Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of health care management decisions, which are often backed by limited, small-scale database analysis. The health care system in Lithuania is based on mandatory social health insurance and is covered by the National Health Insurance Fund. Based on a national Health Insurance database. The study aimed to explore the distribution, change, and interrelationships of health care costs across the age groups of patients with multimorbidity, suggesting different priorities at different age groups. Method. The study identified all adults with at least one chronic disease when any health care services were used over a three-year period between 2012 and 2014. Further data analysis excluded patients with single chronic conditions and further analysed patients with multimorbidity, accounting for increasing resource usage. The costs of primary, outpatient health care services; hospitalizations; reimbursed and paid out-of-pocket medications were analysed in eight age groups starting at 18 and up to 85 years and over. Results. The study identified a total of 428,430 adults in Lithuania with at least two different chronic diseases from the 32 chronic disease list. Out of the total expenditure within the group, 51.54% of the expenses were consumed for inpatient treatment, 30.90% for reimbursed medications. Across different age groups of patients with multimorbidity in Lithuania, 60% of the total cost is attributed to the age group of 65–84 years. The share in the total spending was the highest in the 75–84 years age group amounting to 29.53% of the overall expenditure, with an increase in hospitalization and a decrease in outpatient services. A decrease in health care expenses per capita in patients with multimorbidity after 85 years of age was observed. Conclusions. The highest proportion of health care expenses in patients with multimorbidity relates to hospitalization and reimbursed medications, increasing with age, but varies through different services. The study identifies the need to personalise the care of patients with multimorbidity in the primary-outpatient setting, aiming to reduce hospitalizations with proactive disease management.
Hepatitis C virus (HCV) infection is one of the major global causes of death and morbidity, and so it remains an important public health concern in Europe [...]
Introduction Estimation of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transfusion risk in blood donors is essential for monitoring the safety of the blood supply and the impact of new screening tests. Due to improvements in donor selection and continuing progress in screening assays, residual risk of virus transmission has significantly decreased over the past years. It is not practical and sometimes even not possible to measure residual risk in blood donors directly and mathematical models are used. The aim of this study was to calculate the prevalence, incidence rates of HBV, HCV and HIV infections and analyse evolution of their transmission residual risk from 2004 to 2018 at the National Blood Center of Lithuania. Materials and methods Data from the archives of the National Blood Center of Lithuania from 2004 to 2018 was retrospectively analysed. The residual risk was calculated for each virus and year by applying the incidence/window-period model suggested by World Health Organization. For the analysis of the residual risk yearly trends a linear regression was used. Results A total of 754,755 blood donors and 1,245,568 donations were included in the analysis and represented a 2.06 donations per donor over 15 years. Average residual risk for HBV, HCV and HIV respectively was 570.04, 807.14 and 35.72 per 1,00,000 donations. During the study period, there was statistically significant downward trend in the residual risk for every analysed virus. Discussion Residual risk of virus transmission has been steadily decreasing over past 15 years in Lithuanian donors, but the current risk remains quite high. It is difficult to establish how much the risk is affected by statistical assumptions or virus prevalence in general population. However, results of this study indicate the need of the population screening program of transfusion transmitted viruses.
Introduction. Quarantine is a complex definition that consists of administrative and sanitary measures designed to prevent the spread of communicable diseases to both humans and animals. Bans and restrictions that have been introduced, have significantly changed people’s lifestyles – individuals have become less physically active and were forced to spend most of their time at home. The aim of the study was to reveal the dominant factors contributing to students’ psycho-emotional health and physical activity during the quarantine period. Methods. This survey was conducted in April 2020 with 304 participating students. The anonymous survey collected demographic data and two standardized questionnaires were used: The International Physical Activity Questionnaire and General Health Questionnaire. Data were processed by SPSS Statistics 23 program. Results. Respondents’ level of physical activity during quarantine was as follows: high level – 42%, medium level – 41%; low level – 17 %. A negative correlation was found – with increasing physical activity, the sum of psycho-emotional state assessment score decreased (r = - .2702, p < .01), and with increasing age of respondents, their total level of physical activity also increased (r = .1364, p < .05). Conclusion. Low intensity of physical activity predominated at all levels of physical activity, for which the main reason was the remote learning during quarantine and recommendations to leave home only for essential matters. Regular physical activity and exercise may be a simple, inexpensive, and effective therapy during the quarantine, and physical activity is significant in treating student depression, stress, and/or increased anxiety. Keywords: depression, youth, stress, sedentary lifestyle.
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