Background: Previous studies have suggested that the coronavirus disease 2019 (COVID-19) pandemic was associated with a decreased rate of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Data on how the COVID-19 pandemic has influenced mortality, seasonality of, and susceptibility to AECOPD in the chronic obstructive pulmonary disease (COPD) population is scarce. Methods: We conducted a national population-based retrospective study using data from the Health Insurance Institute of Slovenia from 2015 to February 2021, with 2015–2019 as the reference. We extracted patient and healthcare data for AECOPD, dividing AECOPD into severe, resulting in hospitalisation, and moderate, requiring outpatient care. The national COPD population was generated based on dispensed prescriptions of inhalation therapies, and moderate AECOPD events were analysed based on dispensed AECOPD medications. We extracted data on all-cause and non-COVID mortality. Results: The numbers of severe and moderate AECOPD were reduced by 48% and 34%, respectively, in 2020. In the pandemic year, the seasonality of AECOPD was reversed, with a 1.5-fold higher number of severe AECOPD in summer compared to winter. The proportion of frequent exacerbators (⩾2 AECOPD hospitalisations per year) was reduced by 9% in 2020, with a 30% reduction in repeated severe AECOPD in frequent exacerbators and a 34% reduction in persistent frequent exacerbators (⩾2 AECOPD hospitalisations per year for 2 consecutive years) from 2019. The risk of two or more moderate AECOPD decreased by 43% in 2020. In the multivariate model, pandemic year follow-up was the only independent factor associated with a decreased risk for severe AECOPD (hazard ratio [HR]: 0.71; 95% confidence interval [CI]: 0.61–0.84; p < 0.0001). In 2020, non-COVID mortality decreased (−15%) and no excessive mortality was observed in the COPD population. Conclusion: In the pandemic year, we found decreased susceptibility to AECOPD across severity spectrum of COPD, reversed seasonal distribution of severe AECOPD and decreased non-COVID mortality in the COPD population.

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Objectives: To analyze strategies of management of patients with diabetic polyneuropathy (DPN) considering the prevalence of DPN and diabetic foot (DF) in Russia. MethOds: The analysis was based on epidemiologic data on DPN and DF, and placebo controlled trials (ALADIN III for alpha-lipoic acid, and D. Ziegler study for Actovegin). Strategies with alpha-lipoic acid (1st group) and with Actovegin (2st group) were compared. In both cases, a 160-day course consisted of 20 days of parenteral injection in hospital, and 140 days of outpatient oral administration. Clinical outcomes and health care system costs were analyzed; cost-effectiveness ratio (CER) was calculated. The share of patients without DF was the main measure of effectiveness. Costs of the drugs, and hospital and outpatient treatment for budget holder were evaluated in two equal-sized groups. During the sensitivity analysis, clinical outcomes (risk of DF) were modeled with increment of 100 persons from 100 to 1000 patients. Results: The cohort of 10 000 patients with type 2 diabetes mellitus contained 6100 patients with DPN including 3700 patients with medium or severe stages. 2100 persons were in risk group for DF, including 1100 patients with high risk. 410 and 330 patients had DF in alpha-lipoic acid group and Actovegin group, respectively. The number of amputations in these groups was 70 and 56. The costs of 160-day treatment was 64,929.73 RUB in the 1st group, and 64,355.73 RUB in the 2nd group. The share of patients without DF was 70.02% and 62.7%. CER were 103,556.19 in alpha-lipoic acid group, and 91,910.50 in Actovegin group. The sensitivity analysis confirmed the advantage of Actovegin administration cOnclusiOns: The study showed clinical and pharmacoeconomic advantages of Actovegin administration in patients with DPN and DF. This strategy has more preferable CER and lower costs for public health care system.

The paper investigates the role and impact of different groups of firms according to their growth type on macroeconomic aggregates at various stages of the economic cycle based on the entire population of firms in Slovenia. The applied classification of growing and fast-growing firms is based on microeconomic theory. Results exhibit that despite larger year-to-year fluctuations, firms with growth towards their long-term equilibrium contributed most to macroeconomic aggregates, i.e. employment, capital and sales, especially in times of economic prosperity. Firms with growth that shifts them closer to their short-term equilibrium proved to be more important primarily for assuring employment stability. Furthermore, we show that using single growth measures prevents us from identifying all growing firms and capturing the true contribution of particular growth groups of firms to studied macroeconomic aggregates. The paper provides both theoretical and empirical information for managers for designing different types of firm growth and enables policy makers to adopt adequate industrial policy measures.

IntroductionMigraine is associated with significant morbidity and a significantly negative impact on the quality of life. A better understanding of the economic impact of migraine is becoming increasingly important. This paper aims to shed light on absenteeism and presenteeism costs of migraine in Slovenia.MethodsWe use the administrative national-level database on sick leave due to migraine for 2016. The absenteeism cost estimate is based on the number of patients with migraine on physician-determined sick leave and average daily labour costs. We calculate productivity costs from a social perspective regardless of who incurs them. Data from the national registry on sick leave are coupled with data from a web-based self-reported survey to also include the cost of presenteeism. MIDAS and WPAI presenteeism items were used and several different scenarios were designed to assess presenteeism costs.ResultsWe estimated annual absenteeism costs per absentee due to migraine at the amount of EUR 531 in 2016 using the NIPH’s administrative data on sick leave. Annual absenteeism costs per absentee due to migraine based on self-reported data amounted to EUR 626. The estimated annual presenteeism costs per patient range from EUR 344 – 900.ConclusionEstimating the economic burden of a disease is becoming increasingly important. This paper is an insight into the absenteeism and presenteeism costs of migraine in Slovenia.