Burden of Stroke in Europe:An Analysis of the Global Burden of Disease Study Findings From 2010 to 2019

BACKGROUND:While most European Regions perform well in global comparisons, large discrepancies within stroke epidemiological parameters exist across Europe. The objective of this analysis was to evaluate the stroke burden across European regions and countries in 2019 and its difference to 2010.METHODS:The GBD 2019 analytical tools were used to evaluate regional and country-specific estimates of incidence, prevalence, deaths, and disability-adjusted life years of stroke for the European Region as defined by the World Health Organization, with its 53 member countries (EU-53) and for European Union as defined in 2019, with its 28 member countries (EU-28), between 2010 and 2019. Results were analyzed at a regional, subregional, and country level.RESULTS:In EU-53, the absolute number of incident and prevalent strokes increased by 2% (uncertainty interval [UI], 0%–4%), from 1 767 280 to 1 802 559 new cases, and by 4% (UI, 3%–5%) between 2010 and 2019, respectively. In EU-28, the absolute number of prevalent strokes and stroke-related deaths increased by 4% (UI, 2%–5%) and by 6% (UI, 1%–10%), respectively. All-stroke age-standardized mortality rates, however, decreased by 18% (UI, −22% to −14%), from 82 to 67 per 100 000 people in the EU-53, and by 15% (UI, −18% to −11%), from 49.3 to 42.0 per 100 000 people in EU-28. Despite most countries presenting reductions in age-adjusted incidence, prevalence, mortality, and disability-adjusted life year rates, these rates remained 1.4×, 1.2×, 1.6×, and 1.7× higher in EU-53 in comparison to the EU-28.CONCLUSIONS:EU-53 showed a 2% increase in incident strokes, while they remained stable in EU-28. Age-standardized rates were consistently lower for all-stroke burden parameters in EU-28 in comparison to EU-53, and huge discrepancies in incidence, prevalence, mortality, and disability-adjusted life-year rates were observed between individual countries.<br/

Analysis of high cost outliers in a polish reference hospital

The growing fi nancial problems of healthcare institutions contribute to the search of methods in properly distributing and clearly justifying resources. One of these is detecting outliers accounting for an important share of hospital costs. The aim of the study is to identify the factors facilitating identifi cation of cost outliers in one of the Polish reference hospitals in northeast Poland. We have analyzed 4,570 patients. Cost analysis was done retrospectively using accountancy and statistical data from the hospital. To select the outliers, we used the interquartile method using the median and the interquartile distance. To evaluate the factors that infl uence the patient being a cost outlier, we considered: age, length of stay, gender, type of admission, reason of discharge, and type of department. Univariate analysis and multivariable logistic regression were used in the study. Our study revealed that the small percentage of the patients is responsible for the signifi cant level of costs. The total cost outliers comprised 9% of the study sample. They accounted for almost 37% of total hospital costs, 40% of direct costs, and 34% of indirect costs. We discovered that age, gender, length of stay, reason of discharge, and type of department has a signifi cant infl uence on being the cost outlier. The study revealed that the probability of being the CO increased more than 6 times for the surgical patients. This is consistent with the analysis of CO by ICD 10. The analysis revealed that almost all patients suffered from diseases related to high proportion of CO, required surgery treatment. It is concluded that identifying the cost outliers can contribute to better knowledge by managers about the nature of the costs outliers and can be especially valuable in the fi nancing systems where high costs outliers are separately paid

Analysis of high cost outliers in a polish reference hospital

The growing fi nancial problems of healthcare institutions contribute to the search of methods in properly distributing and clearly justifying resources. One of these is detecting outliers accounting for an important share of hospital costs. The aim of the study is to identify the factors facilitating identifi cation of cost outliers in one of the Polish reference hospitals in northeast Poland. We have analyzed 4,570 patients. Cost analysis was done retrospectively using accountancy and statistical data from the hospital. To select the outliers, we used the interquartile method using the median and the interquartile distance. To evaluate the factors that infl uence the patient being a cost outlier, we considered: age, length of stay, gender, type of admission, reason of discharge, and type of department. Univariate analysis and multivariable logistic regression were used in the study. Our study revealed that the small percentage of the patients is responsible for the signifi cant level of costs. The total cost outliers comprised 9% of the study sample. They accounted for almost 37% of total hospital costs, 40% of direct costs, and 34% of indirect costs. We discovered that age, gender, length of stay, reason of discharge, and type of department has a signifi cant infl uence on being the cost outlier. The study revealed that the probability of being the CO increased more than 6 times for the surgical patients. This is consistent with the analysis of CO by ICD 10. The analysis revealed that almost all patients suffered from diseases related to high proportion of CO, required surgery treatment. It is concluded that identifying the cost outliers can contribute to better knowledge by managers about the nature of the costs outliers and can be especially valuable in the fi nancing systems where high costs outliers are separately paid