Unalp-Arida Aynur, Ruhl Constance E
Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA ; and.
DLH, LLC, Bethesda, Maryland, USA .
Am J Gastroenterol. 2024 Dec 31. doi: 10.14309/ajg.0000000000003241.
Digestive diseases are common in the United States and lead to significant morbidity, mortality, and health care utilization. We used national survey and claims databases to expand on earlier findings and investigate rates and trends in the digestive disease burden in the United States. The Nationwide Emergency Department Sample, National Inpatient Sample, Vital Statistics of the United States: Multiple Cause-of-Death Data, Optum Clinformatics Data Mart, and Centers for Medicare and Medicaid Services Medicare 5% Sample and Medicaid files were used to estimate claims-based prevalence, medical care, and mortality with a digestive disease diagnosis. Digestive disease prevalence (claims-based, 2019) was 24.2% among Medicaid beneficiaries, 33.2% among private insurance enrollees, and 51.5% among Medicare beneficiaries and rose over the previous decade. Digestive diseases contributed to 42 million emergency department visits, 17 million hospital stays, and 472,000 deaths in 2019. Women had higher medical care rates with a digestive disease diagnosis, but mortality rates were higher among men. Blacks had higher medical care use and mortality rates compared with Whites, and Hispanics had lower rates. During the study period, ambulatory care and emergency department visit rates with a digestive disease diagnosis rose, while hospitalization and mortality rates declined. Among private insurance enrollees, rates were higher compared with national data for hospitalizations, but lower for emergency department visits. The digestive disease burden in the United States is substantial, particularly among Blacks and older adults. Further research is needed to better understand reasons for disparities and trends in health care use and mortality reported in this paper.
消化系统疾病在美国很常见，会导致严重的发病率、死亡率以及医疗资源的大量使用。我们利用全国性调查和理赔数据库，在早期研究结果的基础上进行拓展，调查美国消化系统疾病负担的发生率和趋势。使用了全国急诊科样本、全国住院患者样本、美国生命统计数据：多死因数据、Optum临床信息数据集市以及医疗保险和医疗补助服务中心的医疗保险5%样本和医疗补助档案，来估计基于理赔的患病率、医疗护理情况以及患有消化系统疾病诊断的死亡率。2019年，基于理赔的消化系统疾病患病率在医疗补助受益人中为24.2%，在私人保险参保人中为33.2%，在医疗保险受益人中为51.5%，且在过去十年中呈上升趋势。2019年，消化系统疾病导致了4200万次急诊科就诊、1700万次住院以及47.2万例死亡。患有消化系统疾病诊断的女性医疗护理率较高，但男性的死亡率较高。与白人相比，黑人的医疗护理使用率和死亡率更高，而西班牙裔的比率较低。在研究期间，患有消化系统疾病诊断的门诊护理和急诊科就诊率上升，而住院率和死亡率下降。在私人保险参保人中，住院率高于全国数据，但急诊科就诊率低于全国数据。美国的消化系统疾病负担很重，尤其是在黑人和老年人中。需要进一步研究以更好地理解本文中报告的医疗护理使用和死亡率方面的差异及趋势的原因。
