SWOISTE CECHY CHOROBOWOŚCI POPULACYJNEJ OBWODU ZAKARPACKIEGO JAKO PRZYKŁADU GÓRZYSTEGO TERYTORIUM UKRAINY. ANALIZA WYSTĘPOWANIA CHORÓB W REGIONIE
Gennadiy О.Slabkiy, Svetlana V. Delehan-Коkaiko
Uzhhorod National University, Uzhhorod, Ukraine
ABSTRACT
Introduction: The state of population health is the most important index of the nation well-being and the criterion for planning the health care system development.
The aim: To determine the special features of population morbidity and the diseases prevalence in Transcarpathian region.
Маterials and methods: The following methods were applied in the course of the study: statistical, comparative and structural-and-logical analysis. The data of the branch statistical reporting were used.
Results: It is revealed that the general indices of population morbidity in Transcarpathian region and the prevalence of diseases is lower than the corresponding indices in Ukraine in the whole, however the morbidity indices have the tendency to growth, and the indices of the diseases prevalence show the tendency to reduction. Proved differences in the indices by the classes of diseases in Ukraine and Transcarpathian region are revealed.
Conclusions: The special features of population morbidity in Transcarpathian region and the diseases prevalence among the population were determined and they should be taken into account in the process of reforming the health care system in the region.
Wiad Lek 2018, 71, 2 cz. I, -355
Introduction
The state of population health is among the most important indices of the nation’s well-being that reflects it’s socio-economic, demographic, ecological and sanitary-hygienic situation and is one of the social indices of social progress, potential of economic growth and the State security and should occupy the leading position in the system of values of any civilized country [1, 2, 3].
Study of the trends in the incidence and prevalence of diseases among the population is one of the important components of strategic planning of the medical branch [4,5].
The aim
Aim:to study and analyze the special features of population morbidity in Transcarpathian region as mountainous territory and the prevalence of diseases in the region.
Materials and methods
The data of the branch statistical reporting for the period of the years 2014-2016 were used in the course of study. The following methods were applied: statistical, comparative and structural-and-logical analysis.
Results
At the beginning of research the indices of population morbidity in Ukraine and Transcarpathian region were studied and compared by the classes of diseases. The results obtained are shown in table I.
General indices of population morbidity in Transcarpathian region for the period of study are lower than the corresponding indices in Ukraine. In 2016 the population morbidity indices of Transcarpathian region are lower than the population morbidity indices of Ukraine by 3157.8 cases per 100 thousand of population that equals to 1.1 times.
Among 16 classes of diseases that were subjected to analysis population morbidity indices of Transcarpathian region in 6 (37.5%) classes are higher, and in 10 (62.5%) classes are lower than in general in Ukraine.
Proved differences in the indices of population morbidity of Transcarpathian region and Ukraine are identified in the following classes:
– lower indices: diseases of urogenital system -1.7 times; some infectious and parasitic diseases -1.4 times; neoplasms and diseases of ear and mastoid process – 1.3 times;
– higher indices: diseases of blood and hemopoetic organs and certain disorders involving the immune mechanism – 1.8 times; diseases of the endocrine system, nutritional and metabolic disorders – 1.8 times; diseases of the digestive system – 1.6 times; diseases of the circulatory system is 1.1.
The analysis of the structure of population morbidity indices of Transcarpathian region and Ukraine (table II) revealed proved differences in the following classes of diseases: diseases of blood and hemopoetic organs and certain disorders involving the immune mechanism (2 times higher level), diseases of endocrine system, nutritional and metabolic disorders (1.9 in times higher level); diseases of the digestive system (1.7 times higher level); diseases of the urogenital system (1.6 times lower level); some infectious and parasitic diseases (1.3 times lower level).
Comparison and analysis of the indices of diseases prevalence among the whole population of Ukraine and Transcarpathian region were further conducted by main classes of diseases. The results obtained are shown in table III.
