Fender P, Megnigbeto C
Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés (CNAMTS), Paris.
Rev Epidemiol Sante Publique. 1997 Jun;45(3):193-202.
This work is aimed at providing improved coefficients applicable to the statistics of Health Insurance concerning the long-lasting conditions in order to assess morbidity of Health Insurance members concerning diseases invoked legislation on long-lasting conditions. To reach this objective, we have applied the consequences of successive equivalence (between diseases and their specific treatment, and between the use of special prescriptions for exempting diseases and the acknowledgment of long-lasting conditions by Health Insurance) to the results of a survey on medicines carried out by the Caisse Nationale d'Assurance Maladie des Travailleurs Salariés in 1993 on the basis of a representative sample. Improved coefficients were equal to the inverse of the proportion of special prescriptions within the whole of the prescriptions including specific treatment. Those coefficients and their confidence intervals have been calculated for seven affections: non-insulin dependent diabetes [1.56-1.67], coronary disease [1.51-1.61], Parkinson's disease [1.51-1.85], manic-depressive psychosis [1.49-1.89], haemorrhagic rectocolitis and Crohn's disease [1.49-2.04], insulin dependent diabetes [1.10-1.20] and tuberculosis [1.61-3.33]. The critical analysis of our work and its comparison with the rare literature on the same subject confirms the value of our results. The application of those improved coefficients to the figures of prevalence and incidence provided by Health Insurance makes it possible to set confidence bounds to the statistics of morbidity concerning the people who are affiliated to that system of Health Insurance and treated for these diseases however serious they are.
这项工作旨在提供适用于医疗保险中与长期病症统计相关的改进系数,以便评估医疗保险参保人员在涉及长期病症相关立法的疾病方面的发病率。为实现这一目标,我们将连续等价(疾病与其特定治疗之间,以及使用特殊处方豁免疾病与医疗保险认可长期病症之间)的结果应用于国家工薪劳动者疾病保险基金1993年基于代表性样本开展的药品调查结果。改进系数等于特殊处方在包括特定治疗的所有处方中的比例的倒数。已针对七种病症计算了这些系数及其置信区间:非胰岛素依赖型糖尿病[1.56 - 1.67]、冠心病[1.51 - 1.61]、帕金森病[1.51 - 1.85]、躁郁症[1.49 - 1.89]、出血性直肠结肠炎和克罗恩病[1.49 - 2.04]、胰岛素依赖型糖尿病[1.10 - 1.20]和结核病[1.61 - 3.33]。对我们工作的批判性分析以及与同一主题的罕见文献的比较证实了我们结果的价值。将这些改进系数应用于医疗保险提供的患病率和发病率数据,使得能够为隶属于该医疗保险体系并接受这些疾病治疗的人群的发病率统计设定置信区间,无论这些疾病有多严重。