Influence of Demographic Factors on Standardised Rate Ratio of Age-adjusted Mortality Rates of Men in Comparison with Women Caused by Neoplasms and Circulatory System Diseases in Slovak Regions during 1996-2013.

AIM: The aim of our study was to find statistical associations including trends of standardised rate ratio of age-adjusted mortality rates for the male population as compared to the female population, in relation to available demographic factors (Chapter II - Neoplasms vs. Chapter IX - Diseases of the circulatory system, Slovak region and calendar year of death). METHODS: Dataset of individual cases of death in Slovakia with some demographic factors during 1996-2013 were provided by Slovak National Health Information Center. We used regression and correlation analyses, as well as analyses of variance and covariance along with descriptive statistics. RESULTS: The standardised rate ratio of age adjusted mortality rates of men versus age-adjusted mortality rates of women differs between Chapter II and Chapter IX (mean 2.08 vs. 1.35, p<0.001). There are also significant differences of standardised rate ratio among regions (p<0.05). Trends show that the standardised rate ratio has significant regional decline for Chapter II: Kosice (p<0.01), Trencín (p<0.001) and Zilina (p<0.05) whereas in Chapter IX Zilina region (p<0.01) is implicated. In other Slovak regions standardised rate ratio stagnates. CONCLUSIONS: Standardised rate ratios of age-adjusted mortality rates for the male population compared to the female population are significantly dependent on chapter, sex and region. Standardised rate ratios either decline or stagnate.

Similarity of Slovak Regions in Neoplastic Mortality in the Context of Risk Factors and Access to Health Care.

AIM: Access to primary health care is highly connected to the prevention of cancer mortality, since the risk factors threatening health can be early identified. The aim of this paper is, firstly, to explore similarity within and between the regions of the Slovak Republic and cancer mortality patterns, and secondly, to reveal if similar regions are characterised by the similar access to health care or risk factors occurrence. METHODS: Data on deaths by sex, type of cancer death and region from 1996 to 2014 is provided by the National Health Information Centre of Slovakia. The relationships between 8 regions and 16 cancer types are described by correspondence analysis for both sexes. RESULTS: The most similar cancer mortality patterns among Slovak regions are between the Nitra and Trnava regions for both sexes, and the Kosice region for males. The Presov region is showed as an outlier from other regions for females, likely due to the highest concentration of Roma marginalised communities. As for access to health care, the Trnava region as well as Nitra region report the lowest densities of physicians, 2.4 and 2.6 per 1,000 inhabitants, respectively. The most serious cancer types mortality is attributed to the digestive organs (C15-C26) in each Slovak region for both sexes with the average proportion of 35.56%. Observed high association between the Nitra region and respiratory cancer (C30-C39) in males may be confirmed by the increased incidence of radon in this region. Similarly, a tight relationship between the Bratislava region and cancer of male genital organs (C60-C63) can relate to the highest proportion of drug users in the Bratislava region. CONCLUSIONS: Based on the findings of similar regions in cancer mortality patterns, we recommend to set the same prevention programs in the Trnava and Nitra regions, on the other hand, different preventive interventions should be introduced in the Presov region.

Age-adjusted Mortality Rates of Neoplasms and Circulatory System Diseases and Their Demographic Factors in Slovak Regions during 1996-2013.

AIM: Knowledge of the causes of deaths in Slovakia is lacking. This is significant because diet and lifestyle factors are different in central Europe compared to Western, Northern and Southern Europe. This study aims to discern trends of age-adjusted mortality rates caused by various diseases in relation to demographic factors. The aim of our study was to find certain statistical aspects including trends of age-adjusted mortality rates caused by neoplastic (Chapter II) and circulatory diseases (Chapter IX) in the Slovak population in relation to available demographic factors (sex, region and calendar year of death). METHODS: Dataset of individual deaths in Slovakia with certain demographic factors (sex, region and calendar year of death) during 1996-2013 were provided by the Slovak National Center of Health Informatics. Regression and correlation analyses and analyses of variance and of covariance were used to yield the level of significance. RESULTS: We found significant differences of age-adjusted mortality rates between men and women, between Chapter II and Chapter IX and among Slovak regions. Age-adjusted mortality rates decline significantly in most regions for both sexes with the exception of stagnation in four regions in a group of Chapter II women (Kosice, Nitra, Trencín and Zilina) and one region in Chapter IX, also in group of women (Zilina). CONCLUSIONS: Mortalities caused either by Chapter II or Chapter IX diseases are significantly dependent on chapter, sex and region with mortalities either declining or stagnating.

