Impact of Infrastructure on Mortality in Marginalised and Segregated Communities in the Slovak Republic.

AIM: Poverty and social exclusion is measured through different criteria and one of them is the health sector. The relationship between Roma population and the health sector is on the edge of researchers' interest in the Slovak Republic. The purpose of this paper is a quantification of the regional disparities in the development of mortality which is causally linked with selected infrastructural determinants - namely access to water and sewerage. These determinants differently participate in the structure of mortality in marginalised and segregated communities and they deepen regional disparities in health. METHODS: It is a spatial analysis of the districts of the Slovak Republic. The data from the Atlas of Roma communities in Slovakia 2013 is applied. Through the multiple linear regression model the relationship between mortality of the Roma population and water and sewerage availability in the Roma settlements is examined. Similarity between the districts is measured by the Euclidean metric system. RESULTS: The most appropriate district for representing the Slovak Republic average is the Dunajská Streda district in a field of arithmetic mean and the Velký Krtís district in a field of median value. The outermost district is represented by the Kosice-okolie district, conversely, the Trnava district is the closest to the rest of the Slovak Republic. The highest statistically significant impacts on mortality are explored in public water supply extension plan and public sewerage supply extension plan. It seems that water play a greater role in determining health of Roma population. The highest number of inhabitants with supplied public water and public sewerage is kept by the Kezmarok district, the Kosice district, and the Spisská Nová Ves district. CONCLUSIONS: Our results can be beneficial for health decision making, since in the Strategic Framework for Health of the Slovak Republic metrics for measuring and evaluating health aspects in Roma communities absent and that prevents them to be correlated with the planned interventions.

Income Inequality in Non-communicable Diseases Mortality among the Regions of the Slovak Republic.

AIM: A great amount of non-communicable disease deaths poses a threat for all people and therefore represents the challenge for health policy makers, health providers and other health or social policy actors. The aim of this study is to analyse regional differences in non-communicable disease mortality in the Slovak Republic, and to quantify the relationship between mortality and economic indicators of the Slovak regions. METHODS: Standardised mortality rates adjusted for age, sex, region, and period were calculated applying direct standardisation methods with the European standard population covering the time span from 2005 to 2013. The impact of income indicators on standardised mortality rates was calculated using the panel regression models. RESULTS: The Bratislava region reaches the lowest values of standardised mortality rate for non-communicable diseases for both sexes. On the other side, the Nitra region has the highest standardised mortality rate for non-communicable diseases. Income quintile ratio has the highest effect on mortality, however, the expected positive impact is not confirmed. Gini coefficient at the 0.001 significance level and social benefits at the 0.01 significance level look like the most influencing variables on the standardised mortality rate. By addition of one percentage point of Gini coefficient, mortality rate increases by 148.19 units. When a share of population receiving social benefits increases by one percentage point, the standardised mortality rate will increase by 22.36 units. CONCLUSIONS: Non-communicable disease mortality together with income inequalities among the regions of the Slovak Republic highlight the importance of economic impact on population health.

Exploration of Influence of Socioeconomic Determinants on Mortality in the European Union.

Economic performance measured through the gross domestic product indicator and the poverty rate varies across the whole European Union, together with the considerable income inequalities in the long-term. Economic growth may not bring a reduction in the health inequalities in the individual countries themselves. In order to eliminate health inequalities, the different types of policies implemented in the health, social and economic systems need to be explored in more detail. Mortality is explored through an indicator of the standardised mortality rate for both sexes explained by the several socioeconomic determinants, among which variables such as the variations of the gross domestic product per capita, the healthcare expenditures, the unemployment rate, and the healthcare system financing. Almost in all the described cases, these dimensions have negative impact. All the influences are expressed in a relative way in order to be suitably interpretable. The analysis is not comprehensive; nevertheless, it contains 18 regression models to cover as many aspects as it is possible. The Discussion section offers an evaluation of the obtained results according to the outcome of the other studies.

Quantification of Similarity Relationships According to Parameters of Day Surgery System.

Performing day surgery should minimise a number of hospitalisation cases, but its use is determined by many factors. It takes advantage of the latest advances in surgical care, enabling better use of highly costly specialised operating room equipment. This analysis of the day surgery system of the Slovak Republic stands on an examination of the five specialised fields-surgery, gynaecology, ophthalmology, otorhinolaryngology, and urology. The explored period covers the years 2009 to 2017. The whole analysis is divided into the two sections-the youth category and for the adult category. For each case, a hospitalisation ratio is computed. A map visualisation supports the analysis outcome. A quantification of the similarity relationships between the regions is done according to a Euclidean distance approach and it is illustrated through the heat map. The centremost region is the Zilina Region with distance at a level of 1.9821, meaning that it performs as the most similar region to a development of a hospitalisation ratio in the whole Slovak Republic regarding all the examined aspects. The findings introduce an important platform for a creation of regional and national health plans in the area of healthcare provision for the population of the country.

