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Long-Term Technology Assessment: Mortality, Hospitalization, and Work Loss Due to Peptic Ulcer and Gastritis/Duodenitis in the Federal Republic of Germany

Published online by Cambridge University Press:  10 March 2009

Bernard S. Bloom
Affiliation:
University of Pennsylvania
Urs Gessner
Affiliation:
Interdisciplinary Research Center for Public Health, Switzerland

Extract

Once the effects of short-term data analysis of new medical technology appear clear, additional or long-term analyses are infrequently performed on subsequent information. This often leads to incomplete understanding of the technology's full medical, social, and economic effects.

Available data for the Federal Republic of Germany on mortality, hospitalization, and work loss due to gastric and duodenal ulcer and gastritis/duodenitis allowed long-term analysis of direct and indirect impacts on the population from 1975 through 1984. Mortality rates declined for all ages (ρ ≤ 0.01) except for those age 75 and older, and nearly equally for all study diagnoses. Hospital discharge rates for all diagnoses rose slowly and steadily, while those for persons diagnosed with gastric ulcer, duodenal ulcer or gastritis/duodenitis declined sharply (ρ = 0.04). Declines of hospital discharges were greater for men than for women. The ongoing decline in rates of mortality and hospital discharges increased after 1977. Rates of work loss per 10,000 population-at-risk for study diagnoses were either stable or increasing until 1979, after which there was a marked decline (ρ = 0.03 for gastric ulcer, ρ = 0.02 for duodenal ulcer, ρ = 0.008 for gastritis/duodenitis). Work loss due to study diseases declined as a percentage of work loss for all diseases during the later study years. Only by examining many years' data could the accelerating declines be discerned, not only for mortality and hospitalizations, which have been examined before, but also for work loss, an infrequently analyzed effect of disease.

Type
General Essay
Copyright
Copyright © Cambridge University Press 1989

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References

REFERENCES

Bloom, B. S.Stretching idealogy to the utmost: Marxism and medical technology. American Journal of Public Health, 1979, 69, 1269–71.Google Scholar
Bulthuis, R.Cimetidine and the cost of peptic ulcer in The Netherlands. Effective Health Care, 1984, 1, 297311.Google Scholar
Coggon, D., Lambert, P., & Langman, M. J. S.Twenty years of hospital admission for peptic ulcer in England and Wales. Lancet, 1981, i, 1302–04.CrossRefGoogle Scholar
Culyer, A. J., & Maynard, A. K.Cost-effectiveness of duodenal ulcer treatment. Social Science and Medicine, 1981, 15c, 311.Google Scholar
Fineberg, H. V., & Pearlman, L. A.Surgical treatment of peptic ulcer in the United States. Lancet, 1981, ii, 1305–07.Google Scholar
Horisberger, B. A review of the epidemiological development of peptic ulcers and an evaluation of duodenal ulcers in the Federal Republic of Germany before and after cimetidine. In Culyer, A. J. & Horisberger, B. (eds.), Economic and medical evaluation of health care technologies. Berlin: Springer-Verlag, 1983.Google Scholar
Jonsson, B. A review of the macroeconomic evaluation of cimetidine. In Culyer, A. J. & Horisberger, B. (eds.), Economic and medical evaluation of health care technologies. Berlin: Springer-Verlag, 1983.Google Scholar
Kurata, J. H., Elashoff, J. D., Haile, B., & Honda, G. D.A reappraisal of time trends in ulcer disease: Factors related to changes in ulcer hospitalization and mortality rates. American Journal of Public Health, 1983, 73, 1066–72.Google Scholar
Kurata, J. H., Elashoff, D. D., Nogawa, A. N., & Haile, B. M.Sex and smoking differences in duodenal ulcer mortality. American Journal of Public Health, 1986, 76, 700–02.Google Scholar
Letters to the editor. American Journal of Public Health, 1980, 70, 436–38.Google Scholar
McKeown, T., & Record, R. G.Reasons for the decline of mortality in England and Wales during the nineteenth century. Population Studies, 1962, 16, 94122.Google Scholar
McKinley, J. B., & McKinley, S. M.The questionable contribution of medical measures to the decline of mortality in the United States in the twentieth century. Milbank Memorial Fund Quarterly, 1977, 55, 405–28.Google Scholar
Raffel, M. W.Comparative Health Systems. University Park: Pennsylvania State University Press, 1984.Google Scholar
Sonnenberg, A.Disability pensions due to peptic ulcer in Germany between 1953 and 1983. American Journal of Epidemiology, 1985, 122, 106–11.Google Scholar
Susser, M.Period effects, generation effects and age effects in peptic ulcer mortality. Journal of Chronic Diseases, 1982, 35, 2940.Google Scholar
Waitzkin, H.A Marxian interpretation of the growth and development of coronary care technology. American Journal of Public Health, 1979, 69, 1260–68.Google Scholar
Walt, R., Katschienski, B., Logan, R., Ashlay, J., & Langman, M.Rising frequency of ulcer perforation in elderly people in the United Kingdom. Lancet, 1986, i, 489–92.Google Scholar