Influence of Demographic Determinants on the Number of Deaths Caused by Circulatory System Diseases in Comparison to the Number of Deaths Caused by Neoplasms in Slovak Regions from 1996-2014.

OBJECTIVES: The objective of our study was to evaluate the influence of available demographic determinants on the number of deaths caused by circulatory system diseases as compared to deaths caused by neoplasms in Slovakia in 1996-2014. METHODS: Mortality data were kindly provided by the National Health Information Centre in Slovakia. The first method was trend curve fitting of death ratios caused by circulatory system diseases (Chapter IX) and of deaths caused by neoplasms (Chapter II) as a function of age for both sexes. The second method comprised a decision tree for classification between deaths caused by Chapter IX and Chapter II diseases. Input variables were available demographic indicators: age, sex, marital status, region, and calendar year of death. Statistical data analyses were performed by IBM SPSS version 19 statistical software. RESULTS: We found that the odds ratios of deaths caused by circulatory system diseases (Chapter IX) in comparison with deaths caused by neoplasms (Chapter II) were non-decreasing. At first, the values of odds ratios are constant until they reach a critical sex-dependent value with a subsequent steady increase. In the case of men the odds ratio was greater than in the 60 years age-group where the odds ratio value increased slowly (from 1.14 at age 60 to 7.25 at age 90 years). The relative increase was 6.36 (7.25/1.14). The odds ratio in the women group was smaller but increased more rapidly (from 0.81 at age 60 to 12.27 at age 90 years). The relative increase was 15.15 in women (12.27/0.81). Hence, the odds ratio of death caused by Chapter IX diseases vs. Chapter II was greater in the older women group (i.e. higher age values). Utilizing the decision tree model, we have found that the most significant demographic determinant of death counts in both ICD Chapters was the age of the deceased, followed by marital status and finally gender. The last two predictors (year and region) were relatively negligible though formally significant. CONCLUSIONS: The proposed method could be useful for prognostic classification of patients and primarily beneficial for hospitals in human or financial resources planning.

In Search of Concerted Strategies for Competitive and Resilient Regions.

The European space-economy represents a complex system with a great internal heterogeneity, intensive socioeconomic interactions and differential growth trajectories among countries and regions. The present study aims to investigate the connectivity between spatial competitiveness and resilience in Europe and seeks to design an operational framework for concerted strategies of competitive and resilient regions. To assess the linkage between resilience and competitiveness, we have developed a new measure, viz. the Resilience and Competitiveness Index (RACI) as a function of two constituent sub-indices: Resilience and Competitiveness. This approach is tested on the basis of detailed data on European regions. The empirical results from 268 EU NUTS2 regions offer a solid anchor point for the proposed operational framework for concerted development strategies of competitive and resilient regions. Our research distinguishes and proposes several systematic types of concerted regional strategies according to the performance of a region measured by Resilience and Competiveness sub-indices. A key result of the study is the design of an operational constellation for strategic regional policy evaluation, with a major added value for policy- and decision-making purposes. The use of official data from Eurostat and of standard indicators in our research assures continuity and consistency with the official Regional Competitiveness Index (RCI) classification and measurement, so that policy makers are able to compare the performance of their regions over time and to develop proper concerted strategies accordingly. The clear evidence of a connectivity between regional competitiveness and resilience may help to develop a governance approach that balances competitiveness (mainly represented by productive assets) with resilience (mainly represented by sustainability and ecological awareness) and thus to deal with the complexity in socioeconomic systems.

Exploration of Disparities in Regions and Specialized Fields of Day Surgery System.

The main objective of this paper was to find similarities among eight Slovak regions from the viewpoint of five specialized day surgery fields and among specialized day surgery fields from the viewpoint of Slovak regions on the basis of day surgery operated and hospitalized patient counts. Day surgery data of paediatric patients and of adult patients from the National Health Information Centre during the years 2009-2017 were used. Correspondence analysis in two dimensions of the Slovak regions and of specialized day surgery fields was applied in order to achieve the paper's objective. The Kosice Region differs most from the overall national average in both groups of paediatric day surgery. This is caused by its largest proportions in the fields of Gynaecology (29.7%) and Urology (48.0%) (operated patients), and in the fields of Gynaecology (60.5%) and Surgery (21.6%) (hospitalized patients). The most different specialized day surgery fields from overall average are: Urology (operated paediatric patients), Gynaecology (hospitalized paediatric patients), Otorhinolaryngology (operated adult patients) and Ophthalmology (hospitalized adult patients). Urogenital system day surgery procedures (Gynaecology, Urology) are separated from other three fields (i.e., Surgery, Ophthalmology, Otorhinolaryngology) either in the first or in the second dimension of the singular value matrix decomposition.