Úvod: Očkovanie proti rotavírusom je účinným nástrojom prevencie rotavírusových gastroenteritíd (RVGE) a nimi spôsobených hospitalizácií. Cieľom tejto práce je opísať stav zaočkovanosti proti rotavírusom u detí do 5 rokov v kmeni zdravotnej poisťovne Dôvera v rokoch 2019–2023 a vyhodnotiť vplyv očkovania na výskyt hospitalizácií s diagnózou RVGE. Súbor pacientov a metódy: Do analýzy boli zahrnutí poistenci zdravotnej poisťovne Dôvera narodení v rokoch 2019–2023 s kontinuálnym poistným vzťahom do konca júna 2024 alebo do úmrtia (n = 106 696). Stav očkovania u poistenca bol vyhodnotený na základe aspoň jedného výskytu predpisu vakcíny proti rotavírusom (ATC skupina J07BH) vo vykázanej zdravotnej starostlivosti. U poistencov boli sledované hospitalizácie s hlavnou diagnózou RVGE (A08.0). Výsledky: Zaočkovanosť proti rotavírusom v rokoch 2019–2023 bola na úrovni 46,4 %. Medzi jednotlivými krajmi Slovenska boli výrazné rozdiely v zaočkovanosti, od 32,7 % v Košickom kraji do 64,0 % v Bratislavskom. Vyššia zaočkovanosť v kraji korelovala s nižším výskytom hospitalizácií pre RVGE (R = -0,925, p < 0,001). Očkovanie proti rotavírusom znižovalo riziko hospitalizácie o 84 % v porovnaní s neočkovanými jedincami (HR = 0,16, CI= 0,14–0,18, p < 0,001, adjustované na pohlavie a kraj jedinca). Záver V rokoch 2019–2023 bola proti rotavírusom zaočkovaná menej ako polovica populácie do 5 rokov. Očkovanie proti rotavírusom je pritom výrazným nezávislým protektívnym faktorom pre výskyt hospitalizácií s RVGE. Zvýšenie zaočkovanosti dokáže nielen znížiť riziko hospitalizácií, má finančný šetriaci efekt, ale zároveň predchádza aj nežiadúcim následkom a komplikáciám RVGE.
Introduction: Vaccination against rotaviruses is an effective tool for preventing rotaviral gastroenteritis (RVGE) and associated hospitalizations. The aim of this study is to describe the state of vaccination against rotaviruses among children under 5 years of age in Dôvera Health Insurance Company from 2019 to 2023 and to evaluate the impact of vaccination on the incidence of hospitalizations with a diagnosis of RVGE. Patient Population and Methods: The analysis included insured individuals from Dôvera born between 2019 and 2023, with continuous insurance coverage until the end of June 2024 or until death (n = 106 696). The vaccination status was assessed based on at least one recorded prescription of the rotavirus vaccine (ATC group J07BH) in the healthcare claims data. Hospitalizations with a primary diagnosis of RVGE (A08.0) were monitored among the insured individuals. Results: Vaccination coverage against rotaviruses in years 2019 to 2023 was at 46.4%. There were significant differences in vaccination rates across various regions of Slovakia, ranging from 32.7% in Košice region to 64.0% in Bratislava region. Higher vaccination rates in a region correlated with a lower incidence of RVGE-related hospitalizations (R = -0.925, p < 0.001). Vaccination against rotaviruses reduced the risk of hospitalization by 84% compared to unvaccinated individuals (HR = 0.16, CI= 0.14–0.18, p < 0.001, adjusted for sex and region). Conclusion: From 2019 to 2023, less than half of the population under 5 years old was vaccinated against rotaviruses. Vaccination against rotaviruses is a significant independent protective factor for the occurrence of RVGE-related hospitalizations. Increasing vaccination coverage can not only reduce hospitalization risks but also has financial savings effects while preventing adverse outcomes and complications associated with RVGE.
