0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Cross-National Changes in the Effects of Peptic Ulcer Disease

Bernard S. Bloom, PhD
[+] Article and Author Information

Requests for Reprints: Bernard S. Bloom, PhD, University of Pennsylvania, 2L, Nursing Education Building, Philadelphia, PA 19104-6020.

Current Author Address: Dr. Bloom: University of Pennsylvania, 2L, Nursing Education Building, Philadelphia, PA 19104-6020.


©1991 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1991;114(7):558-562. doi:10.7326/0003-4819-114-7-558
Text Size: A A A

Objective: To describe and to analyze the changing effects of peptic ulcer disease over time.

Design: Variables relating to peptic ulcer disease from 1970-1986 were compared. The variables included rates of mortality, hospitalizations, operations, physician visits, and endoscopies, and the amount of disability-related loss of work and early retirement in six countries (Belgium, England and Wales, the Federal Republic of Germany, The Netherlands, Sweden, and the United States).

Measurements: Nonparametric epidemiologic time-trend analysis. Main Results: The historic, slow, declining trend in mortality and hospitalization rates continued. The rate of operations for peptic ulcer disease exhibited a large, one-time reduction, then returned to a parallel declining trend, but at a lower level. The rate of physician visits declined by 50%. The greatest changes were found in the rate of endoscopy use and in disability-related loss of work and early retirement, where increasing trends were quickly followed by decreasing trends. The elderly, especially women, generally did not share many of these benefits.

Conclusions: The effects of new interventions can be understood more fully by examining several variables in many countries over a long time. Contrary to expectations, the effects of the widespread use of histamine H2 antagonists have been more indirect (affecting work loss and disability retirement more) than direct (affecting high-cost medical service use and mortality less).

Topics

peptic ulcer

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)