Determining chronic disease prevalence in local populations using emergency department surveillance

D.C. Lee, J.A. Long, S.P. Wall, B.G. Carr, S.N. Satchell, R.S. Braithwaite and B. Elbel

American Journal of Public Health, 2015, vol. 105, issue 9, e67-e74

Abstract: Objectives. We sought to improve public health surveillance by using a geographic analysis of emergency department (ED) visits to determine local chronic disease prevalence. Methods. Using an all-payer administrative database, we determined the proportion of unique ED patients with diabetes, hypertension, or asthma. We compared these rates to those determined by the New York City Community Health Survey. For diabetes prevalence, we also analyzed the fidelity of longitudinal estimates using logistic regression and determined disease burden within census tracts using geocoded addresses. Results. We identified 4.4 million unique New York City adults visiting an ED between 2009 and 2012.Whenwe compared our emergency sample to survey data, rates of neighborhood diabetes, hypertension, and asthma prevalence were similar (correlation coefficient = 0.86, 0.88, and 0.77, respectively). In addition, our method demonstrated less year-to-year scatter and identified significant variation of disease burden within neighborhoods among census tracts. Conclusions. Our method for determining chronic disease prevalence correlates with a validated health survey and may have higher reliability over time and greater granularity at a local level. Our findings can improve public health surveillance by identifying local variation of disease prevalence.

Keywords: adolescent; adult; aged; asthma; chronic disease; cluster analysis; demography; diabetes mellitus; emergency health service; female; health survey; human; hypertension; insurance; male; middle aged; prevalence; procedures; reproducibility; socioeconomics; statistics and numerical data; United States; young adult, Adolescent; Adult; Aged; Asthma; Chronic Disease; Diabetes Mellitus; Emergency Service, Hospital; Female; Health Surveys; Humans; Hypertension; Insurance Claim Review; Male; Middle Aged; New York City; Population Surveillance; Prevalence; Reproducibility of Results; Residence Characteristics; Small-Area Analysis; Socioeconomic Factors; Young Adult (search for similar items in EconPapers)
Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2015.302679_6

DOI: 10.2105/AJPH.2015.302679

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