Browsing by Subject "Morbidity"

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Open Access
Demographics, treatment and outcomes of atrial fibrillation in a developing country: the population-based TuRkish Atrial Fibrillation (TRAF) cohort
(Oxford University Press, 2017) Yavuz, B.; Ata, N.; Oto, E.; Katircioglu-Öztürk, D.; Aytemir, K.; Evranos, B.; Koselerli, R.; Ertugay, E.; Burkan, A.; Ertugay, E.; Gale, C. P.; Camm, A. J.; Oto, A.
Aims: Although atrial fibrillation (AF) is increasingly common in developed countries, there is limited information regarding its demographics, co-morbidities, treatments and outcomes in the developing countries. We present the profile of the TuRkish Atrial Fibrillation (TRAF) cohort which provides real-life data about prevalence, incidence, comorbidities, treatment, healthcare utilization and outcomes associated with AF. Methods and results: The TRAF cohort was extracted from MEDULA, a health insurance database linking hospitals, general practitioners, pharmacies and outpatient clinics for almost 100% of the inhabitants of the country. The cohort includes 507 136 individuals with AF between 2008 and 2012 aged >18 years who survived the first 30 days following diagnosis. Of 507 136 subjects, there were 423 109 (83.4%) with non-valvular AF and 84 027 (16.6%) with valvular AF. The prevalence was 0.80% in non-valvular AF and 0.28% in valvular AF; in 2012 the incidence of non-valvular AF (0.17%) was higher than valvular AF (0.04%). All-cause mortality was 19.19% (97 368) and 11.47% (58 161) at 1-year after diagnosis of AF. There were 35 707 (7.04%) ischaemic stroke/TIA/thromboembolism at baseline and 34 871 (6.87%) during follow-up; 11 472 (2.26%) major haemorrhages at baseline and 10 183 (2.01%) during followup, and 44 116 (8.69%) hospitalizations during the follow-up. Conclusion: The TRAF cohort is the first population-based, whole-country cohort of AF epidemiology, quality of care and outcomes. It provides a unique opportunity to study the patterns, causes and impact of treatments on the incidence and outcomes of AF in a developing country. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017.
Open Access
Does morbidity matter? Perceived health status in explaining the share of healthcare expenditures
(Routledge, 2012) Solakoğlu, E. G.; Civan, A.
We argue that the demand for healthcare services can be better explained by individual need based variables rather than by macro variables such as the Gross Domestic Product (GDP) per capita and the share of public healthcare expenditures. This study introduces a self-rated health variable called morbidity that describes individual needs for health care – healthy individuals need less health care than sick ones – and that is measured through personal interviews conducted by the Organization for Economic Co-operation and Development (OECD). In addition, stationary properties of the series are considered in order to understand the effect of shocks to expenditure behaviour on health care. Stationary test results show that we should not only use differenced values for the model variables but also incorporate time-specific effects into the model. Using the appropriate specification and accounting for the time effect, we find evidence supporting the hypothesis that the share of healthcare expenditure in GDP rises with the increased need for health care. The need for health care is also found to be more important than per capita GDP when explaining the change in the share of healthcare expenditures for the examined countries.