Measuring and monitoring success in compressing morbidity
Measuring and monitoring success in compressing morbidity
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DOI：
10.7326/0003-4819-139-5_part_2-200309021-00015
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发表时间：
2003-09-02
影响因子：
39.2
通讯作者：
Fries, JF
中科院分区：
文献类型：
--
作者：
Fries, JF
1980年提出的死亡率压缩范式认为，如果首次患病、残疾或其他疾病的平均年龄推迟，并且如果这种推迟大于预期寿命的增加，那么累积的终生发病率将减少--压缩在较晚的发病时间和死亡时间之间。国家长期护理调查、国家健康访谈调查和其他数据现在都记录了从1982年开始残疾人数下降的趋势，最近则在加速下降。每年下降约2%，而死亡率每年下降约1%，从而证明了美国人口水平的发病率压缩。现在，纵向研究将良好的健康风险状况与终身累积残疾的长期减少联系起来;行为健康风险较少的人的残疾程度仅为风险因素较多的人的四分之一，残疾的发生时间从7年推迟到12年，远远超过这些群体寿命的增加。在老年人群中进行的健康促进计划的随机对照试验表明，健康风险降低，健康状况改善，医疗保健利用率降低。目前正在采取的保健政策举措有望增加和巩固老年人的健康成果。
The Compression of Morbidity paradigm, introduced in 1980, maintains that if the average age at first infirmity, disability, or other morbidity is postponed and if this postponement is greater than increases in life expectancy, then cumulative lifetime morbidity will decrease-compressed between a later onset and the time of death. The National Long-Term Care Survey, the National Health Interview Survey, and other data now document declining disability trends beginning in 1982 and accelerating more recently. The decline is about 2% per year, contrasted with a decline in mortality rates of about 1% per year, thereby documenting compression of morbidity in the United States at the population level. Longitudinal studies now link good health risk status with long-term reductions in cumulative lifetime disability; persons with few behavioral health risks have only one-fourth the disability of those who have more risk factors, and the onset of disability is postponed from 7 to 12 years, far more than any increases in longevity in the groups. Randomized, controlled trials of health enhancement programs in elderly populations show reduction in health risks, improved health status, and decreased medical care utilization. Health policy initiatives now being undertaken have promise of increasing and consolidating health gains for the elderly.