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. 2020 Feb 24:12:215-222.
doi: 10.2147/CLEP.S238804. eCollection 2020.

Incidence Rates of Four Major Non-Communicable Chronic Diseases in the Chinese Adult Population from 2007 to 2016: A Study Based on a National Commercial Claims Database

Yu Yang #  1   2 , Xiaoyu Sun #  1   2 , Jinwei Wang  3 , Chao Yang  3 , Luxia Zhang  1   2   3
Affiliations

Incidence Rates of Four Major Non-Communicable Chronic Diseases in the Chinese Adult Population from 2007 to 2016: A Study Based on a National Commercial Claims Database

Yu Yang et al. Clin Epidemiol. .

Abstract

Background: The spread of non-communicable chronic diseases (NCDs) is a global crisis. Understanding the dynamics of NCDs at the population level is crucial to develop prevention strategies as well as to evaluate the effectiveness of intervention. However, studies investigating the incidence rate of NCDs among the general population are limited, especially for developing countries like China. We aim to evaluate the incidence rates of four major NCDs from 2007 to 2016, based on a national commercial claims database in China.

Methods: Cancer, stroke, coronary heart disease (CHD) and end-stage kidney disease (ESKD) accounted for over 90% of claims data were included as major NCDs. The definition of the above diseases followed the guideline of disease definitions of critical illness insurance released by the Insurance Association of China. Age-standardized incidence rates (ASRs) of those major NCDs among subgroups of sex, demographic regions, and China city tiers were reported. The trends of incidence rates were described as annual percent change (APC) as well as average annual percent change (AAPC) and were then examined by joinpoint models.

Results: For the population insured in 2007, the average 10-year ASRs of cancer, CHD, stroke, and ESKD were 221.0, 55.5, 43.5, 11.0 per 100,000 person-years, respectively. For males, the ASRs of cancer, CHD, ESKD continuously increase in the past decade with AAPC of 1.4%, 5.2%, and 3.3%; while the ASRs of stroke were decreased with APC of 3.7% after 2009. For females, the increased ASRs of cancer with AAPC of 4.2% and CHD with AAPC of 2.0%; while decreased trends of ASRs were observed for stroke and ESKD. Patterns of ASRs changing varied between different demographic regions and city tiers.

Conclusion: Commercial claims data could be a valuable data source to evaluate the disease burden for major NCDs in China. The disease burden of severe stroke was decreasing while cancer, CHD and ESKD were still increasing in China. More efforts should be put into control of CHD, especially in the northern part of China.

Keywords: Asian; claims database; incidence rate; non-communicable chronic diseases.

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Conflict of interest statement

Prof. Dr. Luxia Zhang report grants from AstraZeneca, outside the submitted work. The authors report no other conflicts on interest in this work.

Figures

Figure 1
Figure 1
Trends of ASRs of the four major NCDs according to sex from 2007 to 2016.
Figure 2
Figure 2
Map of percentage change in ASRs of the four major NCDs from 2007 to 2016.
See this image and copyright information in PMC

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