ABSTRACT
Chronic obstructive pulmonary disease (COPD) is the third cause of mortality and disability (assessed by DALY) among patients above 60 year old. Severe and very severe COPD (FEV(1) = equal or less than 50% and 30% of expected value, respectively) is estimated at 20% of all COPD patients. Advanced COPD usually leads to physical and mental deterioration, the patients often manage with the problems caused by the disease and other comorbidities poorly. This leads to increased risk of COPD exacerbations and further deterioration of the patient's status, increased costs of medical care and eventually increased risk of death. Current organization of medical care for those patients does not provide adequate health and social support for them. However, it seems that introducing an integrated approach proposed by World Health Organization, could improve the situation of advanced COPD patients. In Poland, this kind of care has been provided in advanced cancer patients throughout stationary palliative care units and hospices during the last several years. This experience should be helpful in integrating actions of general practitioners and specialized nurses, as well as providing access for the specialists' consultations according to the individual needs of the patients. It should also allow for broad cooperation with auxiliary staff, such as social workers, medical assistants and volunteers, as well as psychologists and clergymen (especially in the terminal phase of the disease).
Subject(s)
Delivery of Health Care, Integrated/organization & administration , Palliative Care/organization & administration , Patient Care Team/organization & administration , Progressive Patient Care/organization & administration , Pulmonary Disease, Chronic Obstructive/therapy , Combined Modality Therapy , Disease Progression , Humans , Needs Assessment/organization & administration , Poland/epidemiology , Practice Guidelines as Topic , Practice Patterns, Physicians' , Pulmonary Disease, Chronic Obstructive/epidemiology , Risk Assessment/organization & administration , Severity of Illness IndexABSTRACT
In this study basic types of pharmacoeconomics analysis are presented. Selected publications concerned influenza vaccinations in risk groups have been discussed. In age groups higher then 65 years costs of treatment are connected with rates of complications and hospitalisations. In COPD patients' pharmacoeconomic analysis shows positive results in more advanced age-groups. In Str. pneumoniae vaccination 23-valent vaccines are more clinically effective. COPD patients Streptococcus pneumoniae vaccination give better pharmacoeconomic results in higher age-groups.
Subject(s)
Influenza Vaccines/economics , Influenza, Human/prevention & control , Pneumococcal Infections/prevention & control , Pneumococcal Vaccines/economics , Pulmonary Disease, Chronic Obstructive/economics , Pulmonary Disease, Chronic Obstructive/prevention & control , Cost-Benefit Analysis , Drug Costs , Economics, Pharmaceutical , Humans , Influenza, Human/complications , Pneumococcal Infections/complications , Poland , Pulmonary Disease, Chronic Obstructive/microbiologyABSTRACT
There is a lack of studies evaluating the prevalence of smoking habit among Polish priests. Due to difficulties in receiving permission from catholic authorities to perform questionnaire study we attempted to assess the prevalence of cigarette smoking among priests from one religious congregation. The aim of the study was also to analyze factors influencing smoking habits in this group. The anonymous questionnaire was sent to all Polish Pallotins and students of Pallotin Seminary in Oltarzew. Only one fourth of them--138 subjects in the age from 20 to 92 yrs (mean age 37.7 yrs)--answered the questionnaire. Among them were 72 priests aged 27-92 yrs. (mean age 50.7 yrs) and 66 students in the age 20-41 yrs (mean age 23.7 yrs.). The rate of current smokers among priests was 13.9%, including 11.1% of daily smokers and 2.8% occasional smokers. The rates of daily and occasional smokers among Seminary students were 4.5% and 6.1%, respectively. Cigarette smoking in the past was reported by 26,4% of priests--8.3% of them had smoked daily, remaining subjects had smoked occasionally. Most of responders considered the fifth commandment of the Decalogue as sufficient reason for abstaining from cigarette smoking. The majority of current smokers attempted to stop smoking, mainly because of wholesome reasons. Near a half of smoking priests and over three fourth of smoking students felt embarrassed to smoke in company of laymen. Every tenth priest and every third student hide his smoking habit from other priests. The study showed low prevalence of cigarette smoking in priests, what resulted mainly from religious reasons.
