USEFULNESS OF THE DATA COLLECTED BY THE NATIONAL PERINATAL INFORMATION SYSTEM OF SLOVENIA FOR QUALITY CONTROL IN PERINATOLOGY

Bacground: The quality of work has been increasingly given more emphasis in all areas of life, the health care being no exception. Without appropriate measures or indicators of health care outcomes, a health care system cannot be improved. The results of quality of work are of utmost importance as they serve as the basis for various comparisons, e.g.among units, department, individual doctors. The aim of this analysis was to establish the results of work in tertiary and secondary centres, and with individual doctors, and compare them in order to approve the good ones and to find those that need be improved. Methods: The analysis involved 32 parameters concerning the results of work, the same parameters as used elsewhere in Europe, with all deliveries and newborns in Slovenia in the time period 2003–2007. We established the differences in the work of tertiary and secondary centres and used them in various comparisons. Results: We found no significant differences among the Slovene maternity hospitals in the incidence of eclampsia during labour, hysterectomy and in the incidence of lethal malformations among early neonatal deaths. We did find numerous significant differences in the manage- ment of labour, termination of labour and in the newborn's condition after birth. Conclusions: Slovenian perinatal information system is unique in Europe for as long as 22 years it has enabled a steady gathering of a large number of perinatal data for every woman who has given birth in Slovenia. Annual analyses that are done on the basis of the collected data for selected quality indicators within the project »Quality of Health Care in Slovenia« make it possible for every maternity hospital in Slovenia or every obstetrician to get an insight into the quality of their work and to compare it with the work of other maternity departments and individual doctors. The system gives the professional bodies and individual doctors an opportunity to improve the results of their professional work which deviate negatively from Slovenian standards

Ovrednotenje nadzora arterijske hipertenzije v ambulantah družinske medicine v Sloveniji

Objective: We performed a study on almost 20,000 Slovene patients with arterial hypertension (AH) to evaluate age- and gender-dependent blood pressure control, differences in the rate of AH control in the period 2002-2008, and to validate a potential impact of selected quality indicators on blood pressure control. Methods: The study was conducted as a part of the "Quality of Healthcare in Slovenia" project, in agreement with the National Medical Ethics Committee of the Republic of Slovenia. Appropriate statistical analyses were performed and the results evaluated. Results: Arterial hypertension control was relatively high (55.8%, 95% CI: 55.1-56.5) in the period 2002-2008 and improved significantly during that period. Based on our statistical model, the improved AH control in year 2006 compared to 2002 is particularly due to lower initial blood pressure values before treatment. Uncontrolled AH was largely attributed to uncontrolled systolic blood pressure. We found positive association between AH control and the frequency of blood pressure control in less than six-month time intervals. Conclusions: According to our results, AH control in family practice in Slovenia is relatively high compared to other European countries, but the results refer only to patients visiting their family medicine physicians.Izhodišča: V študiji, ki je vključevala okrog 20.000 slovenskih bolnikov z arterijsko hipertenzijo (AH), smo ugotavljali nadzor krvnega tlaka v odvisnosti od spola in starosti, nadzor AH v obdobju 2002-2008 in ocenili možni vpliv izbranih kazalnikov kakovosti na nadzor krvnega tlaka. Metode: Študija je potekala v okviru projekta "Kakovost v zdravstvu Slovenije" z dovoljenjem Komisije Republike Slovenije za medicinsko etiko. Rezultate smo statistično analizirali in jih ovrednotili. Rezultati: Nadzor AH v obdobju 2002-2008 je bil sorazmerno dober (55,8%, 95% CI: 55.1-56.5) in se je v tem obdobju značilno povečal. Rezultat, da gre za boljši nadzor v letu 2006 v primerjavi z 2002, je na podlagi našega statističnega modela predvsem posledica nižjega krvnega tlaka pred začetkom zdravljenja. Nenadzorovana AH je bila predvsem posledica nezadostno nadzorovanega sistoličnega krvnega tlaka. Nadzor AH je bil boljši pri bolj pogosti kontroli krvnega tlaka v intervalih, manjših od šestih mesecev. Zaključki: Glede na rezultate naše študije je nadzor AH v ambulantah družinske medicine v Sloveniji sorazmerno dober v primerjavi z drugimi evropskimi državami, vendar moramo pri tem upoštevati, da podatki veljajo samo za bolnike, ki so obiskali svojega zdravnika - specialista družinske medicine

