scholarly journals Prevalence of chronic conditions and multimorbidity in Estonia: a population-based cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e049045
Author(s):  
Mikk Jürisson ◽  
Heti Pisarev ◽  
Anneli Uusküla ◽  
Katrin Lang ◽  
M Oona ◽  
...  
Keyword(s):  
Health Insurance ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Population Based ◽  
Cross Sectional Study ◽  
Insurance Fund ◽  
Age Group ◽  
Health Insurance Fund ◽  
Sectional Study ◽  
Cross Sectional

ObjectivesPrevalence estimates for specific chronic conditions and multimorbidity (MM) in eastern Europe are scarce. This national study estimates the prevalence of MM by age group and sex in Estonia.DesignA population-based cross-sectional study, using administrative data.SettingData were collected on 55 chronic conditions from the Estonian Health Insurance Fund from 2015 to 2017. MM was defined as the coexistence of two or more conditions.ParticipantsThe Estonian Health Insurance Fund includes data for approximately 95% of the Estonian population receiving public health insurance.Primary and secondary outcome measuresPrevalence and 95% CIs for MM stratified by age group and sex.ResultsNearly half (49.1%) of the individuals (95% CI 49.0 to 49.3) had at least 1 chronic condition, and 30.1% (95% CI 30.0 to 30.2) had MM (2 or more chronic conditions). The number of conditions and the prevalence of MM increased with age, ranging from an MM prevalence of 3.5% (3.5%–3.6%) in the youngest (0–24 years) to as high as 80.4% (79.4%–81.3%) in the oldest (≥85 years) age group. Half of all individuals had MM by 60 years of age, and 75% of the population had MM by 75 years of age. Women had a higher prevalence of MM (34.9%, 95% CI 34.7 to 35.0) than men (24.4%, 95% CI 24.3 to 24.5). Hypertension was the most frequent chronic condition (24.5%), followed by chronic pain (12.4%) and arthritis (7.7%).ConclusionsHypertension is an important chronic condition amenable to treatment with lifestyle and therapeutic interventions. Given the established correlation between uncontrolled hypertension and exacerbation of other cardiovascular conditions as well as acute illnesses, this most common condition within the context of MM may be suitable for targeted public health interventions.

scholarly journals Physical-mental health comorbidity: A population-based cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260464
Author(s):  
Mikk Jürisson ◽  
Heti Pisarev ◽  
Anneli Uusküla ◽  
Katrin Lang ◽  
Marje Oona ◽  
...  
Keyword(s):  
Mental Health ◽  
Chronic Conditions ◽  
Population Based ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health Disorders ◽  
Estonian Population ◽  
Age And Sex ◽  
Mental And Behavioral Disorders

Background Multimorbidity is associated with physical-mental health comorbidity (PMHC). However, the scope of overlap between physical and mental conditions, associated factors, as well as types of mental illness involved are not well described in Eastern Europe. This study aims to assess the PMHC burden in the Estonian population. Methods In this population-based cross-sectional study we obtained health claims data for 55 chronic conditions from the Estonian Health Insurance Fund (EHIF) database, which captures data for all publicly insured individuals (n = 1 240 927 or 94.1% of the total population as of 31 December 2017). We assessed the period-prevalence (3 years) of chronic physical and mental health disorders, as well as associations between them, by age and sex. Results Half of the individuals (49.1% (95% CI 49.0–49.3)) had one or more chronic conditions. Mental health disorders (MHD) were present in 8.1% (8.1–8.2) of individuals, being higher among older age groups, women, and individuals with a higher number of physical conditions. PMHC was present in 6.2% (6.1–6.2) of the study population, and 13.1% (13.0–13.2) of the subjects with any chronic physical disorder also presented with at least one MHD. Dominating MHDs among PMHC patients were anxiety and depression. The prevalence of MHD was positively correlated with the number of physical disorders. We observed variation in the type of MHD as the number of physical comorbidities increased. The prevalence of anxiety, depression, and mental and behavioral disorders due to the misuse of alcohol and other psychoactive substances increased as physical comorbidities increased, but the prevalence of schizophrenia and dementia decreased with each additional physical disease. After adjusting for age and sex, this negative association changed the sign to a positive association in the case of dementia and mental and behavioral disorders due to psychoactive substance misuse. Conclusions The burden of physical-mental comorbidity in the Estonian population is relatively high. Further research is required to identify clusters of overlapping physical and mental disorders as well as the interactions between these conditions. Public health interventions may include structural changes to health care delivery, such as an increased emphasis on integrated care models that reduce barriers to mental health care.

scholarly journals Multimorbidity among Tuberculosis Cases’ Bangladesh Perspective

