Hospitalization for dog bites in Poland between 2006-2020.

INTRODUCTION AND OBJECTIVE: Owning a dog or spending time around a dog have many benefits, but also pose a risk of being bitten or attacked. Currently, publications on dog bites and related factors come from both high-income countries and low- and middle-income countries. So far, no attempt has been made to assess this phenomenon in Poland. The aim of this study was to determine the number of such events and evaluate hospital medical assistance provided to dog bite victims in Poland in the period of 15 years between 2006-2020. MATERIAL AND METHODS: This cross-sectional study was based on the data from the Nationwide General Hospital Morbidity Study and cases with the code W54 (ICD-10) as the cause of hospitalization. As part of the analysis, victim demographical data, with an emphasis on city- and country-dwellers, as well as treatment variables were assessed. RESULTS: Between 2006-2020, 4,145 cases of hospitalizations for dog bites were found, of which approx. 42% occurred in 2020 during the COVID-19 pandemic and lockdowns. Most of the victims were children aged 0-9, and this is especially common among boys living in the countryside. It was found that regardless of the place of residence, there was a systematic decrease in hospitalization of men as they were older. In women, however, the decrease in hospitalization concerned only the age groups 0-39. Among older women, the percentage of hospitalization increased, especially among rural women aged 60 and over. CONCLUSIONS: Hospital discharge records report a small number of dog bites. These are only the tip of the iceberg. The problem has a multi-factorial nature and requires epidemiological monitoring and further research on correlates and determinants, as well as preventive measures.

Analysis of diabetic patients hospitalizations in Poland by gender, age and place of residence.

Background: There are few updated data on rates of hospital mortality of diabetic patients and length of their hospital stay on a country level. To determine such rates we provided analysis using claims data from a Nationwide General Hospital Morbidity Study carried out by the National Institute of Public Health - National Institute of Hygiene (NIPHNIH) in Warsaw from 2010 to 2018. Objective: The aim of the study was to analyze the nine years changes of in-hospital morbidity and mortality in diabetic patients and length of hospital stay using a comparative approach by gender, age and place of residence. Material and methods: The data on all patients from general hospitals in Poland treated because of diabetes were taken from a nationwide database, kept since 1979 by the Department for Monitoring and Analyses of Population Health of NIPH-NIH. This database contains information gathered under the Statistical Research Program of Public Statistics. Hospitalization rates were used to evaluate the 'hospitalized' incidence of diabetes (number of hospitalization cases due to diabetes per year by the analyzed unit of population). In-hospital mortality was calculated as the percentage of deceased patients out of all patients hospitalized due to diabetes. Results: The number of cases and hospitalization rates of diabetic patients was rapidly declining by 18.8% for type 2 (E11) and 23.7% for type 1 (E10) diabetes. The downward tendency in the scope of hospitalization affected mainly older women and rural residents. Hospital mortality due to diabetes rose up dangerously to 3.77% exceeding the rates recorded eight years earlier. Conclusions: The recent reduction in hospitalization rates of people with diabetes in Poland may be associated with an unexpected increase in hospital mortality.

Nationwide General Hospital Morbidity Study as a source of data about Polish population health

The objective of this article is description of the important source of data on hospitalised morbidity collected in Poland within the frameworks of public statistics, and also underlying the significance of the quality of data collected at the hospital level for the purpose of the practical application of them. The Nationwide General Hospital Morbidity Study has been conducted by the Department of Population Health Monitoring and Analysis of the NIPH-NIH for more than 40 years within the frameworks of the Programme of Statistical Surveys of Official Statistics. Since the year 2000, it has had a complete character, collecting individual data for all cases of hospitalisation in Poland within the scope compliant with the MZ/Szp-11 form, among others, sex, age, place of residence of a patient, data on hospital, information about the course of treatment (length of stay in hospital, principal diagnosis and comorbidity, applied medical procedures, the mode of admission and discharge). The collected data are anonymous. In the recent years, annually, more than 8 million of the cases of hospitalisation have been documented. Almost all obliged hospitals (96%) participate in the study. Some weak point is the completeness of submitted data, in particular, regarding information about the external causes of injuries and poisonings (in the year 2017, 27% of the required data were missing). Interestingly, a high level of missing data is generated by a comparatively small number of hospitals. Significant differences are observed in the quality of data depending on the voivodship of hospital location. The collected data render it possible to, among others, determine the frequency of hospitalisations due to particular causes taking under consideration the localisation of a hospital, and also the sex, age and the place of residence of patients, the analysis of the duration of hospital stay or in-hospital fatality. The aggregated results are reported to international databases (WHO, OECD, Eurostat), and support the administrative authorities of various levels. They are also a basis for numerous published scientific papers. The most important results of routine analyses are presented of the web page of the Study (http://www.statystyka1.medstat.waw.pl/).

