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1.
Sci Rep ; 14(1): 11975, 2024 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-38796493

RESUMO

A situation of emergency involving the whole population introduces changes in the dynamics of the health services that are provided. The magnitude of these shifts should be also linked to the medical speciality within which the health benefits are delivered. The aim of the paper was to identify changes in tendencies in inpatient medical service delivery during the COVID-19 pandemic by medical specialties. On the basis of a database extracted for in-patient treatment received from the public payer, a retrospective analysis was carried out. Comparing the values of the dynamics of the services provided in each medical speciality, the period before the COVID-19 pandemic was collated to the years of the pandemic (2020-2021). In the period before COVID-19, positive patient dynamics were observed in more than half of the specialities. Between 2020 and 2021, virtually all specialties reversed the trend and negative dynamics were recorded. The dynamics in 2021 indicate a process of return to the values from 2015 to 2019. Emergency situation has affected the dynamics of healthcare provision in different specialities to various extent. The most resistant to the negative impulses of the state of emergency were the areas that are strictly organisationally and financially defined (e.g. the group of "therapeutic and drug programmes").


Assuntos
COVID-19 , Atenção à Saúde , Pacientes Internados , Pandemias , Humanos , COVID-19/epidemiologia , Polônia/epidemiologia , Estudos Retrospectivos , Pacientes Internados/estatística & dados numéricos , SARS-CoV-2/isolamento & purificação , Hospitalização/estatística & dados numéricos
2.
Front Public Health ; 12: 1344040, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38389942

RESUMO

Introduction: Bariatric surgery has known health benefits and may lower the medication-related costs. This study aimed to assess the cost of medications prior to and after bariatric surgery in the Polish nationwide registry. Methods: The study included 2,390 adults. The analysis was conducted separately for a 12-month pre-operative period, and a 12-month postoperative period. The total costs of medication and cost per anatomical therapeutic chemical group were assessed and the mean cost per patient in the preoperative and postoperative periods was compared. Results: The study showed a significant increase in the overall medication costs and mean costs of medications per patient in the year after bariatric surgery. This increase was related mainly to low-molecular-weight heparins used in the 1st month after surgery. Alternatively, costs of medication used in the cardiovascular system diseases and anti-infectives decreased significantly. The total costs of hypoglycemic agents were reduced by 46%, antihypertensive medications by 29%, and lipid-lowering drugs by 38. Conclusions: In general, medication costs are higher in the first year after surgery. The increase results from the perioperative use of low-molecular-weight heparins, whereas a significant cost reduction of glucose-, lipid-lowering, antihypertensive, and anti-infective medications was observed.


Assuntos
Anti-Hipertensivos , Cirurgia Bariátrica , Adulto , Humanos , Análise de Dados , Heparina de Baixo Peso Molecular , Período Pós-Operatório , Lipídeos
3.
Ann Agric Environ Med ; 30(4): 705-714, 2023 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-38153075

RESUMO

INTRODUCTION: The rapidly growing market for drugs, including oncology and haemato-oncology drugs, is generating enormous financial expenditure for healthcare systems. In Poland, access to high-cost treatments is possible mainly within drug programmes, funded by public healthcare systems. The path of proceeding adopted in Polish regulations is similar to the solutions adopted in other countries. OBJECTIVE: The aim of this study was to demonstrate the actual costs incurred by the treatment entity in the process of treating patients under the drug programme at the Regional Oncology Centre in Olsztyn, north-east Poland. MATERIAL AND METHODS: The oncology drug programme B.54 'Treatment of patients with refractory or malignant plasmocytic myeloma' implemented at the Regional Oncology Centre in Poland between 2018-2021, was selected for the analysis. The choice of the B.54 programme was based on the small population of patients meeting the inclusion criteria for this programme, and the large number of diagnostic procedures stipulated in the drug programme description. On average, 25 patients were treated per year. The financial analysis used the financial categories related to hospital billing information. The costs were presented based on the purchasing power parity of money in 2021, i.e. 1 USD-inter is equivalent to 1.837 PLN. RESULTS: The flat rate form of financing medical services does not cover the actual costs of treatment. Providing patients with necessary medical services without their full coverage by the public payer, burdens the budget of the centre and may lead to indebtedness of the treatment entity. CONCLUSIONS: Without an increase in the valuation of benefits under drug programmes, corresponding to the actual costs of treatment, the expected increase in access to innovative therapies will be difficult to accomplish.


