Browsing by Author "Terzic-Supic, Z. (15840732000)"

Objective: The objective was to analyze possible inequalities by gender in the utilization of health services (general practitioner [GP] and hospital), among people with non-communicable diseases (NCDs) in the Republic of Serbia, with special reference to multimorbidity. In addition, we examined the prevalence patterns of NCDs by sociodemographic characteristics of the population. Study design: This study is a population-based, cross-sectional survey. Methods: A secondary analysis from the 2013 Serbian National Health Survey included 13,765 adults aged ≥20 years. Multivariable logistic and linear regression analyses were performed to assess the association between NCDs and health care utilization. Results: Multimorbidity was present in 30.2% of the total sample. An increased number of NCDs was associated with a higher utilization of both primary (odds ratio [OR] for having any GP visit is 3.17 in males and 3.14 in females; unstandardized coefficient [B] for number of GP visits is 0.33 for both gender) and secondary health care services (OR for having any hospitalization is 2.45 in males and 1.97 in females; B for number of overnight stays in hospital is 1.62 in males and 0.97 in females) in Serbia. Conclusions: Our study provided strong evidence that an increased number of NCDs was significantly associated with a higher utilization of health care services in Serbia. There is a need for wise, decisive, and integrated care interventions for effective management of NCDs and their risk factors. Further research is necessary with special emphasis on the role of the health system in satisfying needs of such patients. © 2017 The Royal Society for Public Health

Objectives: Physical activity level decreases during young adulthood. As social media are nowadays widely used and are included into many people's daily routines, the interventions on these websites have the possibilities to be integrated into those routines without becoming a burden. The aim of this study was to assess physical activity level among first- and fifth-year medical students and social media intervention with the aim to improve physical activity among them. Study design: Prospective longitudinal study was conducted during October of 2016 at the Faculty of Medicine, University of Belgrade, Serbia. The study included 375 first- and fifth-year students. Methods: At the baseline, students filled in the questionnaire and were asked to join a Facebook discussion group. The intervention consisted of motivation for physical activity through motivational pictures, texts, and discussions. The second assessment was carried out after one month. Based on the reported physical activity level, students were divided into groups: sufficient (>600 metabolic equivalent [MET]-minutes/week) and insufficient physical activity (≤600 MET-minutes/week). Results: Total of 85.4% of students were sufficiently active at the baseline, whereas 90.4% were sufficiently active after one month. Multivariate logistic regression analysis showed that students who were part of the Facebook group (odds ratio [OR]: 3.51, 95% confidence interval [CI]: 1.46–8.43) and students who had sufficient physical activity at the baseline (OR: 5.44, 95% CI: 2.44–12.13) had a higher likelihood to be sufficiently active after one month. Conclusion: Social media are shown to be valuable in health-promoting interventions and can be used for interventions targeting lifestyle change among young adults. © 2019 The Royal Society for Public Health

Background: In times of austerity, the availability of econometric health knowledge assists policy-makers in understanding and balancing health expenditure with health care plans within fiscal constraints. The objective of this study is to explore whether the health workforce supply of the public health care sector, population number, and utilization of inpatient care significantly contribute to total health expenditure. Methods: The dependent variable is the total health expenditure (THE) in Serbia from the years 2003 to 2011. The independent variables are the number of health workers employed in the public health care sector, population number, and inpatient care discharges per 100 population. The statistical analyses include the quadratic interpolation method, natural logarithm and differentiation, and multiple linear regression analyses. The level of significance is set at P<0.05. Results: The regression model captures 90 % of all variations of observed dependent variables (adjusted R square), and the model is significant (P<0.001). Total health expenditure increased by 1.21 standard deviations, with an increase in health workforce growth rate by 1 standard deviation. Furthermore, this rate decreased by 1.12 standard deviations, with an increase in (negative) population growth rate by 1 standard deviation. Finally, the growth rate increased by 0.38 standard deviation, with an increase of the growth rate of inpatient care discharges per 100 population by 1 standard deviation (P<0.001). Conclusions: Study results demonstrate that the government has been making an effort to control strongly health budget growth. Exploring causality relationships between health expenditure and health workforce is important for countries that are trying to consolidate their public health finances and achieve universal health coverage at the same time. © 2016 The Author(s).

Background: In times of austerity, the availability of econometric health knowledge assists policy-makers in understanding and balancing health expenditure with health care plans within fiscal constraints. The objective of this study is to explore whether the health workforce supply of the public health care sector, population number, and utilization of inpatient care significantly contribute to total health expenditure. Methods: The dependent variable is the total health expenditure (THE) in Serbia from the years 2003 to 2011. The independent variables are the number of health workers employed in the public health care sector, population number, and inpatient care discharges per 100 population. The statistical analyses include the quadratic interpolation method, natural logarithm and differentiation, and multiple linear regression analyses. The level of significance is set at P<0.05. Results: The regression model captures 90 % of all variations of observed dependent variables (adjusted R square), and the model is significant (P<0.001). Total health expenditure increased by 1.21 standard deviations, with an increase in health workforce growth rate by 1 standard deviation. Furthermore, this rate decreased by 1.12 standard deviations, with an increase in (negative) population growth rate by 1 standard deviation. Finally, the growth rate increased by 0.38 standard deviation, with an increase of the growth rate of inpatient care discharges per 100 population by 1 standard deviation (P<0.001). Conclusions: Study results demonstrate that the government has been making an effort to control strongly health budget growth. Exploring causality relationships between health expenditure and health workforce is important for countries that are trying to consolidate their public health finances and achieve universal health coverage at the same time. © 2016 The Author(s).

Background: Cystic pancreatic tumors are increasingly found in medical practice. The aim of this study was to examine the prevalence of misdiagnosis of these lesions and the factors associated with preoperative misdiagnosis. Methods: A retrospective analysis included 66 patients treated in the Clinic for Digestive Surgery, Clinical Center of Serbia, from 1983 to 2013. We included all patients with biopsy-confirmed cystic pancreatic tumors during the study period. We analyzed preoperative parameters, intraoperative and postoperative data of examined patients. Based on the preoperative diagnosis and the biopsy findings, patients were divided into two groups: correct preoperative diagnosis and misdiagnosis. Results: Prevalence of misdiagnosis was 34.85%. Average age was 45.3 ± 16.9 years, 54 (81.8%) were females. Patients with misdiagnosis had significantly higher odds of being older (Odds ratio [OR]: 1.06, 95% Confidence interval [CI]: 1.01–17.86), to present with symptoms of nausea or vomiting (OR: 5.85, 95% CI: 1.49–23.00), to have a clinically palpable tumor (OR: 4.64, 95% CI: 1.21–17.86), and to have received the diagnosis in the period between 1992 and 2003. Conclusion: During the 30-year study period, more than one third of the patients in our study had a misdiagnosis preoperatively. The likelihood of misdiagnosis was higher among older patients, patients with symptoms of nausea or vomiting, patients with a clinically palpable tumor, and patients treated during the period between 1992 and 2003. The decline in the prevalence of misdiagnoses should be expected, due to advances in imaging methods and their availability, which are increasing significantly. © 2020, Springer-Verlag GmbH Austria, part of Springer Nature.