Surveillance in a time of changing health care practices: estimating ectopic pregnancy incidence in the United States.
OBJECTIVES: Ectopic pregnancy is a common condition with significant health consequences; complications are a major cause of maternal mortality in the United States. Accurate ascertainment of the number of ectopic pregnancies occurring in the United States has been dramatically affected by changing...
| Publicado en: | Maternal & Child Health Journal Vol. 6; no. 4; pp. 227 - 237 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2002
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106817743&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106817743 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10927875 N9J jtl: Maternal & Child Health Journal issn: 10927875 maglogo: N pubinfo: dt: Dec2002 vid: 6 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 106817743 106817743 2003046308 10.1023/a:1021106032198 NLM12512764 106817743 ppf: 227 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Surveillance in a time of changing health care practices: estimating ectopic pregnancy incidence in the United States. aug: au: Zane SB Kieke BA Jr. Kendrick JS Bruce C affil: Maternal Health Team, Maternal and Infant Health Branch, Division of Reproductive Health, CDC, 4770 Buford Highway, NE, Mailstop K-23, Atlanta, GA 30341; saz3@cdc.gov sug: subj: Pregnancy, Ectopic Epidemiology Pregnancy, Ectopic Trends Disease Surveillance Methods Disease Surveillance Evaluation United States Surveys Resource Databases, Health Hospitalization Ambulatory Care Pregnancy, Ectopic Surgery Reliability Data Analysis Software Inpatients Outpatients Data Collection Methods International Classification of Diseases Female Pregnancy Adolescence Adult Incidence Confidence Intervals Sample Size Descriptive Statistics Epidemiological Research Human Adolescent: 13-18 years Adult: 19-44 years Female ab: OBJECTIVES: Ectopic pregnancy is a common condition with significant health consequences; complications are a major cause of maternal mortality in the United States. Accurate ascertainment of the number of ectopic pregnancies occurring in the United States has been dramatically affected by changing medical practices, causing estimates based on hospital data to be falsely low. This study was performed to identify nationally representative data on ectopic pregnancies and determine overlap of these data, to calculate the annual weighted number of ectopic pregnancies and confidence intervals for these estimates, and to determine barriers to estimation of ectopic pregnancy incidence. METHODS: To assess whether a national estimate of the incidence of ectopic pregnancy could be calculated, we analyzed 1992-99 data from the six nationally representative data sets that include information on ectopic pregnancy. We examined relevant data in each data set and assessed whether any combination of data sets could be used to estimate ectopic pregnancy incidence. We calculated weighted estimates and 95% confidence intervals for hospitalizations, outpatient surgeries, outpatient medical procedures, and physician visits for and self-reports of ectopic pregnancy. RESULTS: Small sample sizes severely limited calculation of estimates of ectopic pregnancy. Data needed for assessing multiple counting was not available consistently. The likelihood of multiple counting of cases was substantial when data set counts were combined. CONCLUSIONS: A reliable incidence rate for ectopic pregnancy in the United States could not be estimated from existing nationally representative data sources. Major advances in diagnosis and treatment of ectopic pregnancy have affected surveillance in two ways: inpatient hospital treatment of ectopic pregnancy has decreased, and multiple health care visits for a single ectopic pregnancy have increased. Alternate means of surveillance are needed to improve understanding of risk factors and trends for ectopic pregnancy, and we recommend examination of the databases of public and private insurance systems and managed care systems. Similar alternate means of surveillance may be needed for other health conditions with comparable changes in management of care. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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