Health economics agenda in the 21st century - Analysis of research publication trends in health economics from 2000 to 2020

Background The aim of this study was to assess the bibliometric output related to health economics from 2000 to 2020. Methods Published papers that were indexed in Pubmed were enumerated and later stratified by regions. Results A declining publication trend was observed, with the most articles recorded in 2015, followed by a steady decline ever since. From 2015 to 2020, as many as 42 thousand articles less was published compared to the projected trend of growth recorded from 2000 to 2015. This decline was the strongest for articles related to Europe and the Americas, while articles related to Africa, Asia, and Australia were rising. Conclusions A steady decline of health economics research output was observed during the past five years, which was to a degree negated by the rising output from the low- and middle-income countries

Re-discovery of Leptochilus quintus Gusenleitner from Mosor Mountain, Croatia (Hymenoptera; Vespidae), after 136 years of presumed extinction

Six males of Leptochilus quintus Gusenleitner were collected in May 2021 on Mosor Mountain in Croatia. This species was assumed to have become extinct since no specimens were collected during the past 136 years. In contrast to the only previously known (holotype) specimen with an entirely black clypeus, the specimens examined have variable amounts of yellow markings on the clypeus, and only one specimen has an entirely black clypeus. Two specimens were sequenced for the mitochondrial COI gene, revealing that their sequences differed in two base pairs and suggesting a certain level of retained genetic diversity in the population. This finding suggests the need for a more detailed faunistic analysis of Croatia and the entire Balkans as an intersection of Central, Eastern and Southern European faunistic elements

Breast, colon, and prostate screening in the adult population of Croatia: does rural origin matter?

INTRODUCTION: The aim of this study was to investigate the utilization of breast, colon and prostate cancer screening in the adult Croatian population in a period without national cancer screening programs, with a special interest in respondents' rural versus urban origin. ----- METHODS: Self-reported screening utilization was investigated in the Croatian Adult Health Survey, which collected health-related information from a representative sample of the adult Croatian population. Breast cancer screening was investigated in women aged over 40 years, while colon and prostate screening was investigated in respondents aged over 50 years. The data were analysed using binary logistic regression. ----- RESULTS: One in five women reported breast cancer screening uptake in the year preceding the survey (22.5%), while only 4.5% reported a colon screening. A total of 6.1% men reported colon screening, while 13.7% of men reported having a prostate cancer screening. Respondents with rural origin reported all sites screening utilization less frequently than those of urban origin (breast: 14.5% vs 27.4%; prostate: 9.6% vs 16.3%; colon-men: 5.7% vs 6.3%; colon-women: 3.6% vs 5.1%; respectively). Multivariable models indicated that people with higher socio-economic status more commonly reported breast and prostate cancer screening uptake. Access to health care was the only independent variable associated with colon cancer screening in men, and the strongest variable associated with colon cancer screening in women. Rural origin was associated only with lower odds of breast screening (adjusted odds ratio 0.60 [95% confidence interval 0.48-0.74]), while in the remaining models, rural origin was not a significant predictor for cancer screening uptake. ----- CONCLUSIONS: Opportunistic cancer screening uptake is low in the Croatian adult population, with existing socio-economic differences in breast and prostate screening, and their absence in colon cancer screening. Rural origin was significantly associated with breast screening, even after adjustment to socioeconomic status and problems in access to health care. Lack of rural origin significance in the other screening sites could be related to small sample sizes of people who reported opportunistic utilization. Overall, access to health care is the strongest cancer screening predictor, and this should have a prominent role in the development of a systematic cancer screening program on a national level

Importance of health care issues in 2005 presidential elections in Croatia

Health and health care provision are among the most important and politically sensitive public service areas. Politicians carefully incorporate health care program changes in their political agendas to gain votes. However, knowing health care priorities of the electoral body is not useful only to politicians, but also to health policy makers, as it enables them to target the most problematic areas in health care. We conducted a telephone survey of representative sample of voters (n=643) immediately before the presidential elections in Croatia in 2005, to determine the possible differences in health care priorities between left-wing and right-wing voters, and found a high level of homogeneity in their opinions. Health care organization, corruption, and financing issues were identified as the top priorities by both left- and right-wing voters. This agreement in voters' expectations, probably caused by a similar frame of mind of Croatian citizens inherited from pre-democratic times of self-government, could be used by health policy makers to rationally invest the means and efforts in dealing with the most problematic health care issues

