ABSTRACT
BACKGROUND: Repeated research while using the same methodology can be useful and it can enable relevant conclusions in the same health care system. The aim of our study was to perform comparative analysis of the agreement between admission and discharge diagnostic groups in period 2014-2017 with period 2006-2013 in the Clinical Center of Kragujevac, Serbia. METHODS: The 5% simple, random sample was made from the basic set of all hospital reports from Clinical Centre Kragujevac, Serbia, in the period 01.01. 2014 - 31.12. 2017 (n=10228). The first four digits of ICD-10 codes at admission and discharge were compared for agreement. We used discharge diagnosis as a "golden standard". Statistical analysis was performed using Cohen's Kappa statistic. RESULTS: In the period 2014-2017, agreement between diagnosis among the most ICD10 groups increased in comparison with the period 2006-2013. Disagreements between diagnosis in the period 2014-2017 in comparation with period 2006-2013 was associated with increased length of stay in the hospital (7.5 vs. 9.1 days, P<0.01), patients were younger (54 vs 49.6 yr, P<0.01), number of males declined (26.3% vs 16.2%, P<0.05), kappa value decreased in XV ICD10 group and XI ICD10 group and kappa value increased in XIV ICD10 group. CONCLUSION: Agreement between admission and discharge diagnosis among the most ICD10 diagnostic groups increased. Introduction of a new web application has increased the quality of data, but interpreting it requires the skill of researchers. Further research should identify modifiable causes of discrepancy between admission and discharge diagnoses.
ABSTRACT
The Aim of this research is to analyze how the socio-demographic characteristics of users of Complementary and Alternative Medicine (CAM) in Serbia influence and impact their consumption of OTC drugs. Respondents and methods: The study employed the third edition of the National Health Survey of the Republic of Serbia, published in 2013, as a data source covering the Serbian population. The sample comprised of 550 interviewed individuals who had been applying a variety of CAM treatments over the previous 12 months. Their socio-demographic characteristics were used as independent variables impacting the consumption of OTC drugs over the previous 2-week period, representing the dependent variable. Results: Two thirds (65.3%) of the CAM users consumed OTC drugs at their own discretion, without recommendation by a physician or a relevant prescription. Users of OTC drugs were most often females whose ages ranged within the average interval of 49.16 ± 16.02, whose education level was to secondary school diploma, who were married and employed, lived in urban areas, mostly Belgrade, belonged to the middle-income group, and followed relevant headlines via public information channels (TV, the internet, radio, and print). Comparison of the results revealed, on the one hand, that 2/3 of respondents who had used and 1/3 of those who did not consume OTC drugs had undergone fecal occult blood tests over the past year (p < 0.05) and, on the other hand, that those respondents had been less frequently hospitalized in the previous year (p = 0.05). In addition, the same responders were found to access available health care services more frequently than did others (p < 0.05). Conclusion: Since, according to the statistics, it is highly likely that respondents who were CAM- and OTC drug-users would be less frequently hospitalized and not use medical leave, these results provide a strong indication that this phenomenon should be investigated in more depth. Moreover, the areas to be considered when defining strategies for determining patient treatments should also include the influence of socio-demographic factors on the patient's consciousness that would enable easier understanding of the proper usage of OTC drugs.
