Prevalence estimation of anorectal malformations using German diagnosis related groups system
Prevalence estimation of anorectal malformations using German diagnosis related groups system
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DOI：
10.1007/s00383-007-2023-6
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发表时间：
2007-12-01
影响因子：
1.8
通讯作者：
Jenetzky, Ekkehart
中科院分区：
文献类型：
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作者：
Jenetzky, Ekkehart
如果没有主要的登记处，罕见先天性疾病的真实患病率是未知的。对肛门直肠畸形（ARM）发生率的估计是基于监测中心和流行病学研究。德国新的住院护理支付经济系统 (G-DRG) 要求每次住院都必须提供报告，包括诊断和手术。这些最初为发病率统计而开发的代码和分类现在被滥用于经济目的。有流行病学用途吗？我们提出了一种新方法来估计全国先天性畸形的患病率，以肛门闭锁为例。由于采用了新的德国 DRG 系统，2002-2005 年的治疗数据收集可以免费获取。如果新生儿必须接受救生手术并且必须通过特定代码进行加密，则可以使用此方法。总体而言，在德国医院中，有 1,012 名 1 岁以下儿童在 4 年内接受了肛门直肠重建手术。与此同时，德国有 2,817,388 名婴儿出生。因此，对于需要手术的所有不同类型的肛门闭锁，全国范围内的患病率约为每 10,000 人 3.6 例（95% CI：3.4-3.8）或 1:2,784。主要 ICD-10 诊断 Q42 的发生率是该比率的两倍，可能是由于新生儿期至少两次住院所致。 G-DRG 系统的经济数据可用于估计德国某些罕见先天性疾病在特定外科手术情况下的年患病率。由于规模较大，它可能是对较小区域注册机构的有用补充。还必须面对其他流行病学问题的进一步计算。
Without major registries, true prevalence of rare congenital diseases is not known. Estimations for occurrence of anorectal malformation (ARM) are based on monitoring centers and epidemiological studies. The new German economical system for payment of inpatient care ( G-DRG) obligates the report of each hospitalization, including diagnoses and procedures. These codes and classifications originally developed for morbidity statistics are now misused for economical purposes. Is there an epidemiological use? We present a new method to estimate national wide prevalence rate of congenital malformations exemplarily for imperforated anus. Due to the new German DRG-system, treatment data collections of the years 2002-2005 are freely accessible. This method is applicable if a life saving surgery is mandatory for newborns and has to be ciphered by specific codes. Overall, in German hospitals 1,012 children below 1 year of age are surgically treated with a reconstructive anorectal surgery during the period of 4 years. In the same time 2,817,388 babies are born in Germany. Hence the national wide prevalence rate is about 3.6 (95% CI: 3.4-3.8) per 10,000 or 1: 2,784 for all different types of anal atresia requiring surgery. Main ICD-10 diagnosis Q42 was given twice this rate, probably due to at least two hospitalizations in the newborn period. The economic data of the G-DRG system can be used to estimate yearly prevalence of some rare congenital diseases in Germany, in case of specific surgical procedures. It may be a useful supplement to smaller regional registries because of larger size. Further calculations for other epidemiological questions have to be faced.