2019 ◽  
Vol 46 (3) ◽  
pp. 74-79 ◽  
Author(s):  
Atiya Tasnim Muna ◽  
Kazi Shafiqul Halim ◽  
Bushra E Zannat Khan ◽  
Kazi Fardana Mostary ◽  
Md Safikul Islam ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Family Income ◽  
Cross Sectional Study ◽  
Multiple Chronic Conditions ◽  
Chronic Medical Conditions ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Short Course ◽  
Directly Observed Treatment

Globally tuberculosis (TB) has become the leading cause of death from infectious diseases. Tuberculosis is a chronic infection and a person may suffer from tuberculosis and other chronic medical conditions at the same time. Co-occurrence of multiple chronic conditions in the same individual, known as multimorbidity (MM) is increasing worldwide. This cross-sectional study was carried out from January 2017 to December 2017 to reveal the extent of multimorbidity among tuberculosis cases. A TB case with multimorbidity was defined as TB with multimorbidity (TB-MM) subject. By convenient sampling, 227 tuberculosis cases from 8 Directly Observed Treatment, Short Course (DOTS) centers from Dhaka, Mymensingh and Netrokona districts were enrolled in this study. Among 227 tuberculosis cases 29 (12.8%) cases had multimorbidity (TB-MM subjects). Prevalence of multimorbidity was significantly higher in age group ≥40 years (p<0.001), male cases (p=0.034) and cases who had family income >30000 BDT/month (p=0.001), were currently smoker (p=0.028) and whose BCG scars were not seen (p<0.001). This study recommends that each TB case should be investigated for other chronic conditions to reveal the actual national magnitude of multimorbidity. Bangladesh Med J. 2017 Sep; 46 (3): 74-79

scholarly journals Determination of Seroprevalence and Risk Factors of Crimean–Congo Haemorrhagic Fever (CCHF) in the Endemic Region in Turkey: A Population-Based Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Rıza Çıtıl ◽  
Mücahit Eğri ◽  
Yalçın Önder ◽  
Fazilet Duygu ◽  
Yunus Emre Bulut ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Animal Husbandry ◽  
Population Based ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Endemic Region ◽  
Cross Sectional ◽  
History Of

Objectives. Turkey is one of the countries that has the most cases of CCHF in recent years among the endemic countries. The disease also poses an important health threat with high mortality rate. The aim of the study was to determine the seroprevalence and risk factors of CCHF in adults aged ≥20 years in Tokat in the endemic region, Turkey. Methods. In this population-based cross-sectional study, a total of 85 Family Medicine Units (FMUs), from over 170 in Tokat, were randomly selected using 50% sampling. The sample size was determined among the subjects aged ≥20 who registered with the FMUs, due to gender, age group, and the urban/rural population size of Tokat using the stratified cluster sampling method. Subjects were invited to the FMUs. A questionnaire was performed face to face. The blood samples were taken, and anti-CCHFV IgG antibodies were measured with ELISA method. Results. 1272 (54.9%) out of 2319 participants were female, and the mean age was 47.3 ± 15.3. Anti-CCHFV IgG seropositivity was 5.6% (n = 130). Seropositivity rates in terms of adjusted odds ratios (AOR) were higher 2.53 times (95% CI: 1.57–4.08; p = 0.001 ) in males; 4.05 (95% CI: 2.14–7.65; p < 0.001 ) in age group ≥65; 0.33 (95% CI: 0.14–0.76; p < 0.001 ) in graduates of high school and above; 0.71 (95%CI: 0.33–1.52; p < 0.001 ) in ones with good income; 1.84 (95%CI: 1.18–2.86; p < 0.001 ) in farmers; 1.64 (95% CI: 1.04–2.27; p < 0.001 ) in people dealing with animal husbandry; and 1.02 (95% CI: 1.03–2.29; p < 0.001 ) in those with history of tick contact. Conclusions. CCHF seroprevalence is still a common public health problem in Tokat, Turkey. Male gender, advanced age group, low-educated, low-income, farmers, animal husbandry, and history of tick contact were found to be risk factors for CCHF. The importance of this kind of community-based studies to identify the seroprevalence in regional and national level increases even more.

scholarly journals Subscription of various health insurance schemes and factors influencing them in rural area of central Karnataka: a cross sectional study

2020 ◽  
Vol 7 (3) ◽  
pp. 898
Author(s):  
Netra G. ◽  
B. A. Varadaraja Rao
Keyword(s):  
Health Insurance ◽  
Cross Sectional Study ◽  
Insurance Fund ◽  
Sectional Study ◽  
Cross Sectional ◽  
Systematic Random Sampling ◽  
Factors Influencing ◽  
Concept Of Health ◽  
The Family ◽  
Field Practice

