Michalina Krzyżak

Information and Communication Technologies in Primary Healthcare – Barriers and Facilitators in the Implementation Process

Abstract Despite the great expansion and many benefits of information and communication technologies (ICT) in healthcare, the attitudes of Polish general practitioners (GPs) to e-health have not been explored. The aim of this study was to determine the GPs’ perception of ICT use in healthcare and to identify barriers to the adoption of EMR (Electronic Medical Records) in the Podlaskie Voivodeship. Online and telephone surveys were conducted between April and May 2013. Responses from 103 GP practices, 43% of all practices in the region, were analysed. The results showed that 67% of the respondents agreed that IT systems improve quality of healthcare services. In the GP group who declared at least partial EMR implementation, 71.4% see the positive impact of IT on practice staff processes and 66.1% on personal working processes. In this group, more than three-quarters of GPs did not see any positive impact of ICT on the average number of patients treated per day, number of patients within the practice or scope of services. The four most common barriers to EMR implementation were: lack of funds, risk of a malfunction in the system, resistance to change, and lack of training and proper information. Although the use of ICT by Polish GPs is limited, their attitude to e-health is generally positive or neutral and resembles the overall pattern in Europe. Barriers identified by GPs need to be taken into account to ensure the effective implementation of e-health across the country.

The Computer-Assisted Web Interview Method as Used in the National Study of ICT Use in Primary Healthcare in Poland – Reflections on a Case Study

Abstract The development and widespread use of ICT in society are reflected by the way research is designed and conducted. The Computer Assisted Web Interview method is becoming more attractive and is a frequently used method in health sciences. The National Study of ICT Use in Primary Healthcare in Poland was conducted using this method. The aim of this paper is to present the major advantages and disadvantages of web surveys. Technical aspects of methodology and important stages of the aforementioned study, as well as key elements for its procedure, are mentioned. The authors also provide reflections based on their analysis of this national study, conducted between January and April 2014.

Trends of potential years of life lost due to main causes of deaths in urban and rural population in Poland, 2002–2011

The aim of the study was to analyse the level and the trends of Potential Years of Life Lost due to main causes of deaths in Poland in 2002-2011, with consideration of place of residence, urban-rural. The material for the study was the number of deaths due to main causes in Poland in years 2002-2011, based on data from the Central Statistical Office. Premature mortality analysis was conducted with the use of PYLL indicator (PYLL - Potential Years of Life Lost). PYLL rate was calculated according to the method proposed by J. Romeder, according to which the premature mortality was defined as death before the age of 70. Time trends of PYLL rate and the annual percent change (APC) were assessed using the Joinpoint Regression Programme. Rural/urban ratio was used to presented the differences in premature mortality between rural and urban areas . In years2002-2011, the PYLL rate for all-cause deaths decreased by 13.2% among men and 16.0% among women in rural areas, whereas in urban decreased it decreased by 15.7% among men and 14.9% among women. In 2011, the main causes of PYLL among men in rural areas were: external causes (32.3%), cardiovascular diseases (23.5%) and cancers (19.4%); in urban areas: cardiovascular diseases (24.7%), external causes (24.3%) and cancers (20.9%). Among women in rural areas, the leading causes were: cancers (39.9%), cardiovascular diseases (20.1%) and external causes (15.1%). The main causes of premature mortality among women in urban areas were: cancers (41.7%), cardiovascular diseases (19.6%) and external causes (11.1%). Premature mortality among men in rural areas was significantly higher than in urban for all analysed causes of death, with the exception of ischaemic heart diseases and colorectal cancer. Premature mortality among women in rural areas was significantly lower than in urban for all analysed cause of deaths, except of cerebrovascular diseases, external causes, suicides and traffic accidents. The presented epidemiological situation for premature mortality indicate differences in the state of health of the inhabitants in urban and rural areas in Poland. The leading causes of premature mortality are caused by preventable deaths, which leads to a need to intensify measures in primary and secondary prevention.

Changes in Dietary Patterns and the Nutritional Status in Men in the Metallurgical Industry in Poland Over A 21-Year Period

Background/Aims: The study was carried out to evaluate the changes in the eating habits and lipid parameters in a 21-year follow-up on a group of 435 men living in Poland. Methods: The studied population was composed of the same subjects: a group of men who were first studied in the years 1987–1989 and in 2008–2010. The following data was gathered: body mass, body mass index (BMI), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride concentration in blood serum. Results: The changes in the eating habits among the studied men registered throughout the 21-year period were positive since they showed a reduction in the caloric content of their diet (p < 0.001), lower total fat content (p < 0.001), total amount of carbohydrates (p < 0.001), sucrose (p < 0.001), iron (p < 0.001), and featured more vitamins: A (p < 0.002), B1 (p < 0.001), and C (p < 0.001). An adverse trend was observed in terms of constant calcium shortages in their food portions (ns). A 21-year follow-up of the studied group showed significant differences in terms of weight (p < 0.001), BMI (p < 0.001), and all cholesterol fractions (p < 0.001) in their blood serum, except cholesterol alone (ns). Conclusion: It is important to continue observing the dietary trends in the studied group, with the focus on the occurrence of potential changes in their bodies.