Cerebrovascular diseases in Poland-inconsistent seasonal patterns of hospitalisation and mortality.

Background: A seasonal variation in the incidence of cerebrovascular diseases still remains inconsistently evidenced. Herein, we analyse the monthly patterns of two health phenomena: hospital admissions and deaths due to these diseases. Methods: We identified 69 511 cases of hospital admissions and 14 956 deaths due to cerebrovascular diseases (ICD10: I60-I69 and G45) among the inhabitants of five Polish voivodeship capitals in 2004-13. The method of time series analysis (exponential smoothing with linear trend and monthly additive seasonality) was applied to calculate the monthly specific seasonal indices. The monthly variation in an in-hospital fatality and nonhospital deaths were also analysed. Results: A summer season reduction in number of cases was observed for hospital admissions and deaths. Interestingly, the winter season effect is much more complex, mainly due to the contribution of December, when a high mortality is accompanied by a substantial decrease in the hospitalisation level. This unique discrepancy was observed for all the studied cities. Moreover, this month is characterised by a notably high in-hospital fatality. However, neither the number of non-hospital deaths nor the average length of hospital stay or the kind of hospitalised diseases evidenced that cerebrovascular problems were more serious in December than in any other month. Conclusion: The obtained results confirmed a seasonal variation in cerebrovascular diseases among the inhabitants of Polish cities. Habitual and administrative limitations in hospital activities observed every December do not seem indifferent from the patient health's perspective since they may lead to a low hospitalisation level and a high in-hospital fatality.

Hospitalization of injured immigrants in Poland - Demographic profile and diagnosis.

INTRODUCTION AND OBJECTIVE: More and more immigrants gradually come to Poland. Little is known, however, about their health situation or their injuries. The objective of this study was to analyse the cases of hospitalization of immigrants due to injuries in 2008-2010, including the number and demographic characteristics of the patients, as well as the nature of injury according to ICD-10 (S00-T98). MATERIAL AND METHODS: The analysis was conducted on the basis of data from the General Hospital Morbidity Study. All the cases of hospitalization due to injuries were covered by the analysis, and a group of foreigners was compared to the general population. RESULTS: The number of foreigners hospitalized due to injuries ranged from 4.6-21.2 thousand in the subsequent years. The share of hospitalization due to injuries equalled 8.2-11.9% of all foreigners' hospital stay. The majority were males, but the proportion of females gradually increased up to 36.7% in 2010. The average age of the hospitalized gradually decreased to the age of 35.2 in 2010. The structure of the nature of injury was different from that of the general population. Prevailing types of injuries were minor injuries of wrist, hand, ankle and foot. Open wounds of the head were also common. CONCLUSIONS: Results of the analysis indicate the most important tendencies related to immigrants' injuries. Further research, as well as monitoring the foreigners' health status is necessary. Taking preventive measures is essential among the most vulnerable group - male immigrants aged 15-19.

Hospitalization of injured immigrants in Poland - Utilization of in-patient services.

INTRODUCTION AND OBJECTIVE: In 2008-2010, the number of foreigners hospitalized due to injuries in Poland ranged from approximately 5-21 thousand. The aim of this study was to analyse the utilization of in-patient services by injured immigrants in 2008-2010, including mode of admission (i.e. referral), mode of discharge, average length of patient stay, seasonality and spatial distribution of hospital admissions. MATERIAL AND METHODS: Analysis was conducted on the basis of data from the General Hospital Morbidity Study. All cases of hospitalization due to injuries were covered by the analysis, and a group of foreigners was compared to the general population. RESULTS: The percentage of immigrants admitted by acute admission through self-referral increased to 80.9% in 2010. The great majority (79.4%) were discharged to in-patient care. The immigrants' stay in the hospital was approximately twice as short than that of an average patient with injury. Immigrants and the rest of the patients were admitted to hospitals in different seasonal rhythm. The great majority of foreigners were treated in hospitals located in two (out of 16) provinces. CONCLUSIONS: This study supports the need for understanding the immigrant experience when accessing health care, as well as the need for further research and contribution of public health.

Association between high temperature and mortality of Warsaw inhabitants, 2008-2013 / Zwiazek umieralnosci mieszkanców Warszawy z wysoka temperatura powietrza, w latach 2008-2013

Different aspects of association between daily maximum temperature and daily number of deaths from all causes (excluding external) in Warsaw in periods of warm months (May - September) in years 2008-2013 were analysed. Analysis of dependence between temperature and mortality for whole population as well as for subpopulations with respect to sex and age demonstrated its similar U-shape. For each subpopulation a value of temperature at which dependence of mortality from temperature is changing its character from decreasing to increasing, interpreted as comfort conditions, was computed. Its value varied between 20 and 24oC with slight tendency to be higher for woman. Heat waves defined as at least three consecutive days with maximal temperature higher than 30oC have additional (to temperature effect itself ) effect on male mortality however, only in males aged 70 years and more the effect was statistically significant.

