Title

Determining Chronic Disease Prevalence in Local Populations Using Emergency Department Surveillance.

Document Type

Journal Article

Publication Date

9-1-2015

Journal

American journal of public health

Volume

105

Issue

9

Inclusive Pages

e67-74

DOI

10.2105/AJPH.2015.302679

Keywords

Chronic Disease--epidemiology; Emergency Service, Hospital--statistics & numerical data; Population Surveillance--methods; Prevalence; Reproducibility of Results; Residence Characteristics--statistics & numerical data

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. When we 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.

Comments

This is an open access PubMed Central article. Click on link for full-text access.

Peer Reviewed

1

Open Access

1