Assuntos
Mieloma Múltiplo , Humanos , Polônia/epidemiologia , Mieloma Múltiplo/tratamento farmacológico , Atenção à Saúde
4.
Artigo em Inglês | MEDLINE | ID: mdl-36900834

RESUMO

The incidence of unruptured intracranial aneurysms (UIAs) amounts to 3.2% among adults. The annual risk of aneurysm rupture is 2-10% and it results in subarachnoid haemorrhage (SAH). The aim of this study is to assess changes in the incidence of unruptured intracranial aneurysms and subarachnoid haemorrhages in Poland between 2013 and 2021 and the cost associated with their in-hospital treatment in the acute phase. The analysis was based on the National Health Fund database. Patients diagnosed with UIA and SAH and hospitalised between 2013 and 2021 were chosen. The statistical analysis was performed with an assumed significance level of α = 0.05. The ratio between the prevalence of SAH and UIA diagnoses was 4:6. The proportion of women in relation to men was higher in both diagnoses. The highest proportions of patients with diagnoses SAH and UIA were found in highly urbanised provinces. The value of medical services in 2021 compared to 2013 increased by 81.8%. The highest values in this period were recorded in Mazowieckie province, and the lowest were recorded in Opolskie province. The overall number of patients hospitalised with diagnosis of UIA or SAH did not decrease, but the risk of aneurysm rupture probably decreased, which resulted in lower incidence of SAH in subsequent years of observation. The recorded changes in the dynamics of the value of medical services per patient or per hospitalisation largely coincided. However, it is difficult to speculate on expected value levels as not all provinces showed linear changes in the value of services provided.


Assuntos
Aneurisma Roto , Aneurisma Intracraniano , Hemorragia Subaracnóidea , Masculino , Adulto , Humanos , Feminino , Hemorragia Subaracnóidea/epidemiologia , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/diagnóstico , Aneurisma Intracraniano/epidemiologia , Incidência , Fatores de Risco , Aneurisma Roto/complicações , Aneurisma Roto/epidemiologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-36673873

RESUMO

Weight loss surgery is linked to health benefits and may reduce the cost to the public healthcare systems. The aim of this study was to assess the cost and cost-structure in the one-year periods before and after a bariatric surgery in the Polish nationwide registry. The study included 2390 obese adults which underwent surgical treatment for obesity in 2017. The cost structure and the total costs per patient for one year before bariatric surgery, preoperatively, and for one year after surgery were analyzed. The total cost of the postoperative period was about PLN 3 million lower than during the preoperative period. After bariatric surgery, a reduction of approximately 59% in costs associated with hospital treatment was observed. The costs of outpatient specialist services, hospital treatment, psychiatric care, and addiction treatment also significantly decreased. There was a negative correlation between the changes in the cost of treatment of patients undergoing obesity surgery and their age. The health care cost during the period of one year after bariatric surgery is lower than in the year preceding the surgery (a greater cost difference is observed in younger people). This is mainly influenced by the reduction in costs associated with hospital treatment.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Adulto , Humanos , Obesidade Mórbida/cirurgia , Polônia , Obesidade/cirurgia , Custos de Cuidados de Saúde
6.
Artigo em Inglês | MEDLINE | ID: mdl-36231265

