Ana Ivičević Uhernik

The economic burden of disease-related undernutrition in selected chronic diseases ☆

BACKGROUND & AIMS Undernutrition is a common and aggravating problem in people suffering from various chronic diseases as well as a source of material costs. The aim of this study was to investigate the prevalence of disease-related undernutrition among adults in Croatia in the year 2012, as well as the cost of undernutrition associated with tumour cachexia, chronic pancreatitis, inflammatory bowel disease, hepatic encephalopathy, chronic obstructive pulmonary disease, chronic renal insufficiency requiring dialysis, cerebrovascular insult, pressure ulcers, and femoral fractures in the elderly. METHODS A cost-of-illness analysis was conducted, including direct costs only. The study employed the dominant cost-of-illness method, which restricts the summation of medical expenditure to the disease of interest. The bottom-up, prevalence-based approach was used. The budget holder perspective was employed, and data sources include the list of reimbursed drugs, clinical opinions, and literature. RESULTS The prevalence of disease-related undernutrition in people over the age of 20 in Croatia in the year 2012 was estimated to be 33.7/1000. The total cost of adult malnutrition for selected diagnoses was 97.35 million EUR, accounting for 3.38% of the total Croatian national health care budget. The largest share was used for medications (43%), followed by 34% for hospitalizations, 13% for community health nursing, while parenteral and enteral nutrition contributed with 6% and 1% respectively. The average cost per patient was estimated at 1640.48 EUR. CONCLUSIONS The cost of malnutrition for the selected diagnoses in Croatia was substantial. These health costs will increase due to population ageing, which calls for undernutrition screening in people at risk as well as for effective approaches in nutrition supplementation.

Association of BMI and nutritional habits with hypertension in the adult population of Croatia.

OBJECTIVE The purpose of the present study was to investigate the distribution of hypertension, its nutritional and other determinants and their association in Croatia. DESIGN Population-based, cross-sectional study. SETTING Croatia. SUBJECTS Representative random sample of 9070 adults (18 years and older) from all Croatian regions, selected using multistage sampling. RESULTS Overall prevalence of hypertension (arterial blood pressure >or=140/90 mmHg) in Croatia was 45.5 %, of which 40 % were newly diagnosed hypertensives. There was no difference in the percentage of hypertensives between the continental and Mediterranean parts of Croatia. Newly diagnosed hypertension was found to be positively associated with increased BMI, age and alcohol consumption in the total sample and with moderate consumption of coffee in women, as well as inversely associated with regular consumption of fruits and vegetables in the total sample and high consumption of coffee in the total sample and in men. No association with newly diagnosed hypertension was recorded for use of animal fat, consumption of whole milk, smoked meat products, for adding salt, smoking and leisure-time physical activity. CONCLUSIONS Hypertension is a major public health problem in both continental and Mediterranean parts of Croatia. Maintenance of normal body mass, its reduction if already increased, and regular consumption of fruits and vegetables are proposed as priorities for primary prevention of hypertension in Croatia.

Association of BMI and nutritional habits with hypertension in the adult population of Croatia – Corrigendum

In the third paragraph of the Sample section on page 98, instead of: Data were collected by public health nurses from April to June 2003. They took anthropometric measures such as height, weight and blood pressure, and interviewed respondents. it should read: Data were collected by public health nurses from April to June 2003. They measured blood pressure and interviewed respondents. Height and weight were self-reported by respondents. This mistake occurred due to incorrect information published in Croatian Adult Health Survey. Users’ guide. In: 2003 Croatian Adult Health Survey Master Microdata File Documentation. Republic of Croatia Ministry of Health. Health Systems Project IBRD Loan 4513-0 HR. Zagreb; 2003.

Development of a Health Information System in a Post-Communist Country

Between 2001 and 2003 a project conducted in Croatia establich and develop a Health Information System based to the latest technologies. The development of sush system is feasible in transitional countries because most of them are still having one main insurer.