Huber Carola A, Nagler Michael, Rosemann Thomas, Blozik Eva, Näpflin Markus, Markun Stefan
Department of Health Sciences, Helsana Insurance Group, Zürich, Switzerland.
Institute of Primary Care, University of Zürich, University Hospital Zürich, Zürich, Switzerland.
Int J Gen Med. 2020 Dec 2;13:1341-1348. doi: 10.2147/IJGM.S275406. eCollection 2020.
Micronutrient laboratory tests (MLT) are increasing in many healthcare systems. This study assessed time trends of annual MLT incidence in the Swiss population and examined the frequency of specific MLT, defined as the number of yearly tests performed in individual persons.
For annual time trends, we used a longitudinal design with a seven-year observation period (2012-2018) and for yearly testing frequency we used a cross-sectional design (2018 only). The database consisted of nationwide insurance claims from adult persons.
Persons with MLT compared to persons without were older (mean age 57.1 years vs 48.6 years) and to a higher proportion female (65.1% vs 45.5%). Between 2012 and 2018, we included 6.7 million person years and found an increase in the proportion of persons receiving any MLT from 24.5% to 35.0%. Tests with strongest absolute increase during the observation period were vitamin D (from 7.4% of persons to 20.4%), vitamin B12 (from 9.0% to 17.6%) and ferritin (from 17.4% to 26.6%). In 2018, vitamin D and vitamin B12 tests were performed more than once in 4.5% and 3.3% of the population, respectively.
We found that the Swiss population undergoes MLT with high and increasing frequency. Testing for vitamin D, vitamin B12 and ferritin is very common and of questionable appropriateness.
在许多医疗保健系统中,微量营养素实验室检测(MLT)的使用正在增加。本研究评估了瑞士人群中年度MLT发病率的时间趋势,并检查了特定MLT的频率,即个体每年进行的检测次数。
对于年度时间趋势,我们采用了为期七年的观察期(2012 - 2018年)的纵向设计,对于年度检测频率,我们采用了横断面设计(仅2018年)。数据库由全国范围内成年人的保险理赔数据组成。
与未进行MLT的人相比,进行MLT的人年龄更大(平均年龄57.1岁对48.6岁),女性比例更高(65.1%对45.5%)。在2012年至2018年期间,我们纳入了670万人年的数据,发现接受任何MLT检测的人群比例从24.5%增加到了35.0%。观察期内绝对增加幅度最大的检测项目是维生素D(从7.4%的人增加到20.4%)、维生素B12(从9.0%增加到17.6%)和铁蛋白(从17.4%增加到26.6%)。2018年,分别有4.5%和3.3%的人群进行了不止一次的维生素D和维生素B12检测。
我们发现瑞士人群进行MLT检测的频率很高且呈上升趋势。维生素D、维生素B12和铁蛋白检测非常普遍,但其适宜性存疑。