Objective: This study investigated the socioeconomic characteristics of dementia patients in Greece and assessed whether these factors influence their healthcare. Methods: A cross-sectional observational study design was used. In total, data from 779 elderly dementia patients were reviewed. Results: On the whole, a larger proportion of primary health care facilities were used by patients with no educational level (Odds Ratio=10.91; 95%; Confidence Interval=3.21–37.14) or no/little income adequacy (Odds Ratio=2.13; 95%; Confidence Interval=1.18–3.86). Moreover, patients with a lower economic status (€0–6000) used primary health care facilities at a lower level (Odds Ratio=0.22; 95%; Confidence Interval=0.12–0.39). After controlling for confounding effects with a logistic regression method, tertiary education (Odds Ratio=7.68; 95%; Confidence Interval=2.76–21.35) was also a factor determining the frequency of patients visiting social care services, as was a higher economic status. In a logistic regression model, a higher educational level and rural areas were related to the use of information and communication technology and their devices (Odds Ratio=65.68; 95%; Confidence Interval=7.22–597.12, tertiary education) and (Odds Ratio=0.16; 95%; Confidence Interval=0.05–0.56). Conclusions: Socioeconomic status and area of residence are two major factors that affect various aspects of dementia care, while accessibility and availability of health structures determine the type of health care patients receive.
Introduction:Patients with schizophrenia seem to have a higher mortality and a lower life expectancy compared to the general population.Aims:To estimate the rate of mortality at a psychiatric hospital and to identify the causes and risk factors of these deaths.Methods:A retrospective study was conducted based on the medical records of patients who had died during the time period from January 2007 to March 2012 at the 250-bed Psychiatric Hospital of Tripolis in Greece.Results:A total of 39 deaths were recorded (mean annual mortality: 1.7 per 1000 inpatients). Patients were predominantly male (67%), mean age 64 years, most of them farmers (41%), with low educational level (69%) and mainly unmarried (72%). Medical co-morbidity was observed in 74% of the cases, mainly hypertension, diabetes and cardiovascular diseases. In 59% hospitalization was made after a court order. Thirty two patients were diagnosed with schizophrenia, mainly of the paranoid form (77%). Haloperidol was the most prescribed antipsychotic drug (62%). The main causes of mortality were respiratory and cardiovascular diseases (each 59%). Six of the occurred deaths could not be determined, but autopsy classified them as natural cause of death.Conclusions:Low rate of mortality, no clear forensic responsibility and high rates of medical co-morbidities in schizophrenia patients were observed in this study. The implementation of medical screening and prevention programs of serious health problems should be a high priority in psychiatric hospitals in order to improve quality of life and extend life expectancy in mentally ill adults.
Background: Stroke incidence and case-fatality are reported to decline in high-income countries during the last decades. Epidemiological studies are important for health services to organize prevention and treatment strategies. Aims: The aim of this population-based study was to determine temporal trends of stroke incidence and case-fatality rates of first-ever stroke in Arcadia, a prefecture in southern Greece. Methods: All first-ever stroke cases in the Arcadia prefecture were ascertained using the same standard criteria and multiple overlapping sources in three study periods: from November 1993 to October 1995; 2004; and 2015-2016. Crude and age-adjusted to European population incidence rates were compared using Poisson regression. Twenty-eight days case fatality rates were estimated and compared using the same method. Results: In total, 1,315 patients with first-ever stroke were identified. The age-standardized incidence to the European population was 252 per 100 000 person-years (95%CI 231 to 239) in 1993/1995, 252 (95%CI 223 to 286) in 2004, and 211 (192 to 232) in 2015/2016. The overall age- and sex-adjusted incidence rates fell by 16% (incidence rates ratio 0.84, 95%CI:0.72 to 0.97). Similarly, 28-day case-fatality rate decreased by 28% (case fatality rate ratio=0.72, 95%CI:0.58 to 0.90). Conclusions: This population-based study reports a significant decline in stroke incidence and mortality rates in southern Greece between 1993 and 2016.
The aim of this study was to calculate the average operational cost per sub-type of stroke patient and to investigate cost drivers (e.g. ALoS, NIHSS score, age) correlated to cost. Methods: Direct medical costs (diagnostic imaging and clinical laboratory exams, overheads/bed cost, pharmaceuticals, ringers and other non-durables and inpatient rehabilitation) per patient were calculated from the providers’ (hospitals’) perspective. Resource use data derived from the “SUN4P” web-based registry and unit costs were retrieved from publically available sources and were assigned to resource use. Results: The sample comprised 6,282 inpatient days of 750 patients (mean age: 75.5±13.3 years) admitted from July 2019 to July 2021, in nine public hospitals. Mean length of stay was 8.4±7.6 days and mean total operational cost was calculated to €1,239.4 (from which 45% and 35% related to diagnostic exams and overheads/bed cost respectively). Mean cost related to hemorrhagic stroke patients that were discharged alive was calculated significantly higher compared to mean cost related to ischemic stroke patients who didn’t undertake thrombolysis and were also discharged alive from the hospital (€2,155.2 vs. €945.2, p<0.001). Linear regression analysis revealed that length of stay was significantly correlated with cost (coefficient beta=232, 95% CI confidence interval = 220–243, p<0.001). Conclusions: These findings are in accordance with current evidence and should be thoroughly assessed to rationalize inpatient reimbursement rates in order to achieve improved value of care.
Background/Aims Dementia is a major disease worldwide, with an increasing incidence rate. This study estimated the societal cost of dementia in Greece, with the aim of helping policy makers to plan health services and evaluate their efficiency. Methods This study was conducted at a specialist neurological hospital in Greece with 110 patients with dementia and 110 caregivers. Local rates were used to determine the cost of services, medicines and staff salaries. Caregivers completed a survey reporting the time spent caring for the patient and any other expenses. Results were correlated with the three stages of disease severity (mild, moderate and severe) with a multivariate regression model. Results Informal care comprised the largest proportion of the total cost of caring for a patient with dementia. Furthermore, it was found that more severe dementia was associated with higher costs in private and public social and informal care. Conclusions Informal carers provide the majority of care for patients with dementia. More support from social care services is needed to cope with the predicted increase in dementia incidence in the near future.
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