Abstract
We attempted to address deficiencies in administrative health service data during a study of cardiorespiratory emergency department visits. From 1994–1996, we obtained data on 9,264 visits and conducted 1,772 follow-up interviews. The median interval between symptoms and visit ranged from 0.8 days (95% CI 0–1.7) for cardiac conditions to 4.0 days for chronic obstructive pulmonary disease (COPD) (95% CI 2.7–5.3) and respiratory infections (95% CI 3.5–4.5). Infection was the most common trigger of respiratory visits. Although most had improved at follow-up, symptoms persisted following the visit for a mean of 4.5 days (95% CI 3.8–5.4) for cardiac conditions to 8.4 days (95% CI 7.2–9.5) for COPD. Among adults aged <70, the mean number of reduced activity days per episode ranged from 4.7 (95% CI 3.9–5.4) for asthma to 6.6 (95% CI 5.9–7.4) for respiratory infections. Our data assist in interpreting epidemiological studies based on administrative data, and illustrate the broad impacts of cardiorespiratory disease episodes.
Résumé
Nous avons tenté de compenser le manque de données administratives sur l’utilisation des services de santé au cours d’une étude sur les visites à l’urgence pour des problèmes cardiorespiratoires. De 1994 à 1996, nous avons recueilli des données sur 9 264 visites et procédé à 1 772 entrevues de suivi. L’intervalle médian entre l’apparition des symptômes et la visite s’étendait de 0,8 jour pour les problèmes cardiaques (IC de 95 %, de 0 à 1,7) à 4,0 jours pour les cas de bronchopneumopathie chronique obstructive (BCO) (IC de 95 %, de 2,7 à 5,3) et les infections respiratoires (IC de 95 %, de 3,5 à 4,5). L’infection est apparue comme le facteur le plus commun à l’origine d’une visite pour problème respiratoire. Même si lors du contrôle de suivi, la plupart des cas s’étaient améliorés, les symptômes persistaient en moyenne de 4,5 jours après la visite pour les problèmes cardiaques (IC de 95 %, de 3,8 à 5,4) à 8,4 jours (IC de 95 %, de 7,2 à 9,5) pour les cas de BCO. Chez les adultes de moins de 70 ans, le nombre moyen de jours d’activités réduites par épisode variait de 4,7 (IC de 95 %, de 3,9 à 5,4) pour l’asthme à 6,6 (IC de 95 %, de 5,9 à 7,4) pour les infections respiratoires. Nos données aident à interpréter les études épidémiologiques fondées sur des données administratives, et illustrent le vaste impact des épisodes de maladies cardiorespiratoires.
Footnotes
This study was funded by Health Canada, The New Brunswick Environmental Trust Fund, and the Program on Energy Research and Development, Natural Resources Canada.
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