Differences in treatment outcomes in selected cancers in Poland compared to other European countries in 2005–2009, based on CONCORD 2 study

Wstep. Wskaźniki 5-letnich przezyc populacyjnych obrazują poziom wyleczalności nowotworow zlośliwych w populacji, a zatem są jednym z najwazniejszych narzedzi do oceny efektywności walki z rakiem. Dzieki ujednoliconej metodologii ogolnoświatowego badania CONCORD 2 wskaźniki obliczone dla Polski mozna bylo porownac z innymi krajami Europy. Celem opracowania byla ocena wyleczalności chorych na wybrane nowotwory w Polsce oraz w niektorych wojewodztwach na tle krajow europejskich. Material i metody. W analizach wlasnych wykorzystano wyniki badania CONCORD 2 obliczone na podstawie danych zgromadzonych przez populacyjne rejestry nowotworow chorych, u ktorych rozpoznano nowotwor zlośliwy w latach 2005–2009 i obserwowanych do konca 2009 roku. Z wynikow wyodrebniono dane dotyczące Polski udostepnione dla celow CONCORD 2 przez Krajowy Rejestr Nowotworow oraz Wojewodzkie Biura Rejestracji Nowotworow w wojewodztwach: dolnośląskim, podkarpackim, świetokrzyskim i wielkopolskim. Wskaźniki 5-letnich przezyc obliczono metodą estymacji Pohar Perme net survival . Wyniki. W Polsce u chorych na raka gruczolu krokowego (74%), piersi (74%), szyjki macicy (53%), okreznicy (50%), odbytnicy (47%), jajnika (34%) i zolądka (19%) wskaźniki 5-letnich przezyc nalezaly do najnizszych w Europie. Natomiast u chorych na bialaczki (49%) i raka pluca (13%) przezycia byly na poziomie przecietnych w Europie. Analiza wedlug wojewodztw wykazala zroznicowanie regionalne. Najwieksze roznice dotyczyly bialaczek w wojewodztwach dolnośląskim i świetokrzyskim (14%), raka gruczolu krokowego w wielkopolskim i świetokrzyskim (10%) oraz raka piersi w wielkopolskim i podkarpackim (6%), co wskazuje na zroznicowanie w standardach profilaktyki i leczenia. Wnioski. Badanie wykazalo zroznicowanie wskaźnika 5-letnich przezyc w Europie na niekorzyśc Polski. W nowotworach dobrze rokujących takich jak: rak gruczolu krokowego, piersi, okreznicy i odbytnicy wskaźniki nalezaly do najnizszych w Europie, natomiast u chorych na raka pluca oraz bialaczki byly na poziomie przecietnych w Europie.

The Use of the Health Disparities Calculator in Analysis of the Lung Cancer Burden in Urban and Rural Populations in the Świętokrzyskie Province (Poland): 1999–2010

Abstract The purpose of the study was a comparative analysis of the burden of lung cancer in urban and rural areas in the Świętokrzyskie Province in the years 1999–2010. The material for the study accounted for information about the number of new cases of lung cancer obtained from the Świętokrzyskie Cancer Registration Office in Kielce and data from the Central Statistical Office concerning the number of deaths due to lung cancer in the years 1999–2010. Crude and age-standardized incidence, mortality, and potential years of life lost rates were calculated separately for groups of men and women in urban and rural areas. A comparative analysis of coefficients in urban and rural areas based on Rate Ratio (RR) and Rate Difference (RD) was performed by using the Health Disparities Calculator. The average annual incidence of lung cancer among men was 18% lower in the urban population than in the rural, while the mortality rate was 16% lower. For women, the incidence and mortality rates were higher in urban areas as opposed to rural areas – by 48% and 54% respectively. The comparative analysis of the burden of lung cancer showed great diversity between urban and rural populations in the Świętokrzyskie Province.

Joinpoint Regression Analysis of Potential Years of Life Lost Due to Main Causes of Death in Poland, Years 2002–2011

Abstract The purpose of the study was to analyse the level and the trends of Potential Years of Life Lost due to the main causes of death in Poland in the years 2002-2011. The material for the study was the information from the Central Statistical Office on the number of deaths due to the main causes of death in Poland in the years 2002-2011. The premature mortality analysis was conducted with the use of the PYLL (Potential Years of Life Lost) indicator. PYLL rate was calculated following the method proposed by J. Romeder, according to which premature mortality was defined as death before the age of 70. Time trends of PYLL rate and the average annual percent change (APC - Annual Percent Change) were assessed using jointpoint models and the Joinpoint Regression Program. In the years 2002-2011, PYLL rate for all-cause deaths decreased by 7.0% among men and 8.1% among women. In 2011, the main reasons for PYLL among men were: external causes (27.6%), cardiovascular diseases (24.2%) and cancers (20.3%). Among women the leading causes were: cancers (41.1%), cardiovascular diseases (19.7%) and external causes (12.5%). PYLL rate increased among men for colorectal cancer, and among women for colorectal and lung cancer. The presented epidemiological situation for premature mortality in Poland shows that in the majority of cases it is caused by preventable deaths, which highlights a need to intensify measures in primary and secondary prevention.