RESUMO

(1) Background: Administrative data allows for time- and cost-efficient acquisition of large volumes of individual patient data invaluable for evaluation of the prevalence of diseases and clinical outcomes. The aim of the study was to evaluate the accuracy of data collected from the Polish National Health Fund (NHF), from a researcher's perspective, in regard to a cohort of atrial fibrillation patients. (2) Methods: NHF data regarding atrial fibrillation and common cardiovascular comorbidities was compared with the data collected manually from the individual patients' health records (IHR) collected in the retrospective CRAFT registry (NCT02987062). (3) Results: Data from the NHF underestimated the proportion of patients with AF (NHF = 83% vs. IHR = 100%) while overestimating the proportion of patients with other cardiovascular comorbidities in the cohort. Significantly higher CHA2DS2VASc (Median, [Q1-Q3]) (NHF: 1, [0-2]; vs. IHR: 1, [0-1]; p < 0.001) and HAS-BLED (Median, [Q1-Q3]) (NHF: 4, [2-6] vs. IHR: 3, [2-5]; p < 0.001) scores were calculated according to NHF in comparison to IHR data, respectively. (4) Conclusions: Clinical researchers should be aware that significant differences between IHR and billing data in cardiovascular research can be observed which should be acknowledged while drawing conclusions from administrative data-based cohorts. Natural Language Processing of IHR could further increase administrative data quality in the future.


Assuntos
Fibrilação Atrial , Administração Financeira , Fibrilação Atrial/epidemiologia , Humanos , Polônia/epidemiologia , Sistema de Registros , Estudos Retrospectivos
7.
Arch Med Sci ; 18(4): 1021-1030, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35832692

RESUMO

Introduction: The aim of our study was to assess the potential value of the Comirnaty vaccine (BNT162b2) in Poland. A model was used to estimate patient events, direct medical costs, utilities, and cost-effectiveness for 1 year with and without implementation of the vaccine. Material and methods: The Markov model with 1-week cycles was used to estimate patient events, direct medical costs, utilities, and cost-effectiveness for 1 year with and without implementing the Comirnaty vaccine in Poland. The incremental cost per quality-adjusted life-year (QALY) gained vs. no vaccine was calculated for the general population and selected age-groups. All costs are reported in PLN (average exchange rate in 2020: 1 EUR = 4.44 PLN). Results: In the base case analysis the incremental cost per QALY gained associated with vaccinating the whole population is 6249 PLN. For individuals aged 60-69 years and > 80 years vaccination is less costly and more effective than no vaccination. The incremental cost per QALY gained when vaccinating individuals aged 40-49 and 30-39 years is 28,135 PLN and 67,823 PLN, respectively. In the general population and in younger subpopulations the incremental cost-effectiveness ratio is most sensitive to the vaccine effectiveness, vaccine price, and SARS-CoV-2 infection rates. Conclusions: When prioritization is required due to supply constraints, vaccination of the elderly is justified because it gives the highest number of QALY gained and generates savings for the health care system. Continual updates of the model concerning vaccine real-life effectiveness and epidemic course are required to refine the prioritisation scheme in the future.

8.
Artigo em Inglês | MEDLINE | ID: mdl-35162248

RESUMO

Technological development around the world has led to the digitalisation of the health system. Along with the digitalisation of the health sector, financial, legal, awareness-related, technological and IT barriers appeared. The aim of the article is to present recommendations for the development of telemedicine services in Poland on the basis of a list of implementation barriers and ways of resolving them in the USA and selected European countries. A literature review was conducted in accordance with the PRISMA-ScR, using the PubMed and Google Scholar databases, Scopus and the OECD iLibrary. A total of 59 literature positions were used, which constituted the references. The article presented the implemented and effective solutions in selected countries. Based on these solutions, recommendations for the development of telemedicine in Poland were presented, as well as successes in the form of telemedicine startups, which can inspire other countries. The analysis of the publications discussed in the article shows that the implementation of telemedicine services should begin with the elimination of barriers limiting the development of telemedicine systems. An important issue in their elimination is to analyse their interconnections and implement such solutions which would have a multi-area coverage.


