Abstract
Background: Gastrointestinal illness (GI) remains a leading cause of morbidity and mortality worldwide. In Canada, research has already demonstrated a rate in excess of one episode per person-year. National passive surveillance programs may be enhanced by information from hospitalizations for acute gastrointestinal disease. The objective of this report is to explore the incidence of acute GI in hospital administrative data collected by the Canadian Institute for Health Information (CIHI) — specifically the hospital morbidity database (HMDB).
Methods: Data from acute care facilities and select chronic care and rehabilitation facilities across Canada were analyzed using standardized rates, and age- and sex-adjusted rates for the years 1995–2004.
Results: The results indicate that GI causes at least 92,765 hospital admissions per year in Canada. In the majority (78.3%) of gastrointestinal hospitalizations, no specific etiology was recorded. Of the remaining diagnoses, 11.6% were due to viruses, 9.7% to bacteria and 0.3% to parasites. Age-standardized rates of hospitalizations for acute GI appear to have declined over the 10-year period.
Conclusion: Gastrointestinal illness is still present in the Canadian population and presents a significant burden to the health care system. Whereas the HMDB likely underestimates the true rate of GI, it does capture cases that are serious enough to require hospitalization. This is a unique source of data and highlights other pathogen-specific disease data not currently collected through national surveillance tools (e.g., viruses).
Keywords: Gastrointestinal illness, diarrhea, hospitalization, Canada
Résumé
Contexte: Les maladies gastrointestinales (MGI) demeurent l’une des principales causes de morbidité et de mortalité dans le monde. Au Canada, des études ont déjà fait état d’un taux de MGI supérieur à un accès par personne par année. Les programmes nationaux de surveillance passive pourraient être améliorés avec des données sur les hospitalisations pour maladie gastrointestinale aiguë. Nous avons voulu analyser l’incidence des MGI aiguës dans les données administratives des hôpitaux recueillies par l’Institut canadien d’information sur la santé (ICIS), plus spécifiquement dans la Base de données sur la morbidité hospitalière (BDMH).
Méthode: Nous avons analysé les données des établissements de soins actifs et de certains établissements de soins chroniques et de réadaptation du Canada à l’aide de taux normalisés et de taux rajustés selon l’âge et le sexe pour les années 1995 à 2004.
Résultats: Nos résultats indiquent que les MGI causent au moins 92 765 hospitalisations par année au Canada. Pour la majorité (78,3 %) des hospitalisations attribuables aux MGI, aucune étiologie précise n’est consignée au dossier du patient. Sur les diagnostics restants, la cause est attribuée à des virus dans 11,6 % des cas, à des bactéries dans 9,7 % des cas et à des parasites dans 0,3 % des cas. Les taux d’hospitalisation pour MGI aiguës normalisés selon l’âge semblent avoir diminué pendant cette période de 10 ans.
Conclusion: Les maladies gastrointestinales sévissent encore dans la population canadienne et représentent un lourd fardeau pour le système de santé. La BDMH sous-estime probablement le taux réel de MGI, mais elle saisit néanmoins les cas suffisamment graves pour nécessiter une hospitalisation. C’est une source de données unique en son genre, et elle contient aussi des données sur d’autres maladies dues à des agents pathogènes (p. ex., d’origine virale) que les outils de surveillance nationale actuels ne recueillent pas encore.
Mots clés: maladies gastrointestinales, diarrhée, hospitalisation, Canada
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