The basic concepts of incidence, prevalence, mortality, and costs provide a foundation for understanding and describing the impact of disease in a population. This forum is designed to give you practi

1 Impact of Disease in the Population: Basic Concepts COLLEGE OF NURSING 1 Pathophysiology Objectives Define epidemiology Describe basic measures in epidemiology ◦Morbidity –incidence, prevalence ◦Mortality ◦Cost COLLEGE OF NURSING 2 1 2 2 Epidemiology Definition ◦Study of the distribution and determinants ofhealth -related states or events inspecified populations and the application of findings to the control of health problems COLLEGE OF NURSING 3 Incidence Estimate of morbidity ◦Number of living persons newly diagnosed or at risk for being newly diagnosed with a specific disorder during a specific time period (e.g., year) Ways to present estimate ◦Total number of new cases ◦Percent –new cases per 100 persons (%) ◦Population rate –new cases per population (e.g., 100,000 population) COLLEGE OF NURSING 4 Incidence of pancreatic cancer in US 56,770 new cases, 2019 1.6% of the population per year, 2014 -2016 12.9 new cases per 100,000 population, 2019 3 4 3 Prevalence Estimate of morbidity ◦Number of ALL persons living persons with a specific disorder during specific time period (e.g., year) regardless of when they were diagnosed (new + prior diagnoses) ◦Applicable to chronic disorders -cases accumulate over time, newly diagnosed persons and those already diagnosed (e.g., HIV) ◦Not applicable to acute disorders that resolve quickly -cases DO NOT accumulate over time (e.g., seasonal influenza) Ways to present estimate ◦Total number of all cases ◦Percent –all cases cases per 100 persons (%) ◦Population rate –all cases per population (e.g., 100,000 population) COLLEGE OF NURSING 5 Prevalence of pancreatic cancer in US 73,554 persons, 2014 5 persons per 100,000 population, 2014 Mortality Estimate of deaths ◦Deaths in persons with a specific disorder during a specific time period (e.g., year) ◦Death directly from disorder or indirectly from complications Many ways to present estimate ◦Total number of deaths ◦Percent –deaths per 100 persons (%) ◦Population rate –deaths per population (e.g., 100,000 population) COLLEGE OF NURSING 6 Mortality from pancreatic cancer in US 45,750 deaths, 2019 11 deaths per 100,000 population, 2019 5 6 4 Cost Estimate of economic burden ◦US dollars ($) during a time period (e.g., year) ◦Many types -actual, projected, direct (formal, non -health), indirect Ways to present estimate ◦Total national cost ◦Average (aka. mean) cost per person ◦Projected average lifetime cost per person ◦Range of average costs per person -lowest and highest average costs COLLEGE OF NURSING 7 Costs for pancreatic cancer in US Average (aka. mean) cost per hospital stay increased from $39,533 to $74,216 between 2004 -2013, equates to a 47% increase Pancreatic Cancer Estimates Measure Estimate & details –United States Population -age, gender, location, etc. Unit -%, per 100,000 population, etc.Year estimate applies Source detailsAuthor/organization Publication Year published Incidence -new cases morbidity 56,770 new cases est. in 2019 3.2% of all new cancer cases, 11 thmost common cancer 12.9 cases per 100,000 population in 20191.6% population per year, 2014 -2016 Incidence stable for past 10 years National Cancer Institute (n.d.), https://seer.cancer.gov/statfacts/html/pancreas.h tml Prevalence –all cases morbidity 73,554 people living in 2014 5 cases per 100,000 in 2014 National Cancer Institute (n.d.), https://seer.cancer.gov/statfacts/html/pancreas.h tml Mortality –death 45,750 deaths in 2019 7.5% of all cancer deaths in 20199.3% survival for 5 years, 2006 -2015 Slight increase of 0.1% each year for past 10 years11 deaths per 100,000 population per year National Cancer Institute (n.d.) , https://seer.cancer.gov/statfacts/html/pancreas.h tml Cost –US dollars ($)any type Hospitalized patients, 2004 -2013 Mean length of stay decreased from to 9.0 to 7.6 daysMean cost of hospital stay increased 47%, from $39,533 to $74,216 Bansal, D., Bansa ,P. & Kapoor, V. (2017). Pancreatic cancer cost-of-care in inpatient setting. Journal of Clinical Journal of Clinical Oncology 35 (Supp 8), 28-28. https://doi.org/10.1200/JCO.2017.35.8_suppl.28 COLLEGE OF NURSING 8 7 8 5 Essay Answer Example Pancreatic cancer is characterized by genetic mutations in pancreatic cells leading to malignant tumor growth, local spread, and metastasis (National Cancer Institute [NCI], n.d.). Pancreatic cancer is the 11 th most commonly diagnosed cancer in the US and accounted for 3.2% of all new cancer cases (NCI, n.d.). For the past 10 years, incidence was stable. During 2019, a reported 57,770 new cases were diagnosed, which equated to 12.9 cases per 100,000 population or 1.6% of the population (NCI, n.d.). During 2014, prevalence was reported as 73,554 people living with pancreatic cancer, which equated to 5 cases per 100,000 population (NCI, n.d.). Regarding mortality, only 9.3% of persons were alive 5 years after diagnosis. Unlike incidence, mortality increased by 0.1% each year for the past 10 years. During 2019, there were 45,750 deaths reported from pancreatic cancer, which equated to 11 deaths per 100,000 population. Pancreatic cancer accounted for 7.5% of all cancer deaths that year (NCI, n.d.). Between 2004 -2013, the average hospital cost per person increased by 47% to $74,216. This was large increase in cost despite a decreased length of stay during that period (Bansal et al., 2017). 187 words COLLEGE OF NURSING 9 9