Assuntos
Telemedicina , Europa (Continente) , Polônia
9.
Value Health Reg Issues ; 25: 104-107, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33865219

RESUMO

OBJECTIVES: To provide real-world data on the impact of autologous hematopoietic stem cell transplantation (AHSCT) on treatment costs of patients with multiple sclerosis (MS) in Poland. METHODS: Medical data of 105 patients who underwent AHSCT in the years 2011 to 2016 were obtained from the National Health Fund (NHF) database. Treatment costs were calculated from the public payer's perspective per patient-year for the total available period as well as 12 months before and after AHSCT. The statistical analysis was performed using MATLAB 2016b. RESULTS: Mean treatment-related costs covered by the NHF per patient-year before and after the transplantation were €4314.9 and €1188.8 , respectively. The average cost of disease-modifying drugs per patient was reduced from €2497.9/year before to €65.3/year after AHSCT. CONCLUSIONS: Although the initial cost of AHSCT is high, the costs involving AHSCT and post-AHSCT treatment could, according to our analysis, pay off in 3.9 years, when compared to the costs of disease-modifying drug therapy in aggressive MS. The study provides evidence that the AHSCT can lead to significant savings in treatment costs of aggressive MS from the public payer's perspective.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Esclerose Múltipla , Custos de Cuidados de Saúde , Humanos , Esclerose Múltipla/terapia , Transplante Autólogo , Resultado do Tratamento
10.
Pol Arch Intern Med ; 131(2): 128-135, 2021 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-33491939

RESUMO

INTRODUCTION: Colorectal cancer (CRC) is a serious health problem, and various screening programs to reduce CRC have been introduced worldwide. However, the cost­effectiveness of a program based on once­in­a­lifetime colonoscopy in Poland is unknown. OBJECTIVES: The main aim of this study was to assess the cost­effectiveness of Polish Colonoscopy Screening Platform (PCSP), the colonoscopy screening program in Poland. PATIENTS AND METHODS: A Markov model was constructed to compare the strategy of colonoscopy screening as compared with no screening in 100 000 subjects. The model was based on data collected from the nationwide Polish CRC screening program whenever possible. The incremental cost­effectiveness ratio (ICER) was calculated and compared with the willingness­to­pay thresholds. A sensitivity analysis was also performed using the Monte Carlo simulation. RESULTS: Colonoscopy screening within PCSP resulted in a 18.9% reduction in CRC incidence and 19.8% reduction in CRC mortality. The strategy allowed a gain of 2317 life­years saved (1959 after discount­ ing). The cost of colonoscopy screening per participant examined was estimated at 267.70 USD (95% CI, 263.08-272.32 USD). The ICER was less than 6500 USD, which was much lower than the accepted willingness­to­pay thresholds, indicating that the screening was cost­effective. CONCLUSIONS: Colonoscopy screening within the PCSP is cost­effective and may have a substantial impact on the Polish society due to life­years saved. The results have good informative value not only for health policy makers and medical practitioners, but also for health technology assessment.


Assuntos
Colonoscopia , Programas de Rastreamento , Análise Custo-Benefício , Detecção Precoce de Câncer , Humanos , Polônia
11.
Breast J ; 25(3): 474-478, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30982222

RESUMO

Breast cancer accounts for 22%-25% of all female cancers diagnosed worldwide. The aim of study was to compare the 5-year relative survival rates for breast cancer patients treated in the years 2008-2010, 2000-2002, and 2005-2007, and to determine their relationships with the methods and costs of treatment. Data were collected from the National Cancer Registry and the Narodowy Fundusz Zdrowia (National Health Fund) data bases. An increase in the 5-year survival rate was observed. The results show the impact of some factors on the survival and treatment costs. It is necessary to create data bases being a platform for further comprehensive analyses.