Investigation of Relationship Between Spatial Distribution of Medical Equipment and Preventable Mortality.

The aim of the study is to investigate the relationship between the spatial distribution of the selected medical equipment and the preventable mortality rate in the regions of the Slovak Republic. The main analytical approach is carried out through the cluster analysis based on a Euclidean distance technique in order to get similarity of the administrative divisions in form of a district and a pseudot2 approach aimed at the determination of a number of the districts in a cluster. A number of medical equipment had a rising tendency from the year 2008. The most extreme position according to a localisation distribution of the computed tomographs and the magnetic resonance imaging scanners is held by the Kosice IV District at the level of 7.50630. From an angle of view of the preventable mortality, the Piestany District holds the most extreme position peaking at the level of 10.97969 for the female sex and the Kezmarok District with the value of 9.44088. The study has the significant dissemination outputs for health policy interventions, especially to draw up regional health plans for computed tomography and magnetic resonance imaging deployment, mainly in locations with a high preventable mortality rate for both sexes.

Development of Regional Disparities in Alzheimer's Disease Mortality in the Slovak Republic from 1996 to 2015.

Alzheimer's disease-subsequently as AD in the text-represents a chronic neurodegenerative disease discussed very often in the recent period. It involves the G30 diagnosis expressing exactly AD and also the F00 diagnosis epitomising dementia in AD. The Slovak Republic has a very various population in terms of the disparities of the population localisation. The analysis is executed on the basement of the standardised mortality rate. It is calculated for the individual districts of the Slovak Republic to get a detailed spatial view and for each year of the explored period from 1996 to 2015 to get a time development. It has a considerably rising tendency. Therefore, the regional disparities of the standardised mortality rate of AD are analysed from an angle of view of its similarity, by its measurement in a form of a Euclidean distance approach. The results of the analysis offer the heat maps as the distance matrices in a graphic form and the maps of the individual districts too. These outputs reveal a very heterogeneous structure of the standardised mortality rate. Another graphic outcome demonstrates a distribution of its values among the districts throughout the whole Slovak Republic for the whole observed period. The results offer a comparison among the districts of the Slovak Republic too. The highest values and also the lowest values are reached in the different districts for the both sexes. Even, one district reaches the opposite result for the individual sexes. The age structure of the deceased population on the G30 diagnosis is also executed and the extreme values from an angle of a view of the districts are picked up. There are evident high differentiations between the individual districts of the Slovak Republic. The conclusion section involves the several key points and the potential suggestions for further research.

Standardised mortality rate for cerebrovascular diseases in the Slovak Republic from 1996 to 2013 in the context of income inequalities and its international comparison.

Non-communicable diseases represent one of the greatest challenges for health policymakers. The main objective of this study is to analyse the development of standardised mortality rates for cerebrovascular disease, which is one of the most common causes of deaths, in relation to income inequality in individual regions of the Slovak Republic. Direct standardisation was applied using data from the Slovak mortality database, covering the time period from 1996 to 2013. The standardised mortality rate declined by 4.23% in the Slovak Republic. However, since 1996, the rate has been higher by almost 33% in men than in women. Standardised mortality rates were lower in the northern part of the Slovak Republic than in the southern part. The regression models demonstrated an impact of the observed income-related dimensions on these rates. The income quintile ratio and Gini coefficient appeared to be the most influencing variables. The results of the analysis highlight valuable baseline information for creating new support programmes aimed at eliminating health inequalities in relation to health and social policy.

Regional disparities in medical equipment distribution in the Slovak Republic - a platform for a health policy regulatory mechanism.

BACKGROUND: This study aims to examine the localisation of selected parameters in the deployment and use of medical equipment in the Slovak Republic and to verify potential regional disparities. The study evaluates the benefits of an analytical platform for regulatory mechanisms in the healthcare system. METHODS: The correspondence analysis is applied to the entire data set containing information regarding medical equipment distribution and mortality. RESULTS: The results highlight regional differences in the use of medical equipment throughout the analysed period from 2008 to 2014. The total amount of medical equipment increased slightly to 9192 devices during the time span. In 2014, there was a significant decrease of 16.44%. Disparities are found in the frequencies and structure of medical equipment. In some regions, medical equipment is not present or is present in low numbers. CONCLUSIONS: The results regarding regional disparities demonstrate the regional development of the amount of medical equipment. The deployment of medical equipment is not proportional, and not all of the analysed devices are available in each region. The tests also indicate the appropriateness of the amount of medical equipment and create a platform for further investigation. The results of the analysis suggest the unsuitable distribution of medical equipment throughout the Slovak regions, where there are significant regional disparities. These findings can serve as a monitoring platform to evaluate the accessibility and efficiency of medical equipment usage. TRIAL REGISTRATION: No human participants were involved in the research.