in outpatient treatment for quarter 2/2016 with respect to age and gender/sex of the patient. In a first approach we analyzed which diagnose chapters are most relevant in dependence of age and gender. To detect diagnostic diversity, we finally applied Shannon's entropy measure. Due to multimorbidity we used different standardizations.
Shannon entropy strongly increases for women after the age of 15, reaching a limit level at the age of 50 years. Between 15 and 70 years we get higher values for women, after 75 years for men.
This article describes a straight forward pragmatic approach to diagnostic diversity using Shannon's Entropy. From a methodological point of view, the use of Shannon's entropy as a measure for diversity should gain more attraction to researchers of health services research.
诊断多样性一直是卫生服务研究多项研究的重点。由于法定医疗保险人群的比例随年龄和性别而变化，因此推测诊断多样性可能受这些参数的影响。
我们分析了石勒苏益格－荷尔斯泰因州2016年第二季度门诊治疗中，患者按国际疾病分类第十版（ICD - 10）编码章节划分的比例，同时考虑了患者的年龄和性别。在第一种方法中，我们分析了哪些诊断章节在年龄和性别方面最为相关。为了检测诊断多样性，我们最终应用了香农熵度量。由于存在多种疾病，我们使用了不同的标准化方法。
15岁之后女性的香农熵大幅增加，在50岁时达到极限水平。在15至70岁之间，女性的值更高，75岁之后男性的值更高。
本文描述了一种使用香农熵来研究诊断多样性的直接实用方法。从方法论的角度来看，将香农熵用作多样性度量方法，应该会吸引更多卫生服务研究人员的关注。