Assuntos
Neoplasias da Mama/mortalidade , Neoplasias da Mama/terapia , Adulto , Antineoplásicos/uso terapêutico , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/economia , Feminino , Custos de Cuidados de Saúde , Humanos , Mamografia/estatística & dados numéricos , Mastectomia/estatística & dados numéricos , Pessoa de Meia-Idade , Oncologistas/estatística & dados numéricos , Polônia/epidemiologia , Sistema de Registros , Taxa de Sobrevida , Resultado do Tratamento , Carga de Trabalho/estatística & dados numéricos
12.
Postepy Dermatol Alergol ; 36(6): 727-733, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31998002

RESUMO

INTRODUCTION: Epidemiological data indicate significant differences in atopic dermatitis (AD) prevalence between countries. AIM: The purpose of this study is to (i) analyse the recorded prevalence of atopic dermatitis (diagnoses of AD reported to the Polish National Health Fund (NHF)) and to (ii) estimate direct costs of medical care for AD incurred by the NHF. MATERIAL AND METHODS: The analysis was based on data reported to the database of the public payer (NHF). The prevalence rates were calculated using the NHF data and population estimates were obtained from the Central Statistical Office of Poland (GUS). RESULTS: In 2017, the annual prevalence rate of AD in the Polish population was 32.5 per 10,000 inhabitants (34.7/10,000 for women and 30.1/10,000 for men). The highest prevalence was observed in the youngest age groups (300/10,000 in children up to 4 years of age and 141/10,000 in 5-9-year-olds). The prevalence rate decreased with age and AD was the least prevalent in patients over 85 years of age (4/10,000). In 2008-2017, NHF expenditure on AD treatment varied between PLN 19.9 million (EUR 5.6 million) in 2008 and PLN 28.4 million (EUR 6.5 million) in 2016. CONCLUSIONS: The prevalence rates of AD in Poland estimated on the basis of NHF data are significantly lower than those reported in previous epidemiological studies conducted in Poland and worldwide. This may indicate that the prevalence of AD in the Polish population is underestimated or that there are no adequate disease control measures in patients with a confirmed diagnosis.

13.
Med Sci Monit ; 26: e921138, 2019 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-31892692

RESUMO

BACKGROUND This retrospective study aimed to analyze all-cause mortality in patients with heart failure with and without diabetes mellitus in 2012 in Poland using data from the National Health Fund [Narodowy Fundusz Zdrowia] (NFZ), the Central Register of the Insured [Centralna Baza Ubezpieczonych] (CBU), and the Polish Universal Electronic System for Registration of the Population (PESEL). MATERIAL AND METHODS Between 1st January 2012 and 31st December 2012, data were analyzed from the NFZ, CBU, and PESEL to include all patients with a primary diagnosis of heart failure, with and without diabetes mellitus and all-cause mortality data. Structured Query Language (SQL) was used to retrieve and manage data from NFZ, CBU, and PESEL. RESULTS In Poland, 32.58% of 201,586 patients with a primary diagnosis of heart failure who died in 2012 also had a diagnosis of diabetes mellitus. The overall mortality rate in men with heart failure and diabetes was eight times higher than for men with heart failure without diabetes. The overall mortality rate in women with diabetes and heart failure was 5.5 times higher compared with women with heart failure without diabetes. More than 90% of deaths in female patients with heart failure, with or without diabetes, occurred in women >60 years. For male patients with heart failure with or without diabetes, 70% of deaths occurred in men >60 years. CONCLUSIONS These findings support the need for continued prevention programs, early diagnosis, and treatment of diabetes, and highlight the increase in mortality for patients with heart failure and diabetes.