Socioeconomic Inequalities Estimation from Public Health Surveys – Data Considerations, Strengths and Limitations

The estimation of socioeconomic inequalities has lately become one of the major topics in public health research, as the numerous studies are showing strong association of inequalities with health status and outcomes. The aim of this study was to provide a general overview of the individual data available for the socioeconomic inequalities estimation from a public health survey and to compare different proxies used for socioeconomic inequalities estimation. The data from the Croatian Adult Health Survey were used, which is a large representative cross-sectional study of the general Croatian population that was performed in 2003. Four variables were compared – education and occupation class, and objective and subjective socioeconomic estimation. Strong regional differences were recorded within Croatia, generally showing better socioeconomic indices in the capital, city of Zagreb. Although all of these variables were significantly associated to one another, breakdown into the gender stratified education-by-occupation groups indicated that income was unevenly distributed in these groups and that it had non-linear association with education, especially in the white-collared occupations. Although socioeconomic inequalities do show striking association with many health related indices and outcomes and should therefore be included in all types of research on human subjects, due attention is needed in research planning, data encoding and entry, as well as interpreting the results based on this data

Socioeconomic status and psychological distress do not predict mortality risk in the island population of Vis, Croatia

Aims. To investigate the association between socioeconomic status and psychological distress measured by the General health questionnaire (GHQ-30) with all-cause mortality, cardiovascular mortality and cancer mortality on the Croatian island of Vis. Methods. This population-based cohort consisted of 1,025 subjects (426 men and 599 women), who were followed up for 18 years or a total of 5.8 million days. The causes of death were extracted from the Croatian National Institute of Public Health database. We calculated the adjusted hazard ratios, with subjective material status, years of schooling and a composite household material status used as estimates of socioeconomic status. Results. There were 279 cases of death (27.2%). Socioeconomic status and psychological distress did not predict either the specific or the all-cause mortality risk. In addition, the interaction between socioeconomic variables and psychological distress also did not yield a significant hazard ratio in all three instances (all-cause, cardiovascular or tumour mortality). Conclusions. These results confirm previous reports of the high level of social equality in the population of the island of Vis. Small and isolated communities may experience a lesser extent of social inequalities in health

Cardiovascular Risk Factors Research in Bosnia and Herzegovina

This study describes the current situation of cardiovascular risk factors research in the Bosnia and Herzegovina, with special emphasis on the Herzegovina region. The available data for the analysis includes various secondary sources, including project reports, official vital statistics data and other sources. Currently, there is a substantial lack of relevant information, which is available from occasional surveys or isolated studies. One of the main problems in detailed analysis is the lack of detailed and reliable census data, which causes problems in calculation of various rates and disables the creation of representative population samples for the field work and subsequent analysis. Comparison of the available information with neighbouring Croatia indicates interesting mixture of relatively high prevalence of some risk factors and rather low prevalence of others; almost 50% of men reported smoking on a daily basis, while only 16.5% of men were obese, while 40% of them had blood pressure over 140/90 mmHg. The results provide useful but incomplete information for the policy, thus suggesting that broader scope of public health research is needed in the region coupled with the census data, in order to provide better information for health policy and ultimately delivery of the optimal health care to the entire population

Cardiovascular Risk Factors Research in Bosnia and Herzegovina

This study describes the current situation of cardiovascular risk factors research in the Bosnia and Herzegovina, with special emphasis on the Herzegovina region. The available data for the analysis includes various secondary sources, including project reports, official vital statistics data and other sources. Currently, there is a substantial lack of relevant information, which is available from occasional surveys or isolated studies. One of the main problems in detailed analysis is the lack of detailed and reliable census data, which causes problems in calculation of various rates and disables the creation of representative population samples for the field work and subsequent analysis. Comparison of the available information with neighbouring Croatia indicates interesting mixture of relatively high prevalence of some risk factors and rather low prevalence of others; almost 50% of men reported smoking on a daily basis, while only 16.5% of men were obese, while 40% of them had blood pressure over 140/90 mmHg. The results provide useful but incomplete information for the policy, thus suggesting that broader scope of public health research is needed in the region coupled with the census data, in order to provide better information for health policy and ultimately delivery of the optimal health care to the entire population