The higher indices of diseases prevalence among the population of Transcarpathian region in comparison to similar indices among the population of Ukraine were found by four (25.0%) classes of diseases, the lower ones were found by twelve (75.0%) classes of diseases.
The highest level of excess of prevalence indices among the population of Transcarpathian region over similar index in Ukraine was registered by the following classes of diseases: diseases of the endocrine system, nutritional and metabolic disorders (1.4 times); diseases of blood and hemopoetic organs and certain disorders involving the immune mechanism, congenital malformations, deformations and chromosomal abnormalities (1.3 times).
The highest level of excess of prevalence indices among the population of Ukraine over similar index in Transcarpathian region was registered by the following classes of diseases: diseases of the urogenital system (1.7 times), diseases of the osteomuscular system and connective tissue (1.6 times), certain infectious and parasitic diseases and neoplasms (1.4 times).
The analysis of the structure of the indices of diseases prevalence among the population of Transcarpathian region and Ukraine (table IY) revealed significant difference in the following classes of diseases: diseases of the osteomuscular system and connective tissue and urogenital system (1.5 times lower level); diseases of the endocrine system, nutritional and metabolic disorders (1.5 time higher level); diseases of blood and hemopoetic organs and certain disorders involving the immune mechanism (1.4 times higher level).
Conclusions
There were determined the special features of population morbidity of Transcarpathian region as the mountainous territory of Ukraine and the prevalence of diseases that include the following.
General indices of population morbidity in Transcarpathian region are lower than the corresponding indices in Ukraine in the whole but they have the tendency to growth. Lower indices of population morbidity in Transcarpathian region than in the whole in Ukraine are registered for the diseases of the urogenital system by 1.7 times, some infectious and parasitic diseases by 1.4 times; neoplasms and diseases of the ear and mastoid process by 1.3 times and higher indices are registered for disease of blood and hemopoetic organs and certain disorders involving the immune mechanism – 1.8 times; diseases of the endocrine system, nutritional and metabolic disorders – 1.8 times; diseases of the digestive system – 1.6 times; diseases of the circulatory system – 1.1times.
General indices of diseases prevalence among the population of Transcarpathian region show the tendency to reduction, while in Ukraine in the whole these indices have the tendency to growth. The highest level of excess of prevalence indices among the population of Transcarpathian region over similar index in Ukraine was registered for classes of the endocrine system diseases, nutritional and metabolic disorders (1.4 times) and the diseases of blood and hemopoetic organs and certain disorders involving the immune mechanism and are congenital malformations, deformations and chromosomal abnormalities (1.3 times). The highest level of excess of prevalence indices among the population of Ukraine over similar index in Transcarpathian region was registered for classes of urogenital system diseases (1.7 times), diseases of the osteomuscular system and connective tissue (1.6 times) and certain infectious and parasitic diseases and the class of neoplasms (1.4 times).
References
1. Dudnyk S.V., Dudina О. О., Gaborets S.R., Slabkiy G. О. Zahal’na kharakterystyka stanu zdorovya naselennya Ukrayiny [General characteristic of population health in Ukraine], Regional health care systems in Ukraine 2014: monografy. – Kyiv, 2015; Ch. І.; 6–26.
2. Health 2020. Main European politics and strategies for the XXI century [Zdorovya 2020. Оsnovy evropeiskoyi polityky ta stratehiya dl’a XXI st.], WHO, Regional Office for Europe, Copenhagеn, 2013; 224 p.
3. Healthcare systems – health – wealth: European WHO ministry conference on healthcare systems [Sistemy zdravookhranieniya – zdorovye – blagosostoyaniye: Evropeiskaya ministerskaya konferentsiya VOZ po sistemam zdravookhranieniya], Таllinn, Estonia, June 25–27 2008; report Copenhagen, WHO, 2009; [Electronic document]: http://www.euro.who.int/_data/assets/pdf_file/0003/78951/E92150R.pdf.; Title from the screen.