Background: In a health insurance program, people who have the risk of a certain event contribute a small amount (premium) toward a health insurance fund. This fund is then used to treat patients who experience that particular event (e.g., hospitalization). It is a form of risk management which is used primarily to hedge against the risk of a contingent, uncertain loss. Health is wealth. Therefore, the concept of health insurance (HI) has evolved which finances health care. Objectives of the study was to assess subscription of various health insurance schemes and factors influencing them in the rural field practice area of SSIMS and RC, Davanagere.Methods: The cross sectional study was conducted in the rural field practice area of SSIMS and RC, Davangere from May to July 2016. A sample of 600 families were visited by systematic random sampling and data was collected from the head of the family with informed consent using a predesigned, pretested questionnaire by house to house interview. Analysis was done by using SPSS v10 and were results presented as percentages and proportions.Results: The total subscription in the study was 69.3%, Yeshasvini co-operative farmers’ health scheme coverage was 84% followed by others. The factors determining the subscription were the amount of premium, lack of funds, lack of awareness, lack of comprehensive coverage, etc.Conclusions: The premium has to be customized so that all the patients are benefited irrespective of the type of HI. 

scholarly journals Age-specific seroprevalence of poliomyelitis, diphtheria and tetanus antibodies in Spain

2002 ◽  
Vol 129 (3) ◽  
pp. 535-541 ◽  
Author(s):  
I. PACHÓN ◽  
C. AMELA ◽  
F. DE ORY
Keyword(s):  
Informed Consent ◽  
Age Groups ◽  
Population Based ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Tetanus Antitoxin ◽  
Blood Specimens ◽  
Tetanus Antibodies

In 1996, a seroepidemiological study was undertaken in Spain, with the main aim of estimating the population's immunity against poliomyelitis, tetanus and diphtheria. A population-based cross-sectional study was conducted, covering the population aged 2–39 years. The sample was stratified by age and rural–urban environment, and informed consent obtained to take blood specimens from subjects attending phlebotomy centres. The study included 3932 persons and the prevalence of antibodies against all three types of poliovirus exceeded 94% across all age groups. From a high of 96% in subjects under the age of 15 years, immunity against diphtheria steadily declined to a low of 32·3% in subjects aged 30–39 years. Similarly, tetanus antitoxin concentrations indicating basic protection were present in 98–99% of the under-14 years age group; thereafter, immunity declined, until reaching 54·6% in the 30–39 years age group.

scholarly journals Is Prescription Nonredemption a Source of Poor Health Among the Roma? Cross-Sectional Analysis of Drug Consumption Data From the National Health Insurance Fund of Hungary

2021 ◽  
Vol 12 ◽  
Author(s):  
Bayu Begashaw Bekele ◽  
Nouh Harsha ◽  
László Kőrösi ◽  
Ferenc Vincze ◽  
Árpád Czifra ◽  
...  
Keyword(s):  
Health Insurance ◽  
Alimentary Tract ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Poor Health ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
Cross Sectional ◽  
Anatomic Therapeutic Chemical ◽  
Roma People

Background: The health status of the Roma is inferior to that of the general population. The causes of poor health among this population are still ambiguous, but they include low utilization of healthcare services. Our study aimed to investigate prescription redemptions in segregated Roma colonies (SRC) where the most disadvantaged quartile of Roma people are living.Methods: A cross-sectional study was carried out with data obtained from the National Institute of Health Insurance Fund Management in the settlements belonging to the study area of the “Public Health-Focused Model Program for Organizing Primary Care Services.” The study included 4,943 residents of SRC and 62,074 residents of the complementary area (CA) of the settlements where SRC were located. Crude and age- and sex-standardized redemption ratios for SRC and CA were calculated for each Anatomic Therapeutic Chemical (ATC) group and for the total practice by ATC group. Standardized relative redemptions (RR) with 95% confidence intervals were calculated for SRC, with CA as a reference.Results: The crude redemption ratios were 73.13% in the SRC and 71.15% in the CA. RRs were higher in the SRC than in the CA for cardiovascular, musculoskeletal system, and alimentary tract and metabolism drugs (11.5, 3.7, and 3.5%, respectively). In contrast, RRs were lower in the SRC than in the CA for anti-infective agents (22.9%) due to the poor redemption of medicines prescribed for children or young adults. Despite the overall modest differences in redemption ratios, some ATC groups showed remarkable differences. Those include cardiovascular, alimentary and musculoskeletal drugs.Conclusion: Redemption of prescriptions was significantly higher among Roma people living in SRC than among those living in CA. The better redemption of cardiovascular and alimentary tract drugs was mainly responsible for this effect. These findings contradict the stereotype that the Roma do not use health services properly and that prescription non-redemption is responsible for their poor health.

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