Assuntos
Complicações do Diabetes/mortalidade , Insuficiência Cardíaca/mortalidade , Adulto , Idoso , Diabetes Mellitus/mortalidade , Feminino , Humanos , Seguro Saúde/tendências , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Sistema de Registros , Estudos Retrospectivos
14.
Ann Agric Environ Med ; 25(3): 568-571, 2018 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-30260172

RESUMO

INTRODUCTION: Several studies have suggested, that diabetes is very important factor of the risk of the chronic a renal disease. The paper aims to present a retrospective analysis of incidence of end-stage renal disease in subgroups of patients with and without diabetes in Poland. MATERIAL AND METHODS: For assessing this problem an electronic search was performed using Polish National Health Fund data base from 01.01.2011 until 31.12.2013 in general population and from 01.01.2012 until 31.12.2012 in 2 populations: with diabetes and without diabetes mellitus. RESULTS: The 43.70 % patients with end-stage renal disease was diabetic. The incidence rate in 2012 was: 292.48 ± 90.97 diabetic men / 100,000 diabetic population; 203.10 ± 90.97 diabetic women / 100,000 diabetic population; 23.44 ± 6.34 non-diabetic men / 100,000 non-diabetic population; 17.88 ± 6.33 non-diabetic women / 100,000 non-diabetic population. CONCLUSIONS: The incidence rate of end-stage renal failure in diabetics was multiple times higher than the incidence rate in non-diabetics. The incidence rate of new ESRD cases in Poland estimated to be 36.17 per 100,000 of general populations in 2011, 35.28% in 2012 and 30.46 per 100,000 of general populations in 2013. In 2012, the incidence rate of new ESRD cases in male diabetics was 292.48 ± 90.97 per 100,000 of diabetes men population, and in women diabetics 203.10 ± 66.06 per 100,000 of diabetes women population. In the same 2012 year, the incidence of new ESRD cases in men non-diabetics was 3.44 ± 6.34 per 100,000 of non-diabetes, and in women non-diabetes 17.58 ± 6.33 per 100,000 of non-diabetes women population.


Assuntos
Diabetes Mellitus/epidemiologia , Falência Renal Crônica/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Diabetes Mellitus/etiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Estudos Retrospectivos
15.
Int J Public Health ; 63(7): 777-786, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29508013

RESUMO

OBJECTIVES: To assess the link between the risks of most frequent cancer sites in Poland and selected socioeconomic variables that potentially affect health outcomes throughout the life course. METHODS: This is a cross-sectional ecological study. Incidence of lung, breast, and colon cancer by voivodeships in 2014 was calculated based on Polish National Cancer Registry. Socioeconomic variables in individual voivodeships were assessed based on Polish Social Cohesion Survey for 2015. Spearman's rank correlation coefficient was used to test the association of incidence rates and socioeconomic variables. The significance level was set at p < 0.05 (two-tailed tests). RESULTS: Statistically significant negative correlation exists between: (1) friend-/neighbour-based social capital and colon and breast cancer, (2) association-based social capital and lung cancer, (3) high religiousness and lung and breast cancer, and (4) income poverty and breast cancer. Statistically significant positive correlation exists between: (1) social isolation, living conditions poverty, poverty resulting from the lack of budget balance, and lung cancer; (2) low/no involvement in religious activity and lung and breast cancer. CONCLUSIONS: Our findings support public health concerns over the implication of socioeconomic environment for cancer.


Assuntos
Disparidades nos Níveis de Saúde , Neoplasias/epidemiologia , Neoplasias da Mama/epidemiologia , Neoplasias do Colo/epidemiologia , Estudos Transversais , Feminino , Humanos , Incidência , Neoplasias Pulmonares/epidemiologia , Masculino , Polônia/epidemiologia , Sistema de Registros , Risco , Fatores Socioeconômicos , Inquéritos e Questionários
16.
Melanoma Res ; 28(1): 52-55, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29120964

