德国医疗记录中“肥胖”的出现频率以及“肥胖”人群的门诊医疗利用情况。一项健康保险数据分析。

Frequency of 'obesity' in medical records and utilization of out-patient health care by 'obese' subjects in Germany. An analysis of health insurance data.

作者信息

Hauner H, Köster I, von Ferber L

机构信息

Klinische Abteilung des Diabetes-Forschungsinstituts, Heinrich-Heine-Universität Düsseldorf, Germany.

出版信息

Int J Obes Relat Metab Disord. 1996 Sep;20(9):820-4.

PMID:8880348

Abstract

OBJECTIVE

The aim of this study was to assess the frequency of the diagnoses 'overweight' or 'obesity' in medical records and to examine the utilization of the out-patient health care system by 'obese' subjects.

DESIGN

All claims-cards, prescriptions and other diagnosis-carrying medical certificates from 1990 of a representative sample of members of a large local health insurance were collected and analyzed anonymously in a patient-related approach.

SUBJECTS

A 5% random sample (n = 6085) of all members of the general local health insurance (AOK) in the city of Dortmund, Germany.

MEASUREMENTS

The percentage of subjects carrying the diagnosis of 'overweight' and/or 'obesity' was determined. In addition, the utilization of medical services and the presence of comorbid conditions in the documents of the AOK was recorded.

RESULTS

A total number of 377 'obese' subjects was identified corresponding with a prevalence rate of 6.2%. Among those, more women than men carried one of these diagnoses (240 vs 137, 7.3% vs 4.9%, p < 0.01). In comparison with an age- and sex-matched control group (n = 1131) the 'obese' subjects had significantly more practice contacts (25.7 vs 17.5/year, p < 0.01) and received more medical services (64.2 vs 43.0/year, p < 0.01), including more prescriptions (20.9 vs 15.5/year, p < 0.01). Furthermore, the 'obese' subjects had more additional diagnoses indicating a higher comorbidity and received more drugs for diseases and complications which are characteristic of obesity but also for other diseases.

CONCLUSION

This data suggests that in view of its high prevalence in Germany obesity is perceived and documented by health professionals only in a minority of affected subjects indicating that this disorder is considerably under-estimated. It is also evident from the data that obesity is mainly noticed in those who have other serious health problems.

摘要

目的

本研究旨在评估病历中“超重”或“肥胖”诊断的频率，并调查“肥胖”患者对门诊医疗保健系统的利用情况。

设计

以患者为导向的方法，对1990年德国多特蒙德市一家大型地方医疗保险机构成员的代表性样本的所有保险卡、处方及其他带有诊断信息的医疗证明进行匿名收集和分析。

研究对象

德国多特蒙德市全体地方医疗保险机构（AOK）成员的5%随机样本（n = 6085）。

测量指标

确定诊断为“超重”和/或“肥胖”的患者百分比。此外，记录AOK文件中医疗服务的利用情况以及合并症的存在情况。

结果

共识别出377名“肥胖”患者，患病率为6.2%。其中，诊断为“超重”或“肥胖”的女性多于男性（240例对137例，7.3%对4.9%，p < 0.01）。与年龄和性别匹配的对照组（n = 1131）相比，“肥胖”患者的门诊就诊次数显著更多（每年25.7次对17.5次，p < 0.01），接受的医疗服务也更多（每年64.2次对43.0次，p < 0.01），包括更多的处方（每年20.9张对15.5张，p < 0.01）。此外，“肥胖”患者还有更多其他诊断，表明合并症更多，并且针对肥胖相关疾病和并发症以及其他疾病接受了更多药物治疗。