4. Коvalchuk L.Ya., Lazoryshynets V.V., Lisnevska N.О. Healthcare in Ukraine: state, problems, projects: specialized edition [Оkhorona zdorovya Ukrayiny: stan, problemy, perspektyvy: spetsializovane vydannya], Kyiv, 2014; 608 p.
5. Reforms in healthcare system: Vinnytsya, Donetsk, Dnipropetrovsk, Odessa, Poltava regions, Kyiv. Results, problems, ways of decision. [Reformuvannya haluzi okhorony zdorovya: Vinnytsya, Donetsk, Dnipropetrovsk, Odessa, Poltava regions, Kyiv. Rezultaty, problems, shlyakhy vyrishennya], Kyiv, 2014; 207 p.
Address for correspondence
Gennadiy О. Slabkiy
Narodna sq., 3, Uzhhorod, 88000, Ukraine
e-mail: G.Slabkiy@ukr.net
Received: 20.02.2018
Accepted: 10.04.2018
Table I. Population morbidity indices in Ukraine and Transcarpathian region by main lasses of diseases (per 100 thousands of population) in the years 2014-2016
Class of diseases |
2014 |
2015 |
2016 |
|||
Ukraine |
Transcarpathian region |
Ukraine |
Transcarpathian region |
Ukraine |
Transcarpathian region |
|
All the diseases, including: |
62 654.2 |
60 007.3 |
62 651.3 |
60 515.1 |
64 242.4 |
61 084.6 |
infectious and parasitic diseases |
2 262.4 |
1 576.1 |
2 196.5 |
1 566.4 |
2 174.5 |
1 576.5 |
neoplasms |
846.0 |
643.5 |
856.9 |
649.1 |
865.9 |
665.5 |
diseases of blood and hemopoetic organs and certain disorders involving the immune mechanism |
417.2 |
747.1 |
415.6 |
719.0 |
410.2 |
736.2 |
diseases of endocrine system, nutritional and metabolic disorders |
959.2 |
1 742.2 |
942.8 |
1 682.5 |
924.9 |
1 622.9 |
psychic and behavioral disorders |
318.8 |
288.4 |
319.,0 |
276.5 |
307.5 |
279.6 |
diseases of nervous system |
1 518.1 |
1492.2 |
1 526.7 |
1505.4 |
1 520.2 |
1472.0 |
diseases of eye and adnexa oculi |
3 251.7 |
3174.4 |
3 271.1 |
3458.9 |
3 219.8 |
3520.0 |
diseases of ear and mastoid process |
2 370.8 |
1831.4 |
2 369.4 |
1 890.5 |
2 364.3 |
1 873.6 |
diseases of circulatory system |
4 381.8 |
4 681.0 |
4 312.6 |
4 782.9 |
4 287.1 |
4855.3 |
diseases of respiratory system |
27 594.0 |
26 188.5 |
27 741.1 |
27 167.0 |
29 540.9 |
27 592.3 |
diseases of digestive system |
2 645.4 |
4 527.3 |
2 668.3 |
4 229.4 |
2 616.9 |
4 202.7 |
diseases of skin and subcutaneous tissue |
3 659.6 |
2 903.5 |
3 663.2 |
2 878.9 |
3 671.9 |
2 938.8 |
diseases of osteomuscular system and connective tissue |
2 907.6 |
2 315.5 |
2 912.8 |
2 270.9 |
2 913.1 |
2 346.6 |
diseases of urogenital system |
4 093.1 |
2 587.4 |
4 161.2 |
2 435.1 |
4 134.3 |
2 380.0 |
congenital defects of development, deformations and chromosomal abnormalities |
111.4 |
212.1 |
113.1 |
136.4 |
111.2 |
113.3 |
injuries, poisoning and other results of outer impact |
4 015.8 |
3 840.9 |
3 970.8 |
3 770.8 |
4 004.2 |
