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Health inequalities: survey data compared to doctor defined data.

Westert, G.P., Schellevis, F.G. Health inequalities: survey data compared to doctor defined data. European Journal of Public Health: 2003, 13(4 sup) 131. Abstract. 11th Annual Eupha Meeting 'Globalisation and Health in Europe: Harmonising Public Health Practices'. Rome, Italy, 20-22 November 2003.
Aim: To compare prevalence of conditions and health inequalities in one study population using two methods of data collection: health interview survey and GP registration of consultations. Methods: Data is from the Second Dutch Survey of General Practice, using a multistage sampling design with approx. 400.000 patients nested in 104 general practices. Consultations of patients were recorded by the GP during one year and a random sample patients (13.000) was invited for a health interview survey. Data on highest achieved level of education was collected in a separate census in the study population (400.000) with a response of 75%. Prevalence of chronic conditions was computed using both data sources. Sex and age adjusted odds ratios were calculated to indicate the differences in prevalence of disease for different educational groups. The analyses were limited to respondents aged 25 and older. Results: Prevalence estimates of chronic conditions vary between method of data collection, but odds ratios indicating educational differences in prevalence of disease show great similarity. For the sixteen chronic conditions studied the association of the latter result is .84 (Spearman’s rho). For example: migraine or severe headache, the chronic condition with the highest prevalence, was observed via self report in 18.3 of the cases and in 3.7 percent presented the condition at the GP’s office. Odds ratios for educational level were 1.4 (p<.01) and 1.3 (p<.01) respectively, indicating that migraine has a higher prevalence in the lowest educational group. Educational differences for diabetes was highest: 2.1 (self report) and 2.4 (GP presented) respectively. Conclusions Data on morbidity collected through health interview survey and GP registration give systematic deviating estimations of the prevalence of disease, but give similar estimations of health inequalities by education.(aut.ref.)
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