OBJECTIVES: Propose a methodology to identify COVID-19 associated deaths using healthcare billing records and evaluate its effectiveness by comparing the results with excess mortality data from 2020 to 2022 and confirmed COVID-19 deaths. METHODS: A retrospective quantitative analysis was conducted by merging healthcare billing records with cause of death data. The term "COVID-19 associated death" was defined as any death occurring within a defined timeframe following a confirmed contact with COVID-19. This category includes individuals who died directly due to COVID-19, with COVID-19 as a contributing factor, or as an aftermath of a COVID-19 infection, as well as those who died from other causes but had previously contracted COVID-19. This broader definition provides a more comprehensive measure of excess mortality compared to the officially confirmed COVID-19 deaths attributed to the virus. RESULTS: We identified 35,399 COVID-19 associated deaths during the 3-year pandemic in Slovakia compared to 21,395 confirmed COVID-19 deaths. CONCLUSION: The identification of COVID-19 associated deaths with our methodology offers a more accurate explanation for the notably high excess mortality observed in Slovakia (31,789 deaths) during the pandemic, relative to the EU27. Given the high level of excess mortality, the officially confirmed deaths are likely underestimated, and the presented methodology provides a more precise measure of mortality. Additionally, healthcare billing records prove valuable in identifying these deaths at the individual patient level using claims data of health insurance companies, which is crucial for implementing targeted preventive measures and improving preparedness for future pandemics.
- MeSH
- COVID-19 * mortalita MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- pandemie MeSH
- příčina smrti * MeSH
- retrospektivní studie MeSH
- SARS-CoV-2 MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika MeSH
OBJECTIVES: Celiac disease (CD) is a chronic autoimmune disorder caused by a complex interplay between genetic and environmental factors. The main goal of our case-control study was to analyse the association of environmental factors with the odds of CD development in a sample of the Slovak population. METHODS: Data were collected from 1,226 respondents (534 CD patients and 692 controls) by a questionnaire. The impact of analysed parameters on the chance of disease development was assessed by multiple regression analysis and expressed as odds ratios (OR). Values of p < 0.05 were considered statistically significant. RESULTS: In the patient group, celiac disease was significantly more prevalent in women than in men (OR = 1.52, p = 0.010). Respondents with a positive family history of CD showed 2.9-fold higher odds of CD compared to others (p < 0.001), and respondents with coexisting autoimmune diseases had 2.6-fold higher odds of CD (p < 0.001). Subjects who had taken antibiotics at least three times a year during childhood had 1.95-fold higher odds of developing CD compared to those who took them less frequently or not at all (p = 0.022). Conversely, individuals who were breastfed in infancy had lower odds of CD compared to non-breastfed respondents (OR = 0.53, p < 0.001). The mode of delivery (vaginal vs. caesarean section), overcoming severe infections, and the timing of gluten introduction in childhood did not show a statistically significant effect on the odds of developing CD. CONCLUSION: Based on our data, being female, having a positive family history of CD, suffering from another autoimmune disease, and frequent use of antibiotics are factors associated with an increased chance of developing CD. On the other hand, breastfeeding in infancy seems to have a protective effect. Our findings highlight the importance of further research in understanding the complexities of this autoimmune condition and providing a foundation for prevention strategies.
- MeSH
- celiakie * epidemiologie MeSH
- dospělí MeSH
- kojení statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- prevalence MeSH
- průzkumy a dotazníky MeSH
- rizikové faktory MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika MeSH
Gestačný diabetes mellitus (GDM) je jednou z najčastejších komplikácií v tehotenstve, ktorá vážne ovplyvňuje zdravie matky aj dieťaťa. Cieľom štúdie bolo z dát zdravotnej poisťovne Dôvera (DZP) zistiť prevalenciu GDM v jej kmeni, zmapovať skríning GDM počas tehotenstva a popôrodnú kontrolu pacientok s GDM. V období 2015–2022 bola prevalencia GDM v poistnom kmeni DZP v priemere 12,5 %, pričom za sledované obdobie došlo k signifikantnému nárastu prevalencie GDM z 11,6 % na 13,3 %. Prevalencia GDM signifikantne stúpala aj s vekom tehotných žien. Boli tiež pozorované významné rozdiely v prevalencii v jednotlivých krajoch Slovenska. Pre včasnú diagnostiku GDM sa na Slovensku realizuje skríning prostredníctvom orálneho glukózového tolerančného testu (oGTT), ktorý sa obvykle vykonáva medzi 24.-28. týždňom gravidity. Z analýzy dát DZP vyplýva, že v sledovanom období (2015–2022) bolo počas tehotenstva skrínovaných 58,9 % poisteniek. Ženy s anamnézou GDM majú tiež vyššie riziko rozvoja diabetu 2. typu (DM2T), preto je potrebné u takýchto žien vykonať kontrolu glykémie najneskôr do 6 mesiacov od pôrodu. Popôrodnú kontrolu absolvovala v kmeni DZP do 7 mesiacov od pôrodu necelá štvrtina poisteniek (21,7 %) a do roka po pôrode malo skontrolovanú glykémiu 32,9 % poisteniek.
Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy, seriously affecting the health of both mother and baby. The aim of the study was to find out the prevalence of GDM in its tribe, to map the screening of GDM during pregnancy and postpartum follow-up of patients with GDM from data of Dôvera Health Insurance Company (DZP). Between 2015 and 2022, the prevalence of GDM in the DZP among insurees averaged 12.5%, with a significant increase in the prevalence of GDM from 11.6% to 13.3% over the study period. The prevalence of GDM also increased significantly with the age of pregnant women. Significant differences in prevalence were also observed in different regions of Slovakia. For early diagnosis of GDM, screening by oral glucose tolerance test (oGTT) is performed in Slovakia, which is usually performed between 24–28 weeks of gestation. The analysis of DZP data shows that 58.9% of insured women were screened during pregnancy in the study period (2015–2022). Women with a history of GDM also have a higher risk of developing type 2 diabetes mellitus; therefore, glycemic control should be performed in such women no later than 6 months after delivery. Less than one-quarter of insured women (21.7%) in the GDM tribe had a postpartum check within 7 months of delivery, and 32.9% of insured women had their glycemia checked within a year after delivery.
- MeSH
- diabetes mellitus 2. typu etiologie MeSH
- gestační diabetes * diagnóza etiologie prevence a kontrola MeSH
- glukózový toleranční test metody MeSH
- klinická studie jako téma MeSH
- komplikace těhotenství diagnóza MeSH
- krevní glukóza MeSH
- lidé MeSH
- plošný screening metody MeSH
- postnatální péče MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Slovenská republika MeSH
Diabetická neuropatia je jednou z najčastejších komorbidít diabetu. Jedným z preparátov využívaných v jej liečbe je kyselina alfa-lipoová (ALA). Z viacerých štúdii sledujúcich závislosť jej efektu na použitej dávke sa preukázala dávka 600 mg denne ako optimálna. Z dát zdravotnej poisťovne Dôvera boli analyzované predpisy ALA v rokoch 2017– 2022. U pacientov na pravidelnej liečbe ALA bola z ich preskripcie stanovená denná užívaná dávka ALA. V roku 2022 bolo z celkového počtu 8 281 pacientov pravidelne užívajúcich ALA 43,8 % na dávke vyššej ako 600 mg denne a 6,1 % na dávke vyššej ako 900 mg denne. Pacienti, ktorí mali predpisy ALA od viacerých lekárov, mali štatisticky významne vyššiu pravdepodobnosť užívania vyššej než odporúčanej dávky. Z dát zdravotnej poisťovne je možné pozorovať, že značná časť pacientov užíva vyššie než odporúčané dávky ALA. Napriek tomu, že podiel pacientov na dennej dávke ALA vyššej ako 600 mg klesá, je potrebné, aby lekári aktívne predchádzali kumulácii predpisov u pacienta.
Diabetic neuropathy is one of the most common comorbidities of diabetes. One of the agents used in its treatment is alpha-lipoic acid (ALA). From several studies investigating the dose-dependence of its effect, a dose of 600 mg daily has been shown to be optimal. The prescriptions of ALA in the years 2017–2022 were analyzed based on the data of the health insurance company Dôvera. In patients on regular ALA treatment, the daily dose of ALA used was determined based on the prescription. In 2022, of the 8,281 patients on regular ALA, 43.8 % were on a dose greater than 600 mg per day and 6.1 % were on a dose greater than 900 mg per day. Patients who had ALA prescriptions from multiple physicians were statistically significantly more likely to be taking a higher than recommended dose. It can be observed of the health insurance data that a significant proportion of patients are taking higher than recommended doses of ALA. Although the proportion of patients on a dose of ALA greater than 600 mg is decreasing, physicians need to be proactive in preventing accumulation of prescriptions in patients.
