Purkiss Shaun Francis, Keegel Tessa, Vally Hassan, Wollersheim Dennis
Department of Public Health, La Trobe University, Bundoora, Victoria, Australia.
Monash Centre for Occupational and Environmental Health, Monash University, Victoria, Australia.
Int J Popul Data Sci. 2020 Dec 11;5(1):1347. doi: 10.23889/ijpds.v5i1.1347.
Chronic disease (CD) is a leading cause of population mortality, illness and disability. Identification of CD using administrative data is increasingly used and may have utility in monitoring population health. Pharmaceutical administrative data using World Health Organization, Anatomic Therapeutic Chemical Codification (ATC) assigned to prescribed medicines may offer an improved method to define persons with certain CD and enable the calculation of population prevalence.
To assess the feasibility of Australian Pharmaceutical Benefits Scheme (PBS) dispensing data, to provide realistic measures of chronic disease prevalence using ATC codification, and compare values with international data using similar ATC methods and Australian community surveys.
Twenty-two chronic diseases were identified using World Health Organization (WHO) formulated ATC codes assigned to treatments received and recorded in a PBS database. Distinct treatment episodes prescribed to individuals were counted annually for prevalence estimates. Comparisons were then made with estimates from international studies using pharmaceutical data and published Australian community surveys.
PBS prevalence estimates for a range of chronic diseases listed in European studies and Australian community surveys demonstrated good correlation. PBS estimates of the prevalence of diabetes, cardiovascular disease and hypertension, dyslipidemia, and respiratory disease with comparable Australian National Health Survey in older adults showed correlations of between ( = 0.82 - 0.99) and a range of percentage error of -11% to 59%. However, other conditions such as psychological disease and migraine showed greater disparity and correlated less well.
Although not without limitations, Australian administrative pharmaceutical dispensing data may provide an alternative perspective on population health and a useful resource to estimate the prevalence of a number of chronic diseases within the Australian population.
慢性病是导致人群死亡、患病和残疾的主要原因。利用行政数据识别慢性病的方法越来越多地被采用,并且在监测人群健康方面可能具有实用价值。使用世界卫生组织解剖治疗化学分类法(ATC)对处方药进行编码的药品行政数据,可能为界定患有特定慢性病的人群提供一种改进方法,并有助于计算人群患病率。
评估澳大利亚药品福利计划(PBS)配药数据的可行性,利用ATC编码提供慢性病患病率的实际测量值,并使用类似的ATC方法和澳大利亚社区调查数据与国际数据进行比较。
利用世界卫生组织制定的ATC编码,在PBS数据库中识别接受并记录治疗的22种慢性病。每年统计个体的不同治疗疗程,以估计患病率。然后将结果与使用药品数据的国际研究估计值以及已发表的澳大利亚社区调查数据进行比较。
欧洲研究和澳大利亚社区调查中列出的一系列慢性病的PBS患病率估计值显示出良好的相关性。PBS对糖尿病、心血管疾病、高血压、血脂异常和呼吸系统疾病患病率的估计值,与澳大利亚老年人全国健康调查的可比数据之间的相关性在( = 0.82 - 0.99)之间,百分比误差范围为 -11%至59%。然而,其他疾病如心理疾病和偏头痛的差异较大,相关性较差。
尽管存在局限性,但澳大利亚药品行政配药数据可能为人群健康提供另一种视角,并且是估计澳大利亚人群中多种慢性病患病率的有用资源。