Health Disparities

1

Incident Disability Burden of Rheumatic heart
disease, Hypertensive Heart Disease, and
Inflammatory Heart Diseasein Thaitand,2004

2
Year lost due to disability-YLD

• YLD IDWL
• Where I is the number of incident cases in the
  reference period,
• DW is the disability weight
• L is the average duration of disability
  (measured in years)

3
Rheumatic heart disease

• I01-I02 Rheumatic Fever
• I05-09 Chronic rheumatic heart disease
• rheumatic fever caused by bacteria called
  Streptococcus
• The infection often causes heart damage,
  particularly scarring of the heart valves,
  forcing the heart to work harder to pump blood.
• The damage may resolve on its own, or it may be
  permanent
• eventually causing congestive heart failure

4
Incidence, duration,and disability weight

• The incidence and duration estimation
• DISMODII
• Input data
• prevalence data hospital admission from DRG
• Age-specific death rate of RHD VA study 1999
• Remission rates are estimated from the number
  of valve replacements

5
disability weight
severity distribution and disability weights
heart failure (as this is the main consequence
of Rheumatic Heart disease) Assume 60
mild (0.08) 30 moderate
(0.35) and 10 severe
(0.65) for aggregate DW of 0.206 (Dutch
weight)

6
Table 1 Hospital admission rate per 1,000
population of Rheumatic Fever and Rheumatic
heart disease in 2004

Note WHO survey in SEA school children
(1986-1990) 0.12 (0.1-1.3) per 1000 population
7
Table 2 Hospital admission and death (VA)of RHD
in 2004

•   

8
Table 3 Hospital admission,valve
replacements,and implied remission rate of
Rheumatic heart disease in 2004

9
Table 4 Incidence and duration of Rheumatic
heart disease (estimated from DISMOD)

10
Table 5 YLD of Rheumatic heart disease by age
and sex in 2004 and 1999

11
Table 5 (cont.) YLD of Rheumatic heart disease
by age and sex in 2004 and 1999

12
Hypertensive heart disease

• I11 Hypertensive heart disease with
  (congestive) heart failure
• I13 Hypertensive heart and renal disease
• Hypertensive heart disease is a late complication
  of hypertension (high blood pressure) that
  affects the heart.
• Without treatment, symptoms of congestive heart
  failure may develop.
• Hypertensive heart disease is the leading cause
  of illness and death from hypertension. It
  affects approximately 7 out of 1,000 people.

13
Incidence, duration,and disability weight

• The incidence and duration estimation
• DISMODII
• Input data
• prevalence data hospital admission from DRG
• Age-specific death rate of HHD VA study 1999
• Remission rates are assumed to be 0
• disability weight
• severity distribution and disability
  weights heart failure (as this is the main
  consequence of hypertensive heart disease)
• Assume 60 mild (0.08)
• 30 moderate (0.35) and
• 10 severe (0.65)
• for aggregate DW of 0.206 (Dutch weight)

14
Table 6 Hospital admission and death (VA) of
Hypertensive heart disease in 2004

15
Table 7 Incidence and duration of Hypertensive
heart disease (from DISMODII)

16
Table 8 YLD of Hypertensive heart disease by
age and sex in 2004 and 1999

17
Table 8 (cont.) YLD of Hypertensive heart
disease by age and sex in 2004 and 1999

18
Inflammatory Heart Disease

• Pericarditis an inflammation of the lining sac
  (pericardium) which surrounds the heart.
• Endocarditis a serious infection of one of the
  four heart valves
• Myocarditis inflammation of heart muscle which
  can be caused by a variety of conditions such as
  a virus, sarcoidosis, and immune diseases,
  pregnancy, and others.
• Cardiomyopathies diseases of the myocardium
  associated with cardiac dysfunction

19
Incidence, duration,and disability weight

• Pericarditis
• incidence hospital admission from DRG
• Duration 1 month (given in the GBD study)
• disability weight Dutch weight 0.206
• Endocarditis Myocarditis Cardiomyopathies
• Incidence and duration
• DISMODII
• Input data
• prevalence data hospital admission from DRG
• Age-specific death rate of Inf.H.D VA study
  1999
• Remission rates are assumed to be 0
• disability weight Dutch weight 0.206

20
Table 9 Hospital admission number and rate per
1,000 population of
pericarditis in 2004

21
Table 10 Hospital admission number and death of
endocarditis, myocarditis and cardiomyopathy in
2004

22
Table 11 Incidence and duration of endocarditis,
myocarditis, and cardiomyopathy (from
DISMODII)

23
Table 12 YLD rates per 100,000 population of
INF.H.D.by age and sex in 2004 and 1999

24
Table 12 (cont.) YLD rates per 100,000 population
of INF.H.D. by age and sex in 2004 and 1999