CHRONOLOGICAL STUDY ON CHRONIC PULMONARY DISEASE FOR A POPULATION COHORT IN TAIWAN
Resource
EPIDEMIOLOGY v.16 n.5 pp.S31
Journal
EPIDEMIOLOGY
Journal Volume
v.16
Journal Issue
n.5
Pages
S3-1
Date Issued
2005
Date
2005
Author(s)
Wang, Y C.
Sung, F C.
Abstract
Introduction: Chronic pulmonary disease is a complex disease associated with both host factors and environmental risks. Aim: This study analyzed the yearly incidence and prevalence of the disease and identified the association between the disease and the potential risk factors, in Taiwan. Methods: Using a cohort data set of 200,000 persons ’ records of hospital visits from 1996 to 2002, established from the National Health Insurance, Taiwan, we observed the pattern of chronic pulmonary diseases (ICD9 490–496) by age (0–14, 15–39 and 40 years), sex, urban/rural areas, co -morbidity and severity of the disease. Results: Among 55, 124 persons ever having had medical visits which led to diagnosed chronic pulmonary disease, 20,819 persons (37.8%) visited once and 2,934 persons (5.3%) were considered as severe cases, with > 21 medical visits in 7 years (at 95 percentile and above, visits). Both the incidence (from 6.9% to 2.3%) and prevalence of the disease (from 9.7% to 5.1%) decreased annually, with peaks in 1997. However, the individual annual visit rate increased from 2.3–3.3 to 3.0 –4.5 visits/ person. Multivariate logistic regression analysis showed there were more severe cases in 1996 than in the other years (odds ratio (OR)=9.9, 95% CI=9.1–10.8). Persons living in urban areas were at a lowered risk (OR=0. 69, 95% CI=0.63–0. 75) for being severe cases. Compared with those aged 15–39 years, severe cases were more likely observed in children ( OR=4.6, 95% CI=3.8–5.1) and the older age group (OR=6.5, 95% CI=5.7–7.4). Males were at higher risk than females (OR =1.8, 95% CI=1.7–2.0). The chronic pulmonary disease patients were also at an elevated risk for having co- morbidity, including hypertension (ICD9 4019–40599, OR=2.3, 95% CI=2.0–2.6), benign prostate hypertrophy or disorders of kidney/ urinary tract (ICD9 591 –600, OR= 3.1, 95% CI= 2. 7–3.7), dermatological disorders (ICD9 690–710, OR=3.4, 95% CI=3.1–3.7), and back disorders (ICD9 721–725, OR=3.1, 95% CI=2. 8–3.4). Conclusion: The cohort data allow a chronological observation of disease patterns. Monitoring medical claims by the insurance system makes diagnosis consistent and reliable. Our analysis of the annual changes in incidence and prevalence of the diseases indicates the beneficial effect of the role that the insurance system plays in dealing with the diseases. The risk associated with weather conditions and ecological status deserves further study.
Type
journal article