TITLE

Cross-national changes in the effects of peptic ulcer disease

AUTHOR(S)
Bloom, Bernard S.; Bloom, B S
PUB. DATE
April 1991
SOURCE
Annals of Internal Medicine;4/1/91, Vol. 114 Issue 7, p558
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
Objective: To describe and to analyze the changing effects of peptic ulcer disease over time.Design: Variables relating to peptic ulcer disease from 1970-1986 were compared. The variables included rates of mortality, hospitalizations, operations, physician visits, and endoscopies, and the amount of disability-related loss of work and early retirement in six countries (Belgium, England and Wales, the Federal Republic of Germany, The Netherlands, Sweden, and the United States).Measurements: Nonparametric epidemiologic time-trend analysis.Main Results: The historic, slow, declining trend in mortality and hospitalization rates continued. The rate of operations for peptic ulcer disease exhibited a large, one-time reduction, then returned to a parallel declining trend, but at a lower level. The rate of physician visits declined by 50%. The greatest changes were found in the rate of endoscopy use and in disability-related loss of work and early retirement, where increasing trends were quickly followed by decreasing trends. The elderly, especially women, generally did not share many of these benefits.Conclusions: The effects of new interventions can be understood more fully by examining several variables in many countries over a long time. Contrary to expectations, the effects of the widespread use of histamine H2 antagonists have been more indirect (affecting work loss and disability retirement more) than direct (affecting high-cost medical service use and mortality less).
ACCESSION #
6970343

 

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