Comparison of indicators of the use of insulin and oral diabetes medication in a Polish population of patients in urban and rural areas in the years 2008, 2011 and 2012

introduction. Diabetes is one of the 10 most important chronic diseases in the world. According to the data of the International Diabetes Federation, in Poland 9% of the population between the ages of 20–79 suffer from diabetes. objective. The aim of this study was to investigate the differences in the prevalence of diabetes in urban and rural areas in Poland, and the preparation of a model describing the phenomenon. materials and method. Differences between urban and rural areas were studied for the occurrence of patients treated with diabetes per 100,000 inhabitants, the number of patients, structure of treatment per the used products, and the costs of reimbursement of treatment products between 2008–2012. Urban and rural cases were compared using zip codes. The basis for classifying a patient as being an inhabitant of an urban or rural area was an urban zip code of the declared place of residence. results. Differences were observed both between various areas of Poland, as well as depending on whether the declared place of residence of the patient was urban or rural. Differences between urban and rural areas within the studied period have increased. The difference in the prevalence of diabetes among the inhabitants of Podlaskie, Śląskie or Świętokrzyskie provinces is striking. conclusion. Differences between urban and rural areas which depend on morbidity and detection of patients in the earlier phase of illness, the structures of medical technologies used in the treatment process, the number of purchased pharmaceuticals, enable better monitoring of effectiveness and quality of politics on prevention and treatment of chronic diseases. It is important for the creation of a health policy to devise a system of indicators, which will enable a decrease in the existing differences between regions, and between the urban and rural areas within the provinces

Glove failure in elective thyroid surgery: A prospective randomized study

Objectives: To analyze perforation rate in sterile gloves used by surgeons in the operating theatre of the Department of Endocrinological and General Surgery of Medical University of Lodz. Material and Methods: Randomized and controlled trial. This study analyses the incidents of tears in sterile surgical gloves used by surgeons during operations on 3 types of thyroid diseases according to the 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes. Nine hundred seventy-two pairs (sets) of gloves were collected from 321 surgical procedures. All gloves were tested immediately following surgery using the water leak test (EN455-1) to detect leakage. Results: Glove perforation was detected in 89 of 972 glove sets (9.2%). Statistically relevant more often glove tears occurred in operator than the 1st assistant (p < 0.001). The sites of perforation were localized mostly on the middle finger of the non-dominant hand (22.5%), and the non-dominant ring finger (17.9%). Conclusions: This study has proved that the role performed by the surgeon during the procedure (operator, 1st assistant) has significant influence on the risk of glove perforations. Nearly 90% of glove perforations are unnoticed during surgery

Managing the Risk of Adverse Events Using the Example of a Hospital in Wroclaw

Health Care Centres are institutions which, because of their specificity and character, are particularly exposed to various kinds of risk. One of the most important and most frequently used methods of risk management is the black spots method. The research material collected for the study comes from one of the hospitals in Wrocław. All hospital stays of the C22 (Face and Jaw Surgery Ward) and H05 (Injury and Orthopaedics Surgery Ward) settlement groups (DRG) were analysed - a total of 178 hospitalisations. The black spots method was used in the study, which consisted of risk identification, the ordering of threats and proposals for remedial actions. Using the black spots method, it was possible to identify adverse events that occurred during the hospitalisation of patients with H05 and C22 DRGs in the Injury and Orthopaedics Surgery Ward and Facial and Jaw Surgery Ward. In both cases, the treatment costs for patients with complications were higher than for the stays without complications

Diagnosis-Related Groups (DRG) and Hospital Business Performance Management

The goal of this article is to present the possibility of using Diagnosis- Related Groups (DRG) in the hospital management process and to analyse the need for business performance management on the part of hospital management staff. The following research methods were used: literature analysis, case studies, and poll analysis. It is not possible to increase the effectiveness of operation of healthcare entities without increasing the importance of IT systems and using DRG more effectively in the management process. Training users in IT and the use of DRGs is important to achieving hospital effectiveness. The increased importance of analyses and planning in a hospital should be reflected in the organisational structure of service providers. Hospital controllers should have a similar role to those present in most companies in other industries

Juvenile idiopathic arthritis morbidity rate in rural and urban areas of Poland 2008–2012

