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The analysis of screening costs for hypercholesterolemia and hyperglycemia as part of obligatory examinations of employees

100%
Marcinkiewicz A., Olejniczak D., Śliż D., Staniszewska A.
International Journal of Occupational Medicine and Environmental Health
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2021
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vol. 34
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issue 5
581-589
EN
ObjectivesHigh prevalence of hyperlipidemia and hyperglycemia requires searching for efficient and cost-effective methods of an early detection of these disorders. In Poland, obligatory employee medical check-ups could be a solution.Material and MethodsThe study included a group of university employees who underwent obligatory occupational examinations in 2018. Each employee had an additional lipid (unit cost: EUR 2.56) and blood glucose profile (EUR 0.93) done. The number of respondents involved in the study was 850 (340 males and 510 females), and their average age was 47 years (SD = 11 years). The education distribution was as follows: employees with secondary vocational and general education (physical, frontline and administrative workers): 176 (age: M±SD 50.3±10.3); employees with a university degree (academics with an M.Sc. or/and Ph.D. title and administrative staff): 535 (age: M±SD 43.6±9.8); and academics with a university title (Ass. Prof. and/or Prof.): 139 (age: M±SD 56.2±10.2).ResultsDyslipidemia (elevated total cholesterol ≥190 mg/dl and/or low-density lipoprotein cholesterol ≥115 mg/dl) was reported in 560 workers (65.9%). Hyperglycemia (fasting glucose ≥100 mg/dl) was observed in 256 workers (31%). The total cost of detecting a single case of dyslipidemia and hyperglycemia was EUR 3.88 and EUR 3.09, respectively. Divided by age groups, the costs were as follows: EUR 4.34 and EUR 4.53 in the age group <45 years; EUR 3.56 and EUR 2.42 in the age group ≥45 years. The costs of detecting a single case of dyslipidemia and hyperglycemia in employees aged ≥45 with regard to education were as follows: EUR 3.20 and EUR 2.07 in persons with secondary vocational and general education; EUR 3.40 and EUR 2.80 in persons with a university degree; and EUR 4.38 and EUR 2.28 in persons with a university title.ConclusionsDue to the fact that the reporting rate for screening tests in the framework of occupational medicine is high, the cost of occupational screening tests for dyslipidemia and hyperglycemia can be lower than the cost of screening tests in the general population.
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Hypercholesterolemia and prevention of cardiovascular diseases in the light of preventive medical examinations of employees in Poland

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Śliż D., Marcinkiewicz A., Olejniczak D., Jankowski P., Staniszewska A., Mamcarz A., Walusiak-Skorupa J.
International Journal of Occupational Medicine and Environmental Health
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2019
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vol. 32
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issue 6
865-872
EN
Long-term exposure to hypercholesterolemia is the cause of atherosclerosis, which in turn causes cardiovascular and cerebrovascular events. In developed countries, including Poland, vascular diseases are the main cause of death. They affect an ever younger part of the population, including the working population. The authors address the problem of epidemiology of cardiovascular diseases, unsatisfactory detection and treatment, economic consequences for the health care system, and the possibilities of using occupational medicine services in the prevention of this health problem. Due to the fact that the early detection of diseases caused by high blood cholesterol levels is relatively low in Poland, obligatory occupational medicine examinations seem to be a key element of the second-line prevention. Therefore, it seems natural to consider the idea of extending the scope of obligatory examinations and introducing tests that allow lipid disorders to be detected at an early stage. This can contribute to a general improvement of the health of the population, and to economic benefits, such as a decrease in the costs of treatment of the disorders that have been detected too late. Broadening the scope of occupational examinations is also important from the perspective of public health and epidemiology of cardiovascular diseases, thus being an element of prevention of civilization diseases. It means improving health and building health awareness, and it should translate into regular health examinations. The performance of these examinations should result not only from the obligation, but also from the patient’s conviction about the importance of early detection of disorders, including lipid disorders, for an effective therapy. Int J Occup Med Environ Health. 2019;32(6):865–72
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Public and private health care services in the opinion of physicians in Poland

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Zgliczyński W. S., Jankowski M., Rostkowska O., Sytnik-Czetwertyński J., Śliż D., Karczemna A., Pinkas J.
International Journal of Occupational Medicine and Environmental Health
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2020
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vol. 33
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issue 2
195-214
EN
ObjectivesHealth care services in Poland are delivered by public and private providers. The aims of this study were to assess the attitudes towards private and public health care services in Poland and to identify differences between them, in the opinion of physicians.Material and MethodsA questionnaire-based survey was carried out among physicians attending mandatory courses delivered at the School of Public Health, the Centre of Postgraduate Medical Education in Warsaw, Poland. The questionnaire included 29 questions concerning private and public health care services.ResultsCompleted questionnaires were obtained from 502 physicians (67.7% females), aged 42.1±10.8 years, with a response rate of 77.2%. In the opinion of the surveyed doctors, the major advantages of private health care units, in comparison with public ones, are short waiting times for an appointment (88.2%), an efficient on-site service (78.6%) and convenient appointment times (75.7%). The respondents gave high scores to items such as relations with patients (p < 0.001), superiors (p < 0.001) and colleagues (p = 0.03) when working in private, rather than public, institutions. In the opinion of physicians, public health care institutions guarantee better employment conditions (44.4% vs. 13%; p < 0.001) and security (29.1% vs. 11.1%; p < 0.001) than private ones. The respondents did not observe any differences (p > 0.05) between public and private facilities in terms of the involvement of medical staff and infrastructure. There were significant differences (p < 0.001) in the perception of working conditions in public and private health care institutions depending on the medical education level and the place of primary employment. Conclusions: Among physicians in Poland, private medical institutions are perceived as better organized and granting faster as well as more comprehensive access to health care services when compared to public ones. Closing the gaps between working conditions in public and private units could encourage physicians to practice in the public health care sector.
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