An analysis of the costs of treating aged patients in a large clinical hospital in Poland under the pressure of recent demographic trends

Health status and its socio-economic covariates in the older population in Poland - the assumptions and methods of the nationwide, cross-sectional PolSenior2 survey

INTRODUCTION

Population ageing constitutes an increasing medical, social, and economic burden worldwide. Optimal senior policy should be based on well-assessed knowledge on the prevalence and control of age-related diseases, multimorbidity, disabilities, and their social determinants. The objective of this paper is to describe the assumptions, methods, and sampling procedures of the PolSenior2 survey, which was aimed at characterising the health status of old and very-old adults in Poland.

MATERIAL AND METHODS

The project was conducted in the period 2018-2019 as a cross-sectional survey of a representative sample of people aged 60 years and over. Subjects were selected using three-stage stratified and proportional random sampling in seven equally sized (n = 850) age groups. The study protocol consisted of face-to-face interviews, specific geriatric scales and tests, and anthropometric and blood pressure measurements performed by well-trained nurses at participants homes as well as blood and urine sample laboratory tests.

RESULTS

In the Polsenior2 study a group of 5987 subjects underwent the questionnaire parts of the survey, and almost all (n = 5823) agreed to blood or urine sample collection.

CONCLUSIONS

In recent decades several studies focused on various aspects of elderly health and life conditions had been carried out in Poland and Central and Eastern Europe. However, none of them is so complex and has covered so many issues as PolSenior2, which is the largest study devoted to the health status of older persons in Poland and one of the largest and the most comprehensive in Europe. The results of the study will help to improve health policy targeted at the elderly population in Poland.

Cost analyses of hospital admissions among the elderly seeking care at a rural tertiary care hospital, South India

Introduction:

In a developing country like India, a proportionately higher number of elderly people live in the rural areas and many of them are financially challenged. Hospitalization and consequent cost thereto pose a heavy burden especially for the elderly.

Objective:

Among elderly in.patients at a tertiary care rural hospital to estimate the average number of episodes of hospitalizations, duration of stay in the hospital, and the direct and indirect costs associated with hospitalizations with 1 year as a reference period.

Materials and Methods:

A structured pre.tested questionnaire was used to capture the details regarding hospitalizations and the costs involved and also the hospital records were verified for the current hospital admission to finally arrive at the direct and indirect costs calculations. Quantitative details like age, episodes of hospitalization in the last 1 year, duration of hospitalization, hospitalization costs, etc., were summarized as median (inter.quartile range [IQR]). Costing analyses were noted separately as direct, indirect, and total costs and expressed in Indian National Rupees (INR).

Results:

The total number of episodes of hospitalization among the 150 study participants was 204 with a mean of 1.36 episodes per person in 1-year duration. The average total cost per episode of hospitalization was found to be INR 11,249 while the average total cost per person per day was INR 1,670.30. The median (IQR) direct and indirect costs were INR 6,222 (3,060-12,670) and INR 690 (200-700), respectively.

Conclusion:

Duration, as well as cost of hospitalization, has been found to be more among females in most age groups among elderly in.patients.

The role of docosahexaenoic acid (DHA) in the prevention of cognitive impairment in the elderly

Aging is an inevitable and progressive biological process that leads to irreversible physiological and functional changes, also in the nervous system. Cognitive decline occurring with age can significantly affect the quality of life of older people. Docosahexaenoic acid (DHA) is necessary for the proper functioning of the nervous system; it can affect its action directly through its impact on neurogenesis and neuroplasticity, but also indirectly by affecting the functioning of the cardiovascular system or anti-inflammatory effect. Literature analysis shows that good nutritional status of n-3 fatty acids, determined on the basis of their level in blood plasma or erythrocytes, is associated with a lower risk of cognitive decline in selected cognitive domains, as well as a lower risk of dementia or Alzheimer’s disease, although studies are also available where the above relationship has not been confirmed. Apart from this, studies on DHA and EPA diet intake, as well as in the form of dietary supplements, show their beneficial effects in the context of cognitive functioning and the risk of dementia. Also, the results of intervention studies, although not explicit, suggest that high doses of DHA and EPA in the form of dietary supplements may slow down the process of deteriorating the cognitive functioning of the elderly within selected domains. Based on the review of the literature, it can be concluded that DHA and EPA play an essential role in the prevention of cognitive impairment.

COVID-19 among Healthcare Workers in the University Clinical Hospital in Wroclaw, Poland

Efforts to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among hospital healthcare staff are crucial for controlling the Coronavirus Disease 19 (COVID-19) pandemics. The study aimed to explore the prevalence and clinical presentations of COVID-19 in healthcare workers (HCWs) at the University Clinical Hospital (UCH) in Wroclaw with 1677 beds. The retrospective study was performed in 2020 using a self-derived structured questionnaire in a sample of HCWs who were diagnosed with SARS-CoV-2 infection confirmed using a PCR double gene test and consented to be enrolled into the study. The significance level for all statistical tests was set to 0.05. The study showed that of the 4998 hospital workers, among 356 cases reported as COVID-19 infected, 70 consented to take part in the survey: nurses (48.5%), doctors (17.1%), HCWs with patient contact (10.0%), other HCWs without patient contact (7.1%), and cleaning personnel (5.7%). HCWs reported concurrent diseases such as hypertension (17.1%), bronchial asthma (5.7%), and diabetes (5.7%). Failure to keep 2 m distancing during contact (65.5%) and close contact with the infected person 14 days before the onset of symptoms or collection of biological material (58.6%) were identified as the increased risks of infection. A large part of infections in hospital healthcare staff were symptomatic (42.9%). The first symptoms of COVID-19 were general weakness (42.9%), poor mental condition (41.4%), and muscle pain (32.9%); whereas in the later stages of the illness, general weakness (38.6%), coughing (34.3%), lack of appetite (31.4%), and loss of taste (31.4%) were observed. In about 30% of the infected HCWs, there was no COVID-19 symptoms whatsoever. The vast majority of the patients were treated at home (85.7%). In conclusion, the majority of the SARS-CoV-2 infections in the hospital HCWs were asymptomatic or mildly symptomatic. Therefore, successful limitation of COVID-19 infection spread at hospitals requires a close attention to future cross-infections.