[Prevalence of tuberculosis in Swiss hospitals in the years 1990 to 1993]

Abstract

The medical statistics of VESKA (Association of Swiss Hospitals), MSV, comprise and include the spectrum of all diseases in patients admitted to Swiss hospitals which are members of the association. Documentation is carried out in accordance with the WHO ICD code. Tuberculosis is registered under the main figures 010 to 018. The MSV makes an essential contribution in a special area to the recording of tuberculosis in Switzerland. The ICD code classes the disease either in positions 1 to 3 as the category of "all (TB) diagnoses' or as "principal diagnosis' in the first place. The numerical values are either recorded individually for the years 1990 to 1993 or as mean values of these four years. Tuberculosis occupies a small space within the overall statistics. Of a total of 722 868 and 369 840 coded diagnoses (1990 to 1993, averages), 1100 and 627, respectively, fall under tuberculosis in the two categories. This corresponds to a proportion of 0.15% and 0.17%, respectively. Tuberculosis becomes more important because the general average hospital stay of 12.7 days is almost doubled with an average of 24.7 days for tuberculosis patients. If the costs per case generally stand at Sfr. 7353.-, then, for tuberculosis patients, they rise to Sfr. 14 301.-. The overall costs for tuberculosis patients per calendar year total Sfr. 15 731 430.- and Sfr. 8 966 915.-, respectively, in the two categories. Tuberculosis is, therefore, a disease which is still of economic significance even in Switzerland. In the category of types of tuberculosis, pulmonary tuberculosis (011) still today occupies first position compared to previous analyses with current figures of 65.1% and 67.7% respectively. In the case of the extra-pulmonary types, uro-genital tuberculosis (016) stands in second place with 5.7% and 3.5% in the two categories, after the group of tuberculosis of other organs (017) with 5.9% and 6.1%, respectively. There was a constant preponderance of male over female patients (64.3% vs. 35.6%). If decades ago tuberculosis shifted to and was spread over more advanced age groups in Switzerland, the proportion of foreigners now within the whole population has brought about a change. Almost twice as many tuberculosis cases occur within the 20-year to 40-year age group than in the other age groups, in which a certain degree of levelling off is apparent. From comparisons of notifications to authorities in Switzerland and from hospitalization rates, it can be deduced that there is no increased need for hospitalization for any particular age group.