Dieu Holly, Kearney Gregory D, Bian Hui, Jones Katherine, Mohan Arjun
Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
assistant professor, Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina
N C Med J. 2018 Mar-Apr;79(2):81-87. doi: 10.18043/ncm.79.2.81.
The purpose of this study was to compare asthma-related emergency department (ED) visit rates across North Carolina. Results from this study can inform health planning while helping public health and health care professionals in identifying geographical areas and targeting age groups to reduce the asthma burden in North Carolina. This was a retrospective data analysis between 2010 and 2014 among North Carolina patients presenting to an ED with a first or second listed diagnosis code related to asthma (ICD-9-CM, 493.xx). Data was obtained from the North Carolina Disease Event Tracking and Epidemiology Collection Tool. Annual, age-adjusted rates were standardized to the 2000 US standard population using the direct method. Repeated measures ANOVA was conducted to compare differences between mean values of asthma-related ED visit rates in regions, urbanicity, and age groups across years. Asthma ED rates were consistently higher in the east (85.1 per 10,000) compared with other regions. While most age group ED rates fluctuated over the study period, univariate test results indicated statistical increases in ED asthma visits among the groups aged 5 to 9 years ( < .01), and 65 and over ( < .03). Public health officials should recognize the disproportionate burden of asthma-related ED visits, particularly among rural and impoverished counties in the eastern portion of North Carolina when prioritizing health concerns across North Carolina.
本研究的目的是比较北卡罗来纳州各地与哮喘相关的急诊科就诊率。该研究结果可为卫生规划提供参考,同时帮助公共卫生和医疗保健专业人员确定地理区域并针对特定年龄组,以减轻北卡罗来纳州的哮喘负担。这是一项对2010年至2014年间在急诊科就诊的北卡罗来纳州患者进行的回顾性数据分析,这些患者的第一或第二诊断代码与哮喘相关(ICD-9-CM,493.xx)。数据来自北卡罗来纳州疾病事件跟踪和流行病学收集工具。年度年龄调整率采用直接法根据2000年美国标准人口进行标准化。采用重复测量方差分析来比较各年份不同地区、城市化程度和年龄组与哮喘相关的急诊科就诊率平均值之间的差异。与其他地区相比,东部地区的哮喘急诊科就诊率一直较高(每10000人中有85.1人)。虽然大多数年龄组的急诊科就诊率在研究期间有所波动,但单变量测试结果表明,5至9岁组(<.01)和65岁及以上组(<.03)的急诊科哮喘就诊人数有统计学上显著增加。在确定北卡罗来纳州的卫生优先事项时,公共卫生官员应认识到与哮喘相关的急诊科就诊负担不均衡,尤其是在北卡罗来纳州东部的农村和贫困县。