Ranko Stevanović

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.

National, Regional and international interoperability of Croatian healthcare information system

Image compression is an essential stage of the data archiving and transmitting process, as it reduces the number of bits and the time required to complete the transmission. In this article, a study of image transmission over the Multi-Carrier Code Division Multiple Access (MC-CDMA) downlink system is presented. The solution proposed relies on source coding combined with channel coding. The Discrete Wavelet Transform (DWT) method is used in conjunction with the SPIHT coder to compress the image, then the data generated is transmitted with the MC-CDMA technique over a noisy channel. The results show that image transmissions performed over MC-CDMA using the SPIHT model are better than the traditional approach like MC-CDMA in the AWGN channel. Keywords—data compression, MC-CDMA, MSSIM, performance evaluation, PSNR, SNR, SPIHT.

The founding of the Centre for Palliative Medicine, Medical Ethics and Communication Skills: a new step toward the development of patient-oriented medicine in Croatia.

One of the main conceptual changes in the 20th century medicine is the inclusion of social dimension. The “golden era” of Parson’s medical model (1), which uses the “active-passive” dichotomy to describe the positions and expectations of physicians and patients, is over. Physicians’ supremacy has slowly and systematically been challenged by the emergence of third party stakeholders, development of new media sources, strengthening of the civil society, and democratization of information, which all have contributed to the development of the patients’ active role in the healing processes (2). The rise of medical consumerism has stimulated the medical authorities to react with a new ideological policy: the patient-oriented medicine, insisting on the partnership in the diagnostic and therapeutic processes, and viewing the patient as a person with biological, psychological, social, and spiritual needs (2).

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.