Application of compound poisson model to estimate underreported risk of non-communicable diseases in underdeveloped areas

Background

Hypertension and diabetes are major components of non-communicable diseases (NCDs), with a substantial number of patients residing in underdeveloped areas. Limited medical resources in these areas often results in underreporting of disease prevalence, masking the true extent of diseases. Taking the underdeveloped Liangshan Yi Autonomous Prefecture in China as an example, this study aimed to correct the underreported prevalence of hypertension and type 2 diabetes so as to provide inspiration for the allocation of medical resources in such areas.

Methods

Assuming the true number of patients in each area follows a Poisson distribution, we applied a Compound Poisson Model based on Clustering of Data Quality (CPM-CDQ) to estimate the potential true prevalence of hypertension and diabetes, as well as the registration rate of existing patients. Specifically, a hierarchical clustering approach was utilized to group the counties based on the data quality, and then the registration rate of the cluster with the best data quality was used as a priori information for the model. The model parameters were estimated by the maximum likelihood method. Sensitivity analyses were performed to test the robustness of the model.

Results

The estimated prevalence of hypertension in the entire Liangshan Prefecture from 2018 to 2020 ranged from 24.59 % to 25.28 %, and for diabetes, it ranged from 4.95 % to 8.42 %. The registration rates for hypertension and diabetes were 14.10 % to 24.59 % and 15.98 % to 29.12 %, respectively. Additionally, the accuracy of clustering the counties with the best data quality had a significant impact on the performance of the model.

Conclusion

Liangshan Prefecture is experiencing a significant high prevalence of hypertension and diabetes, accompanied by a concerningly low registration rate. The CPM-CDQ proved useful for assessing underreporting risks and facilitating targeted interventions for NCDs control and prevention, particularly in underdeveloped areas.