3 881.4 |
Table II. The structure of population morbidity indices in Ukraine and Transcarpathian region by main classes of diseases, 2014-2016,%
Class of diseases |
2014 |
2015 |
2016 |
|||
Transcarpathian region |
Ukraine |
Transcarpathian region |
Ukraine |
Transcarpathian region |
Ukraine |
|
All the diseases, including: |
100 |
100 |
100 |
100 |
100 |
100 |
infectious and parasitic diseases |
2.6 |
3.6 |
2.6 |
3.5 |
2.6 |
3.4 |
neoplasms |
1.1 |
1.4 |
1.1 |
1.4 |
1.1 |
1.3 |
diseases of blood and hemopoetic organs and certain disorders involving the immune mechanism |
1.2 |
0.7 |
1.9 |
0.7 |
1.2 |
0.6 |
diseases of endocrine system, nutritional and metabolic disorders |
2.9 |
1.5 |
2.8 |
1.5 |
2.7 |
1.4 |
psychic and behavioral disorders |
0.5 |
0.5 |
0.5 |
0.5 |
0.5 |
0.5 |
diseases of nervous system |
2.5 |
2.4 |
2.5 |
2.4 |
2.4 |
2.4 |
diseases of eye and adnexa oculi |
5.2 |
5.2 |
5.7 |
5.2 |
5.8 |
5.0 |
diseases of ear and mastoid process |
3.1 |
3.8 |
3.1 |
3.8 |
3.1 |
3.7 |
diseases of circulatory system |
7.8 |
7.0 |
7.9 |
6.9 |
7.9 |
6.7 |
diseases of respiratory system |
43.6 |
44.0 |
44.9 |
44.3 |
45.2 |
46.0 |
diseases of digestive system |
7.5 |
4.2 |
7.0 |
4.3 |
6.9 |
4.1 |
diseases of skin and subcutaneous tissue |
4.9 |
5.8 |
4.8 |
5.8 |
4.8 |
5.7 |
diseases of osteomuscular system and connective tissue |
3.9 |
4.6 |
3.8 |
4.7 |
3.8 |
4.5 |
diseases of urogenital system |
4.3 |
6.5 |
4.1 |
6.6 |
3.9 |
6.4 |
congenital defects of development, deformations and chromosomal abnormalities |
0.2 |
0.2 |
0.2 |
0.2 |
0.2 |
0.2 |
injuries, poisoning and other results of outer impact |
6.4 |
6.4 |
6.2 |
6.3 |
6.4 |
6.2 |
Table III. Indices of prevalence among population in Ukraine and in Transcarpathian region by main classes of diseases
(per 100 thousands of population), 2014-2016
Class of diseases |
2014 |
2015 |
2016 |
|||
Ukraine |
Transcarpathian region |
Ukraine |
Transcarpathian region |
Ukraine |
Transcarpathian region |
|
All the diseases, including: |
170 128.0 |
159 324.8 |
171 096.7 |
158 506.1 |
172 692.9 |
157 577.1 |
infectious and parasitic diseases |
3 427.3 |
2 599.6 |
3 347.6 |
2 530.0 |
3 319.9 |
2 435.6 |
neoplasms |
3 965.2 |
2 872.1 |
4 085.8 |
2 937.0 |
4 121.1 |
3 027.7 |
diseases of blood and hemopoetic organs and certain disorders involving the immune mechanism |
1 588.6 |
2 056.4 |
1 578.4 |
2 054.0 |
1 569.3 |
2 057.6 |
diseases of endocrine system, nutritional and metabolic disorders |
8 342.3 |
11 656.8 |
8 497.3 |
11 736.7 |
8 569.3 |
11 864.8 |
psychic and behavioral disorders |
3 996.4 |
4 202.8 |
3 989.9 |
4 204.4 |
3 972.4 |
4 173.4 |
diseases of nervous system |
4 632.2 |
3 736.4 |
4 667.3 |
3 789.8 |
4 670.3 |
3 762.3 |
