Compression of morbidity and its alternatives with the context of health inequalities

在健康不平等的背景下压缩发病率及其替代方案

• 批准号: 389292058
• 负责人: Professor Dr. Siegfried Geyer
• 金额: --
• 依托单位: Forschungs- und Lehreinheit Medizinische Soziologie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2017
• 资助国家: 德国
• 起止时间: 2016-12-31 至 2020-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/389292058?language=en
• 关键词: Compression; morbidity; its; alternatives; context

Fries' hypothesis of morbidity compression refers to the shortening of time periods between the onset of disease, disability, and death. It is assumed that prevention and improved living conditions are contributing to changes of morbidity. As a pessimistic alternative Gruenberg put up the hypothesis of morbidity expansion as an unplanned consequence of medical progress. As a last alternative the dynamic equilibrium according to Manton describes an expansion of lifetimes spent in states of illness and disability, but with improved abilities for managing everyday life. For Germany and for the cases of myocardial infarction, stroke, multimorbidity and functional impairments it will be examined whether the development of morbidity can be described as morbidity compression. As a second step it will be considered whether morbidity changes are developing along the lines of social inequalities. As the third step it will be explained whether and to what extent the development of morbidity can be explained by health-related behaviours and/ or by changes of preventive and curative measures. The main basis of the analyses are data of the Statutory Health Insurance of Lower Saxony (AOK Niedersachsen) of the years 2005 to 2015. During the course of the project the data of 2016 and 2017 will be supplemented. The number of individuals in the annual datasets are approx. 2 Mio. per year. The health insurance data will be used for performing analyses on myocardial infarction, stroke, and multimorbidity. The data of the KORA/ KORA-Age study shall be used for replicating the findings on myocardial infarction, and also behaviour-based explanations shall be developed. Finally, the data of the Survey of Health, Ageing and Retirement in Europe (SHARE) shall be used for examining the development and the explanation of functional impairments. The development of morbidity compression affects major areas of the future development of welfare and the health care system. This refers e.g. to the development of working lifetime, priority setting in health care, the care of the elderly, or on how to develop residences for self-determined housing at old age.

Fries的发病率压缩假说是指疾病发作、残疾和死亡之间的时间缩短。据推测，预防和改善生活条件有助于改变发病率。作为一个悲观的替代方案，Gruenberg提出了发病率增长是医学进步的意外后果的假设。作为最后一种选择，根据曼顿的动态平衡描述了在疾病和残疾状态下度过的生命时间的延长，但管理日常生活的能力有所提高。对于德国和心肌梗死、卒中、多发性硬化和功能障碍病例，将检查发病率的发展是否可以描述为发病率压缩。作为第二步，将考虑发病率的变化是否沿着社会不平等的路线发展。作为第三步，将解释发病率的发展是否以及在多大程度上可以用与健康有关的行为和/或预防和治疗措施的变化来解释。分析的主要依据是2005年至2015年萨克森州国家健康保险（AOK Niedersachsen）的数据。在项目实施过程中，将对2016年和2017年的数据进行补充。年度数据集中的个体数量约为。两百万每一年。健康保险数据将用于对心肌梗死、卒中和多发性硬化进行分析。KORA/ KORA-Age研究的数据应用于复制心肌梗死的结果，还应开发基于行为的解释。最后，欧洲健康、老龄化和退休调查的数据将用于审查功能障碍的发展和解释。发病率压缩的发展影响到福利和卫生保健系统未来发展的主要领域。例如，这指的是工作年限的发展、卫生保健的优先事项的确定、老年人的护理，或如何发展住宅供老年人自主决定住房。