Jurevičiūtė Skirmantė, Kalėdienė Ramunė
Department of Health Management, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Health Management, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Medicina (Kaunas). 2015 Nov;51(5):312-9. doi: 10.1016/j.medici.2015.09.002. Epub 2015 Nov 19.
In Lithuania, hospitalization was planned to be reduced with the approval of the national healthcare restructuring program. The aim of this study was to describe regional inequalities of hospitalization and hospital morbidity in Lithuania and to associate them with mortality in the regions.
Routine hospital discharge data of Lithuanian hospitals, reimbursed by the Compulsory Health Insurance Fund and registered in database SVEIDRA, was used. Age-adjusted general hospitalization and hospital morbidity rates (per 1000 population) due to cardiovascular diseases (CVD), malignant neoplasms and external causes were calculated. Contribution of diseases, causing major public health problems, to general hospitalization was evaluated by analysis of components. Association of general hospitalization or hospital morbidity and mortality of respective causes was evaluated using non-parametric Spearman correlation.
General hospitalization and hospital morbidity of CVD, malignant neoplasms and external causes had increased from 2005 to 2011. Inequalities of hospitalization and hospital morbidity existed between regions of Lithuania. In Šiauliai, Klaipėda, Utena and Panevėžys regions, general hospitalization remained higher than national level. In Marijampolė, Alytus and Kaunas regions, general hospitalization became lower than Lithuanian average. There was no statistically significant correlation between variation in hospitalization and mortality rates in the regions.
Despite national efforts to decrease hospital care, our study detected the failure of hospitalization reduction and revealed an increase of hospitalization with the existing regional inequalities in Lithuania.
在立陶宛，经国家医疗保健结构调整计划批准，计划减少住院治疗。本研究的目的是描述立陶宛住院治疗和医院发病率的地区不平等情况，并将其与各地区的死亡率相关联。
使用由强制健康保险基金报销并登记在SVEIDRA数据库中的立陶宛医院常规出院数据。计算了因心血管疾病（CVD）、恶性肿瘤和外部原因导致的年龄调整后的一般住院率和医院发病率（每1000人口）。通过成分分析评估了导致重大公共卫生问题的疾病对一般住院治疗的贡献。使用非参数Spearman相关性评估一般住院治疗或医院发病率与各原因死亡率之间的关联。
2005年至2011年期间，心血管疾病、恶性肿瘤和外部原因的一般住院治疗和医院发病率有所增加。立陶宛各地区之间存在住院治疗和医院发病率的不平等。在希奥利艾、克莱佩达、乌田纳和帕涅韦日斯地区，一般住院治疗率仍高于全国水平。在马里扬泊列、阿利图斯和考纳斯地区，一般住院治疗率低于立陶宛平均水平。各地区住院治疗率变化与死亡率之间无统计学显著相关性。
尽管国家努力减少医院护理，但我们的研究发现住院治疗减少未成功，并揭示了立陶宛住院治疗率上升且存在现有的地区不平等情况。