RESUMO

Vemurafenib, ipilimumab and dabrafenib were registered for the treatment of advanced skin melanoma pursuant to the results of randomized phase III clinical trials. Real-world data on survival time for patients treated with those drugs in daily clinical practice are so far limited. Patients with advanced skin melanoma treated under reimbursement programmes (drug programmes), for which they were qualified pursuant to uniform inclusion criteria in force in all oncology centres in Poland. Data were obtained from the electronic databases of the national payer (NFZ) responsible for the implementation and monitoring of reimbursement (drug) programmes. The analysis included all patients included for treatment with vemurafenib (since March of 2013), ipilimumab (since March of 2014) and dabrafenib (since July of 2015) until December 2016. The end date of the observation was set to 31 December 2016. The total survival analysis was performed using the Kaplan-Meier estimator. Until 31 December 2016, 759 patients were treated with vemurafenib, 370 with ipilimumab and 181 with dabrafenib. The overall survival (OS) median was 9.8 months for patients treated with vemurafenib (95% confidence interval: 8.8-10.6) and 6.9 months for patients treated with ipilimumab (95% confidence interval: 5.7-9.2). For patients treated with dabrafenib, the OS median was not reached because of an overly short observation period. The probability of surviving 12 months in the group of patients treated with vemurafenib was 40.5%, ipilimumab was 35.1% and dabrafenib was 60.7%. The probability of surviving 24 and 36 months in the group of patients treated with vemurafenib or ipilimumab amounted to, respectively, 20.1, 15.4 and 21, 18.8%. OS of patients with advanced melanoma treated in daily clinical practice may be comparable to the ones achieved in registration trials. The use of appropriate treatment inclusion criteria may affect the obtained OS.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Melanoma/mortalidade , Padrões de Prática Médica/normas , Mecanismo de Reembolso , Neoplasias Cutâneas/mortalidade , Protocolos de Quimioterapia Combinada Antineoplásica/economia , Seguimentos , Humanos , Imidazóis/administração & dosagem , Indóis/administração & dosagem , Ipilimumab/administração & dosagem , Melanoma/tratamento farmacológico , Melanoma/economia , Melanoma/patologia , Oximas/administração & dosagem , Polônia , Prognóstico , Estudos Retrospectivos , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/economia , Neoplasias Cutâneas/patologia , Sulfonamidas/administração & dosagem , Taxa de Sobrevida , Vemurafenib , Melanoma Maligno Cutâneo
17.
Ginekol Pol ; 88(6): 296-301, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28727127

RESUMO

OBJECTIVES: In 2013 malignant endometrial cancers have amounted to 7.3% of all cancers diagnosed among women in the report by the Polish National Cancer Registry Raw prevalence rate amounted to 28.7, whereas standardised prevalence rate 15.6 per 100 000 population. Among the causes of death, these cancers amounted to 3% and were ranked ninth on the list of the most common causes of oncologic mortality of women. In the year 2013 a total of 1243 women died of malignant endometrial cancers. A stable increase of malignant endometrial cancer incidence has been observed for 2 decades. Despite that fact, the increase of the mortality incidence is at a much lower level, which demonstrates the much higher effectiveness of the treatment of such cancers. The recording rate of the malignant endometrial cancer mortality amounts to 95%, so the presented absolute numbers are reliable. Examining the clinical stages of malignant endometrial cancers, we can establish that approx. 85% of them are diagnosed at stage I or II according to the FIGO classification. Patients with advanced stages of cancer represent less than 15%. MATERIAL AND METHODS: retrospective analysis of endometrial body cancer prevalence data for the entire population of Poland, assessment of malignant endometrial cancer prevalence in the years 2008-2015 and overall survival probability in the population of patients undergoing adjuvant chemotherapy. RESULTS: The number of patients with a diagnosed malignant endometrial cancer within the studied period in Poland remains on a stable level (2008 - 30.6 thousand patients, 2015 - 40.2 thousand patients). Among all listed patients with the indica-tion of C54 each year approx. 20% enters hospital treatment. System therapy with chemotherapy drugs was used in approx. 1-2% of patients treated in hospitals. The average age of the patients was 64.9 years, and the median age 65 years. The num-ber of observations was 2085, including 1088 censored observations. The average survival for the sample under study was 30.67 month (SD = ± 0.6); median survival time was 23.93 month. The number of censored observations was 1088 (52.16%). Probable survival of 1 year is achieved by 67.57% of patients, 2 years by 49.73%, 3 years by 40.68%, above 5 years 30.77%. CONCLUSIONS: The incidence of endometrial cancer in Poland in the years 2008-2015 continues to grow at 5% upward trend (in Europe 3.4-5.9). In Poland in 2012, crude incidence rate for cancer of the uterus was 29.8 and did not differ significantly from the results in countries such as Finland, Slovakia, Sweden, Belgium and Bulgaria. The overall survival after adjuvant chemotherapy for patients with malignant endometrial cancer in Poland shows considerable differences depending on the region of the country.


