Benchmarking the burden of 100 diseases: results of a nationwide representative survey within general practices

被引：19

作者：

Grimaldi-Bensouda, Lamiae ^{[1
,2
]}

Begaud, Bernard ^{[3
]}

Lert, France ^{[4
]}

Rouillon, Frederic ^{[5
]}

Massol, Jacques ^{[6
]}

Guillemot, Didier ^{[7
,8
]}

Avouac, Bernard ^{[2
]}

Duru, Gerard ^{[9
]}

Magnier, Anne-Marie ^{[10
]}

Rossignol, Michel ^{[11
,12
]}

Abenhaim, Lucien ^{[13
,14
]}

机构：

[1] Inst Pasteur, Equipe Accueil Pharmacoepidemiol & Malad Infect, Paris, France

[2] LA SER, Paris, France

[3] Univ Bordeaux, U657, Bordeaux, France

[4] Ctr Epidemiol & Populat Hlth, INSERM U1018, Villejuif, France

[5] Univ Paris 05, Ctr Hosp St Anne, Paris, France

[6] Univ Franche Comte, UFR Med, F-25030 Besancon, France

[7] Inst Pasteur, Paris, France

[8] Univ Paris Ile France Ouest, Paris, France

[9] CYKLAD Grp, Rillieux La Pape, France

[10] Univ Paris 06, Fac Med, Paris, France

[11] McGill Univ, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ, Canada

[12] LA SER Ctr Risk Res, Montreal, PQ, Canada

[13] London Sch Hyg & Trop Med, Dept Epidemiol, London, England

[14] LA SER Europe, London, England

来源：

BMJ OPEN | 2011年 / 1卷 / 02期

关键词：

QUALITY-OF-LIFE; HEALTH-STATUS; MENTAL-HEALTH; PRIMARY-CARE; SF-12; MULTIMORBIDITY; QUESTIONNAIRE; PREVALENCE; ASSOCIATION; COMORBIDITY;

D O I：

10.1136/bmjopen-2011-000215

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: To assess the burden of diseases and quality of life (QOL) of patients for a large variety of diseases within general practice. Design: In a representative nationwide cross-sectional study, a total of 825 general practitioners (GPs) were randomly selected from across France. Independent investigators recruited 8559 patients attending the GPs' practices. Data on QOL (12-Item Short Form questionnaire) and other individual characteristics were documented by the independent investigators for all participants in the waiting room. Medical information was recorded by GPs. Sampling was calibrated to national standards using the CALMAR (CALage sur MARges) weighting procedure. Associations of lower scores (ie, below vs above the first quartile) of physical and mental component scores (physical component summary score (PCS) and mental component summary score (MCS), respectively) with main diseases and patients characteristics were estimated using multivariate logistic regression. Weighted morbidity rates, PCS and MCS were computed for 100 diagnoses using the International Classification of Diseases (9th version). Results: Overall mental impairment was observed among patients in primary care with an average MCS of 41.5 (SD 8.6), ranging from 33.0 for depressive disorders to 45.3 for patients exhibiting fractures or sprains. Musculoskeletal diseases were found to have the most pronounced effect on impaired physical health (OR=2.31; 95% CI 2.08 to 2.57) with the lowest PCS (45.6 (SD 8.8)) and ranked first (29.0%) among main diagnoses experienced by patients followed by cardiovascular diseases (26.7%) and psychological disorders (22.0%). When combining both prevalence and QOL, musculoskeletal diseases represented the heaviest burden in general practice. Conclusions: Etude epidemiologique de l'Impact de sante public sur 3 groupes de pathologies (EPI3) is the first study to provide reference figures for burden of disease in general practice across a wide range of morbidities, particularly valuable for health-economics and healthcare-system evaluation.

引用

页数：11