diseases of eye and adnexa oculi |
8 372.7 |
6 187.4 |
8 374.7 |
6 508.3 |
8 262.2 |
6 561.5 |
diseases of ear and mastoid process |
3 120.1 |
2 396.3 |
3 130.9 |
2 476.5 |
3 134.3 |
2 418.8 |
diseases of circulatory system |
52 718.8 |
52 570.8 |
52 956.9 |
5 1381.9 |
52 970.4 |
51 013.2 |
diseases of respiratory system |
33 696.5 |
3 119.1 |
33 952.9 |
3 2496.0 |
35 709.3 |
32 853.8 |
diseases of digestive system |
16 890.0 |
17 54.0 |
16 998.1 |
16 714.5 |
16 825.5 |
16 002.6 |
diseases of skin and subcutaneous tissue |
4 427.6 |
3 799.6 |
4 452.1 |
3 700.3 |
4 513.3 |
3 712.8 |
diseases of osteomuscular system and connective tissue |
9 201.1 |
6 179.8 |
9 301.8 |
5 981.4 |
9 313.2 |
5 848.5 |
diseases of urogenital system |
9 282.1 |
5 986.5 |
9 382.3 |
5 768.5 |
9 370.0 |
5 617.6 |
congenital defects of development, deformations and chromosomal abnormalities |
657.5 |
842.3 |
679.2 |
872.3 |
691.0 |
873.3 |
injuries, poisoning and other results of outer impact |
4 276.0 |
4 050.7 |
4 240.8 |
4 006.3 |
4 266.3 |
4 149.8 |
Table IY. The structure of prevalence indices among the whole population of Ukraine and Transcarpathian region by main classes of diseases, 2014-2016,%
Class of disease |
2014 |
2015 |
2016 |
|||
Transcarpathian region |
Ukraine |
Transcarpathian region |
Ukraine |
Transcarpathian region |
Ukraine |
|
All the diseases, including: |
100 |
100 |
100 |
100 |
100 |
100 |
infectious and parasitic diseases |
1.6 |
2.0 |
1.6 |
2,0 |
1.5 |
1.9 |
neoplasms |
1.8 |
2.3 |
1.9 |
2.4 |
1.9 |
2.4 |
diseases of blood and hemopoetic organs and certain disorders involving the immune mechanism |
1.3 |
0.9 |
1.3 |
0.9 |
1.3 |
0.9 |
diseases of endocrine system, nutritional and metabolic disorders |
7.3 |
4.9 |
7.4 |
5.0 |
7.5 |
5.0 |
psychic and behavioral disorders |
2.6 |
2.4 |
2.7 |
2.3 |
2.6 |
2.3 |
diseases of nervous system |
2.3 |
2.7 |
2.4 |
2.7 |
2.4 |
2.7 |
diseases of eye and adnexa oculi |
3.9 |
4.9 |
4.1 |
4.9 |
4.2 |
4.8 |
diseases of ear and mastoid process |
1.5 |
1.8 |
1.6 |
1.8 |
1.5 |
1.8 |
diseases of circulatory system |
33.0 |
31.0 |
32.4 |
31.0 |
32.4 |
30.7 |
diseases of respiratory system |
19.6 |
19.8 |
20.5 |
19.8 |
20.8 |
20.7 |
diseases of digestive system |
11.0 |
9.9 |
10.5 |
9.9 |
10.2 |
9.7 |
diseases of skin and subcutaneous tissue |
2.4 |
2.6 |
2.3 |
2.6 |
2.4 |
2.6 |
diseases of osteomuscular system and connective tissue |
3.9 |
5.4 |
3.8 |
5.4 |
3.7 |
5.4 |
diseases of urogenital system |
3.8 |
5.5 |
3.6 |
5.5 |
3.6 |
5.4 |
congenital defects of development, deformations and chromosomal abnormalities |
0.5 |
0.4 |
0.6 |
0.4 |
0.6 |
0.4 |
injuries, poisoning and other results of outer impact |
2.5 |
2.5 |
2,5 |
2,5 |
2,6 |
2.5 |