Recent changes in the prevalence of diseases presenting for health care.
Recent changes in the prevalence of diseases presenting for health care.
复制标题
医疗保健疾病流行率的最新变化。
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
M. Barley
中科院分区：
文献类型：
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作者：
D. Fleming;K. W. Cross;M. Barley
背景
基于实践的发病率调查提供了关于需要保健的疾病流行率的信息。英格兰和威尔士上一次大规模调查是在1991年进行的。
目的
揭示1991年至2001年间疾病流行率的变化。
研究设计
对向全科医生就诊的人进行基于人口的分析。将2001年皇家全科医师学院每周回报服务（WRS）报告的疾病年度患病率与第四次全国全科医学研究（MSGP4）中的Morbidity统计报告的患病率进行比较。
设置
2001年，38个一般性做法对妇女地位调查作出了贡献，对326 000人进行了监测。
方法
患病率是根据各调查年份中输入的发病率阅读代码确定的。疾病和疾病组的定义来自与国际疾病分类第9版（ICD 9）的章节、主要亚组和3位数代码对应的Read代码。以2001年全国人口普查人口为标准，计算每万登记人口的标准化患病率和99%置信区间（CI）。根据非重叠CI确定患病率的调查差异。
结果
感染引起的疾病普遍减少，退行性疾病增加。精神疾病、皮肤病和肌肉骨骼疾病的患病率变化不大。其他恶性和良性皮肤肿瘤、甲状腺机能减退症和糖尿病的发病率特别高。结膜疾病、耳部感染、急性心肌梗塞和心力衰竭、呼吸道感染和受伤的人数明显减少。
结论
GP的角色在不断变化。这些结果证实了慢性病管理作为GP的主导（尽管不是唯一）作用的重要性。结果表明，使用WRS作为疾病流行率的数据来源。
BACKGROUND
Practice-based morbidity surveys inform on the prevalence of diseases presenting for health care. The last major survey in England and Wales was conducted in 1991.
AIM
To reveal changes in disease prevalence between 1991 and 2001.
DESIGN OF STUDY
Population-based analysis of persons presenting to GPs. Annual prevalence of diseases reported in the Weekly Returns Service (WRS) of the Royal College of General Practitioners in 2001 was compared with prevalence reported in Morbidity Statistics from General Practice, Fourth National Study (MSGP4).
SETTING
Thirty-eight general practices contributing to the WRS, monitoring a population of 326,000 in 2001.
METHOD
Prevalence was determined from Read codes for morbidity entered in the respective survey years. Diseases and disease groups were defined from Read codes mapping to the chapters, major sub-groups and 3-digit codes of the International Classification of Disease version 9 (ICD9). Age-standardised prevalence rates per 10,000 registered persons and 99% confidence intervals (CIs) were calculated using the national census population for 2001 as the standard. Survey differences in prevalence were identified from non-overlapping CIs.
RESULTS
There was a general reduction in the prevalence of disease caused by infection and an increase of degenerative disorders. The prevalence of mental disorders, skin disease and musculoskeletal disorders showed little change. Particular increases were noted for other malignant and benign neoplasms of the skin, hypothyroidism and diabetes. There were marked reductions for disorders of the conjunctiva, ear infections, acute myocardial infarction and heart failure, respiratory infections and injuries.
CONCLUSIONS
The role of the GP continues to change. These results confirm the importance of the management of chronic diseases as the dominant (though not the sole) role of the GP. The results demonstrate the use of the WRS as a source of data on disease prevalence.