Carlos Alvarez-Ibáñez1, María Mercedes Guerra-García. 1. Medicina Familiar y Comunitaria, Centro de Salud de Porriño, Gerencia de Atención Primaria de Vigo, Vigo, Spain. carlos.alvarez.ibanez@sergas.es
Abstract
OBJECTIVE: To analyse trends in the incidence of hospitalisation due to upper gastrointestinal bleeding (UGB) and the relationship with the prescribing of anti-ulcer agents. DESIGN: Retrospective observational ecological study. SETTING: Spanish National Health System (NHS) for the nine years between 1st January 2000 and 31st December 2008. INCLUSION CRITERIA: Patients aged 15 or over hospitalised due to UGB were divided into four age groups: 15-44, 45-64, 65-74 and ≥75 years old. Drugs, A02B subgroup, prescribed under the NHS. EXCLUSION CRITERIA: Prescription of medicines in hospital or public-employee insurance companies. MEASUREMENTS: Incidence (number of new cases of UGB occurring in one year), Incidence rate (incidence per 100,000 inhabitants), Dispersion rate (number of packets dispensed per year per 100,000 inhabitants), and Hazard ratio (HR, ratio between the rate of the last year over the first year. Annual rates were calculated by the standardised direct method). DATA SOURCE: Ministry of Health. RESULTS: We identified 110,150 hospital admissions due to UGB (61.17% male, 38.83% female). Values for 95% UGB: Total Mean Incidence Rate (MIR)=34.45 [32.70, 36.20], HR=0.83. Males: MIR=43.07 [40.41, 45.72], HR=0.80 and females: MIR=25.20 [25.18, 27.23], HR=0.88. HR HDA by age group in males: 15-44 years=0.64; 45-64 years=0.74, 65-74 years=0.74 and >74 years=0.85. Females: 15-44 years=0.82, 45-64 years=0.71, 65-74 years=0.3 and >74 years=0.89. Drug dispensing (2000-2008): HR proton pump inhibitors=4.43; HR all anti-ulcer agents=3.01. CONCLUSIONS: Over nine years the dispensing of anti-ulcer agents by the Spanish National Health System has multiplied without having regard to the evolutionary trend of hospitalisation due to UGB.
OBJECTIVE: To analyse trends in the incidence of hospitalisation due to upper gastrointestinal bleeding (UGB) and the relationship with the prescribing of anti-ulcer agents. DESIGN: Retrospective observational ecological study. SETTING: Spanish National Health System (NHS) for the nine years between 1st January 2000 and 31st December 2008. INCLUSION CRITERIA: Patients aged 15 or over hospitalised due to UGB were divided into four age groups: 15-44, 45-64, 65-74 and ≥75 years old. Drugs, A02B subgroup, prescribed under the NHS. EXCLUSION CRITERIA: Prescription of medicines in hospital or public-employee insurance companies. MEASUREMENTS: Incidence (number of new cases of UGB occurring in one year), Incidence rate (incidence per 100,000 inhabitants), Dispersion rate (number of packets dispensed per year per 100,000 inhabitants), and Hazard ratio (HR, ratio between the rate of the last year over the first year. Annual rates were calculated by the standardised direct method). DATA SOURCE: Ministry of Health. RESULTS: We identified 110,150 hospital admissions due to UGB (61.17% male, 38.83% female). Values for 95% UGB: Total Mean Incidence Rate (MIR)=34.45 [32.70, 36.20], HR=0.83. Males: MIR=43.07 [40.41, 45.72], HR=0.80 and females: MIR=25.20 [25.18, 27.23], HR=0.88. HR HDA by age group in males: 15-44 years=0.64; 45-64 years=0.74, 65-74 years=0.74 and >74 years=0.85. Females: 15-44 years=0.82, 45-64 years=0.71, 65-74 years=0.3 and >74 years=0.89. Drug dispensing (2000-2008): HR proton pump inhibitors=4.43; HR all anti-ulcer agents=3.01. CONCLUSIONS: Over nine years the dispensing of anti-ulcer agents by the Spanish National Health System has multiplied without having regard to the evolutionary trend of hospitalisation due to UGB.
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