Accidental drownings in Poland in 2000-2012.

OBJECTIVE: Drowning is a public health problem which is poorly recognized and analyzed in the Polish literature so far. MATERIAL AND METHODS: We analyzed all available sources of information on drowning in Poland, i.e. the data of the Central Statistical Office (causes of deaths, accidents at work) and Police Headquarters (circumstances of drowning). We discussed changes in drowning frequency, analyzing both time and space perspective as well as demographic profiles of fatal drowning cases. RESULTS: In 2000-2012, an estimated 12,702 persons died due to drowning in Poland (median of crude mortality rate - 2.6 per 100,000 population). Mortality due to drowning was on downward trend. Males aged 45-59 years, especially with vocational education, were at the highest risk of drowning. In the period analyzed, the highest and the lowest mortality rates were reported in Warminsko-mazurskie (median of mortality rate - 4.7) and Slaskie voivodships (median of mortality rate - 1.2), respectively. The highest drowning frequency was noted in the period from June to August in which a total of 5,981 cases were registered, i.e. 47.1% of all recorded drownings. CONCLUSIONS: A risk of death due to drowning in Poland is higher compared to the average in other EU countries. There is a necessity for public health intervention in this field. Furthermore, reporting systems regarding drowning in Poland should be unified.

[Main causes of death among Polish population in 2030]. / Najwazniejsze przyczyny zgonów Polaków w 2030 roku.

The purpose of the study was the identification of main causes of death in Poland in 2030 and the assessment of mortality associated with them. It was assumed that the population age structure in 2030 shall develop in accordance with the prognosis of the Central Statistical Office. Mortality level was estimated using the projections for the regions (groups of countries), defined on the basis of some geographical and economic criteria, published by WHO as the result of the Global Burden of Disease Study. It was found that in 2030 mortality in Poland will increase by 17%-25% in comparison to 2008 which will be the result of changes in the age structure of the population. At the same time, the risk of death, expressed by age specific mortality rates, will decrease. Similar effects are expected for particular main causes of death. Ischaemic heart disease and cerebrovascular diseases will continue to account for the most frequent reasons of death. In comparison to 2008 a significant increase of mortality due to diabetes mellitus and prostate cancer will be observed. According to some projections, it will also refer to the chronic obstructive pulmonary disease as well as malignant neoplasms of colon, rectum and stomach. Mortality due to suicides and road traffic accidents will decrease.

[Risk of deaths from cardiovascular diseases in Polish urban population associated with changes in maximal daily temperature]. / Ryzyko zgonu z powodu chorób ukladu krazenia mieszkanców polskich miast zwiazane z dobowymi zmianami temperatury maksymalnej.

The paper presents results of analysis of short-term effect of changes in maximal daily temperature on daily mortality from cardiovascular diseases in warm season in years 1999-2006. Analysis was carried out in six large Polish cities--Katowice, Kraków, Lódz, Poznan, Warszawa and Wroclaw. Generalized additive models were used in the analysis. Potential confounding factors--long term changes of mortality, day of week and other meteorological factors (atmospheric pressure, humidity, mean wind speed) were taken into account during model building process. Analysis was done for two age groups--0-69 and 70 years and older. Significant, positive association between daily maximal temperature and risk of death from cardiovascular diseases was found only in older age group.

[Hospital morbidity in Mazowian voivodeship in the first year of the new health care system]. / Hospitalizacja w woj. mazowieckim w pierwszym roku po wprowadzeniu reformy opieki medycznej.

The aim of this study was to analyse the frequency hospitalisation in Mazowian voivodeship by sex, age, place of residence (urban-rural), and major causes of hospitalisation in the first year of the new health care system in compare with the period 1991-1996. Data used in the study covered a 10% sample of hospitalised persons discharged or deceased in hospitals operating under Ministry of Health or Polish State Railways. The outcome measures were age-standardised hospital discharge rates. Obtained results showed a systematic increase of the discharge rates between 1991 and 1999 of both men and women. It was found that frequency of hospitalisation in urban areas was higher then in rural ones and that the difference was remarkable increasing in 1999.

Highlights on the health status of the Polish population in 1999/2000.

In the paper we describe the main problems of the Polish population health status and their trends in the past years. A meaningful improvement in several health parameters can be noticed in Poland since 1991. In the year 2000 life expectancy was 69.7 and 78.0 for males and females respectively--an increase by 3.6 and 2.7 years in comparison with 1991 values. There have been declining trends in cardiovascular mortality, cancer mortality (more often in younger age groups), infant mortality, incidence of infectious diseases. Mental health problems are the growing issue. It has been stressed that the pace of progress is far too slow to achieve the level of health indicators in EU countries in the not too distant future.