Assuntos
Quimioterapia Adjuvante/mortalidade , Neoplasias do Endométrio/tratamento farmacológico , Neoplasias do Endométrio/mortalidade , Estudos Transversais , Feminino , Humanos , Estimativa de Kaplan-Meier , Polônia , Estudos Retrospectivos
18.
PLoS One ; 12(6): e0178764, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28582404

RESUMO

AIM: to investigate the drug-class-specific changes in the volume and cost of antidiabetic medications in Poland in 2012-2015. METHODS: This retrospective analysis was conducted based on the National Health Fund database covering an entire Polish population. The volume of antidiabetic medications is reported according to ATC/DDD methodology, costs-in current international dollars, based on purchasing power parity. RESULTS: During a 4-year observational period the number of patients, consumption of antidiabetic drugs and costs increased by 17%, 21% and 20%, respectively. Biguanides are the basic diabetes medication with a 39% market share. The insulin market is still dominated by human insulins, new antidiabetics (incretins, thiazolidinediones) are practically absent. Insulins had the largest share in diabetes medications expenditures (67% in 2015). The increase in antidiabetic medications costs over the analysed period of time was mainly caused by the increased use of insulin analogues. CONCLUSIONS: The observed tendencies correspond to the evidence-based HTA recommendations. The reimbursement status, the ratio of cost to clinical outcomes and data on the long-term safety have a deciding impact on how a drug is used.


Assuntos
Diabetes Mellitus Tipo 2/economia , Gastos em Saúde/estatística & dados numéricos , Hipoglicemiantes/economia , Seguro Saúde/economia , Biguanidas/economia , Biguanidas/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Hipoglicemiantes/uso terapêutico , Incretinas/economia , Incretinas/uso terapêutico , Insulina/economia , Insulina/uso terapêutico , Polônia , Mecanismo de Reembolso/estatística & dados numéricos , Estudos Retrospectivos , Tiazolidinedionas/economia , Tiazolidinedionas/uso terapêutico
20.
Postepy Dermatol Alergol ; 34(6): 573-579, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29422823

RESUMO

INTRODUCTION: Epidemiological data on anaphylaxis have been underestimated both in Poland and worldwide. AIM: To evaluate the prevalence of anaphylaxis in Poland, including a classification by gender, age and residential region. MATERIAL AND METHODS: The data used in the analysis were derived from two sources, the National Health Fund records of healthcare services for 2008-2015 (official statistics) and a questionnaire-based survey conducted in 2015 on a sample of 305 allergists practicing in different regions of Poland. RESULTS: In 2015, 3144 people received treatment for anaphylactic shock (T78.0, T78.2, T80.5, T88.6) with an estimated prevalence rate of anaphylaxis of 8.2 per 100,000 (8.4 for females and 7.9 for males). The highest prevalence rate was found for women aged 50-54 years (14.5 per 100,000). There was a very large difference in the prevalence of anaphylaxis between rural and urban areas (13.1 vs. 0.8 per 100,000). In 2015, the Polish NHF spent PLN 3.5 million (EUR 835,000) on the management of anaphylaxis. Of the allergists surveyed, 73% had been currently managing patients who had experienced anaphylactic shock. The most common causes of anaphylaxis included insect venom (41.4%), food (29.8%) and drugs (17.4%). CONCLUSIONS: A central anaphylaxis registry should be established in Poland. This is the only approach that would allow collecting a wide range of reliable information on the cases, management and consequences of anaphylaxis. Ongoing management of patients who have experienced anaphylactic shock should be improved.

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