Personality characteristics of couples of which partners are present at labour

Raziskava je zajela 40 parov, katerih partnerji so prisostvovali porodu in 4o parov, kjer so ženske rojevale same. Izenačevalni faktor je bil izobrazba. Za ugotavljanje osebnostni karakteristik enih in drugih smo uporabili instrumente: EPQ, PIE, SSG, vprašalnik o psiholoških aspektih poroda ter intrevju. Ženske katerih partnerji prisostvujejo pri porodu, so v primerjavi s partnerji bolj čustvene, emocionalno labilne. Njihovi partnerji teže k večji socialni zaželjenosti in sprejetosti. Žene, ki rojevajo same imajo večji strah pred porodom in bolj negativno mnenje o spolnosti. So introvertirane, emocionalno bolj neuravnovešene, manj prilagodljive. Njihovi partnerji so bolj togi, nepopustljivi, ekstravertirani in impulzivni

Pulse pressure in patients with arterial hypertension in Slovenia

Namen: Namen naše študije je bil določiti porazdelitev pulznega tlaka (PP), sistoličnega (SBP) in diastoličnega (DBP) krvnega tlaka v odvisnosti od spola in starosti ter ugotoviti odnos med PP, SBP in DBP. Analizirali smo podatke za 19972 bolnikov z arterijsko hipertenzijo v Sloveniji. Metode: Podatke o meritvah arterijskega krvnega tlaka (SBP, DBP) na nadlahti smo pridobili pri več kot 360 družinskih zdravnikih iz zdravstvenih kartotek bolnikov. Večino podatkov smo zbrali v obdobju 2002-2006. Rezultati: Povprečen PP je bil (71,2 +- 16,9) mmHg, povprečen SBP (172,8 +- 18,1) mmHg in povprečen DBP (101,6 +- 10,4) mmHg. Analiza z linearno regresijo je pokazala statistično značilno povezavo PP tako s starostjo (p < 0,001) kot tudi s spolom (p < 0,001). Pulzni tlak je naraščal s starostjo, pri moških in ženskah podobno. Ženske so imele statistično značilno višji PP (p < 0,001) kot moški v starostnem obdobju 35-65 let, razlika pa je bila manj izrazita po 80. letu starosti. Pulzni tlak je v črki U podobnem odnosu z DBP ter v skoraj linearnem odnosu s SBP. Zaključek: Rezultati naše študije kažejo, da je PP pri slovenskih bolnikih z arterijsko hipertenzijo odvisen tako od spola kot od starosti bolnika, na osnovi česar želimo spomniti na pomen upoštevanja PP pri načrtovanju antihipertenzivnega zdravljenja.Purpose: The aim of our study was to evaluate age- and gender-dependent pulse pressure (PP), systolic blood pressure (SBP), and diastolic blood pressure (DBP) distributions as well as their interconnected relationships in a large patient sample diagnosed with arterial hypertension in Slovenia. Methods: Data on brachial arterial pressure measurements (SBP, DBP) were taken from the medical records of 19,972 arterial hypertension patients. More than 360 family medicine physicians participated in the study. The majority of the data was collected from 2002 to 2006. Results: Mean PP, SBP and DBP were (71.2 Ž 16.9) mmHg, (172.8 +- 18.1) mmHg and (101.6 +- 10.4) mmHg, respectively. Linear regression analysis showed a significant association of PP with age (p < 0.001) and with gender (p < 0.001). Pulse pressure increased similarly with age for men and women. Women had significantly higher PP than men during ages of 35 to 65 years (p < 0.001), but the difference was less evident for those above 80 years. Pulse pressure had a U-shape-like relationship with DBP, and astrong, almost linear relationship with SBP. Conclusion: The results of our study show age- and gender- dependent differences in PP distribution for Slovene patients with arterial hypertension. These findings may remind family medicine physicians to take PP values into consideration when planning antihypertensive therapy