Trends in Gastroesophageal Reflux Disease as Measured by the National Ambulatory Medical Care Survey
Trends in Gastroesophageal Reflux Disease as Measured by the National Ambulatory Medical Care Survey
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DOI：
10.1007/s10620-009-1004-0
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发表时间：
2010-07-01
影响因子：
3.1
通讯作者：
Richter, Joel E.
中科院分区：
文献类型：
--
作者：
Friedenberg, Frank K.;Hanlon, Alexandra;Richter, Joel E.
反流病的患病率正在增加。保健利用，包括医生访问这种疾病是缺乏的。我们的目的是使用全国门诊医疗调查分析1995-2006年期间GERD的医生就诊趋势。我们还试图通过评估质子泵抑制剂和H2受体阻滞剂的处方趋势来间接确定GERD的医疗保健利用率。国家门诊医疗保健调查是对大约3,000名办公室医生的调查，使用三阶段概率抽样程序来外推到美国人口。将1995年至2006年期间所有符合GERD症状和/或诊断的访视合并为单一分类变量。加权数据用于描述性和推断性统计分析。加权后，所有诊断中有N = 321，513例成人门诊护理。在整个检查期间，返流访视增加。使用逻辑回归，反流就诊与女性性别、40岁以上和钙通道阻滞剂使用相关。质子泵抑制剂的使用在研究期间大幅增加，而H2阻滞剂的使用下降。大多数反流患者是家庭医生和内科医生接诊的。1995年至2006年间，美国胃食管反流病门诊就诊频率显着增加。PPI治疗的使用正在大幅增加。年龄较大、女性和钙通道阻滞剂的使用与GERD就诊频率较高相关。对这种疾病的医疗保健利用正在增加，这可能是由于我们不断增加的肥胖流行病。
The prevalence of reflux disease is increasing. Health-care utilization including physician visits for this disorder is lacking. Our purpose was to analyze the trend in physician visits for GERD from the period 1995-2006 using the National Ambulatory Medical Care Survey. We also sought to determine health-care utilization for GERD indirectly by assessing prescription trends for proton-pump inhibitors and H2 receptor blockers during the period.The National Ambulatory Medical Care Survey is a survey of approximately 3,000 office-based physicians that uses a three-stage probability sampling procedure to allow extrapolation to the US population. All visits between 1995 and 2006 for symptoms and/or diagnoses compatible with GERD were combined into a single categorical variable. Weighted data was utilized for descriptive and inferential statistical analysis.After weighting, there were N = 321,513 adult ambulatory care encounters for all diagnoses. Visits for reflux increased throughout the examined period. Using logistic regression, visits for reflux were associated with female gender, age over 40, and calcium channel blocker use. Proton-pump inhibitor use increased substantially during the study period while H2 blocker use declined. Family practitioners and internists saw the majority of reflux patients.The frequency of ambulatory visits in the United States for gastroesophageal reflux disease increased significantly between 1995 and 2006. The use of PPI therapy is increasing even more substantially. Older age, female gender, and use of calcium channel blockers were associated with a higher frequency of GERD visits. Health-care utilization for this disorder is increasing perhaps due to our ever-increasing epidemic of obesity.