COPD prevalence and hospital admissions in Galicia (Spain). An analysis using the potential of new health information systems.

INTRODUCTION AND OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is a major public health problem. The aim of this study was to ascertain the prevalence of COPD and whether such prevalence was positively or negatively associated with COPD admissions, using all the data of a regional health care system. MATERIALS AND METHODS: We designed a descriptive cross-sectional study which included all subjects aged over 45 years, diagnosed with COPD in primary care in 2013. We also calculated the number of such patients who had a record of hospital admissions due to this disease. COPD prevalence and incidence of admissions were calculated. Poisson regression models were then used to analyse the association between cases with diagnosis of COPD and admissions due to COPD, by sex, adjusting for socio-demographic variables and distance to hospital. Sensitivity subanalyses were performed by reference to the respective municipal rurality indices. RESULTS: Median municipal prevalence of COPD was 5.29% in men and 2.19% in women. Among patients with COPD, 28.22% of men and 16.00% of women had at least one hospital admission. The relative risk of admission per unit of the standardised prevalence ratio was 0.37 (95% CI 0.34-0.41) for men and 0.39 (95% CI 0.34-0.45) for women. CONCLUSIONS: There is a significant negative association between COPD prevalence and hospital admissions due to this disease. The proportion of admissions is lower in municipalities lying furthest from hospitals. There is considerable municipal variability in terms of COPD prevalence and proportion of admissions. In-depth attention should be given to disease-management training programmes.

[Descriptive study of suicide in Galicia, 1987]. / Estudio descriptivo do suicidio en Galicia, 1987.

Deaths caused by suicide in Galicia during 1987 are studied, in order to identify high incidence areas where further studies could be designed to define specific factors for suicide. Three hundred and three death certificates and their corresponding judicial reports in the subgroup E950-959 of the International Classification of Diseases (ICD-9) were processed. Suicide rate in Galicia was found to be 10.65 per 100,000 inhabitants, with 5,313 Years of Potential Life Lost. The suicide rate in the province of Coruña was the highest (12.79 per 100,000 inhabitants) and, within it, the Narón area reached the highest rate (35.40 deaths per 100,000 inhabitants). Male to female ratio was 3.7. Mean age at suicide was 52.8 (sigma = 18.8), the range being 14-90 years. The age distribution was concentrated at older ages, especially among women, who contributed to a higher number of deaths by suicide on sundays and first days of the week. Hanging was the method chosen in 66% of deaths. We conclude that Galicia has a high mortality due to suicide, especially in the industrial area where the economic crisis is more pronounced.

[The quality of mortality statistics. Galicia 1987]. / Aproximación a calidade das estadísticas de mortalidade. Galicia 1987.

We intend to study the reliability of the mortality statistics in Galicia (1987), comparing the basic cause of death, with that we obtain by the Autopsy Report (AR). After independently studying 90 AR, three physicians selected the basic cause of death, subsequently coded by the same team. All this persons were blind in relation with the previous certification. 41.1% of the causes of death agreed in 4 digit, 45.6% agreed in 3 digit and the 63.3% remained in the same ICD-9 group. Taking into account all the mistakes found, the 13.3% took place due to an incomplete definition, but the classification remained correct. The 10.0% due to an error in the logic sequence, the 15.6% by an error in the selection of the cause of death and, in the 20.0% there was no relationship between causes. For cardiovascular diseases, the Predictive Positive Value (PPV) was 76.9%, the Sensibility (S) was 83.0% and the Specificity (Sp) 90.9%. For the tumors, the value of the PPV and the S was 73.7% and the Sp was 92.9%. In spite of selection bias because of the method used, we think that the information produced is useful for evaluating the quality of mortality statistics in Galicia. When comparing our results with similar studies, we find an acceptable level.

[Habits of alcohol consumption in the child population of Galicia]. / Hábitos de consumo del alcohol entre la población infantil gallega.

An investigation carried out, amongst 1,200 school children of both sexes, between the ages of 5 and 14, in rural and urban areas of Galicia, to find out the amount of alcohol drinkers, shows that 71.6 por 100 of them drink alcohol and 31.3 por 100 are habitual drinkers. Percentages of alcohol drinkers are highest amongst: boys (76% boys to 67.2% girls), children above the age of 11 (84.6%), children working class backgrounds (38.1%, 20.7% 16.6% of children from working class, middle class and upper class respectively). There is no difference in the percentage of drinkers in rural and urban areas, but there is as to the amount of alcohol consumed (the percentage is higher in rural areas than in urban ones). Most alcohol is consumed in the home (92.6% of the children). The most popular drink is wine (83.2%). 27.6% of the children have at time been drunk.