[b][/b][b]Objective. [/b]The aim of this study was to investigate the juvenile idiopathic arthritis (JIA) morbidity rate in the Polish population, calculated per 1,000 inhabitants of a given province, taking into account the differences between urban and rural areas, gender and area of residence (province) 2008–2012. [b]Method.[/b] From the NFZ IT systems information was obtained on the treatment of patients who had M08 and M09 juvenile arthritis, diseases classified elsewhere by the ICD-10 diagnosis code in the settlement report of the hospital. The number of patients, their gender and age at individual diagnoses were calculated based on the PESEL number provided in the statistical reports of the patient with the analysed ICD-10 diagnosis. Urban and rural cases were compared using commune zip codes. The basic for classifying the patient as a member of a urban or rural population was the zip code of the declared place of residence. [b]Results[/b]. In Poland, the number of patients suffering from juvenile idiopathic arthritis has been increasing since 2008 – from 9.2 thousand in 2008 to 11.4 thousand in 2012. The majority were girls (approx. 62%). Most patients were living in urban areas; in 2008, 5.9 thousand: urban areas – 64% of women and 36% of men; 3.2 thousand: rural areas – 62% of women, 38% of men); in 2012, 7.2 thousand – urban areas); 4.2 thousand – rural areas. The morbidity indicators ranged from 0.195 – 0.357 per 1,000 inhabitants, depending on the year, gender and place of residence (province and commune)

Glove failure in elective thyroid surgery: A prospective randomized study

Objectives: To analyze perforation rate in sterile gloves used by surgeons in the operating theatre of the Department of Endocrinological and General Surgery of Medical University of Lodz. Material and Methods: Randomized and controlled trial. This study analyses the incidents of tears in sterile surgical gloves used by surgeons during operations on 3 types of thyroid diseases according to the 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes. Nine hundred seventy-two pairs (sets) of gloves were collected from 321 surgical procedures. All gloves were tested immediately following surgery using the water leak test (EN455-1) to detect leakage. Results: Glove perforation was detected in 89 of 972 glove sets (9.2%). Statistically relevant more often glove tears occurred in operator than the 1st assistant (p < 0.001). The sites of perforation were localized mostly on the middle finger of the non-dominant hand (22.5%), and the non-dominant ring finger (17.9%). Conclusions: This study has proved that the role performed by the surgeon during the procedure (operator, 1st assistant) has significant influence on the risk of glove perforations. Nearly 90% of glove perforations are unnoticed during surgery

Epidemiology of Rheumatoid Arthritis (RA) in rural and urban areas of Poland – 2008–2012

Objective The aim of this study is to investigate the morbidity rate due to Rheumatoid Arthritis (RA) in the Polish population during 2008–2012, calculated per 1,000 inhabitants, and taking into account the differences between provincess, area of residence (urban or rural) and gender. Material and Methods From the NFZ IT systems, PESEL number information was obtained for all 17 types of services contracted in 2008–2012, for patients whose main diagnosis in the report was the ICD-10 disease code: M05.X – seropositive rheumatoid arthritis, or M06.X – other rheumatoid arthritis. The number of patients, gender and age were calculated based on the PESEL number provided in the statistical reports of the patient with the analysed ICD-10 diagnosis. Urban and rural cases were compared using commune zip codes. The basis for classifying the patient as a member of an urban or rural population was the Zip Code of the declared place of residence. Urban and rural areas are classified based on administrative criteria provided by the Central Statistical Office: the National Official Register of Territorial Division of the Country (TERYT). Results During the studied period the number of RA patients increased from 173,844–230,892. In urban areas, the most patients were recorded in the Śląskie Province, the least in Lubuskie Province. Patients from rural areas were approx. 1/3[sup]rd[/sup] of the total population of patients in Poland. In rural areas, the most patients were recorded in the Mazowieckie Province, the least in Lubuskie Province. The morbidity rate in cities was 5.08 in 2008 and increased to 8.14 in 2012 in rural areas, respectively, it was 3.74 and increased to 3.98. Regardless of the place of residence the women fell ill 3.5 times more frequently. The lowest morbidity rate, both in rural and urban areas, was recorded in the Lubuskie Province, the largest in Świętokrzyskie Province. The the most probable explanation of the highest morbidity rate in the latter province is a worse access to a rheumatologist: in this province there is the lowest number of inhabitants per one employed rheumatologist. Conclusions In Poland, the number of RA sufferers is increasing, which is probably a result of increasing life expectancy. In Poland, also exists a differences in morbidity between urban and rural inhabitants. Differences may also derive from undiagnosed cases of the disease