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DYNAMICS OF THE NEWLY DISCOVERED MALIGNANT DISEASES
OF THE POPULATION IN THE DISTRICT OF PLOVDIV
Shopov Dimitar Georgiev
MD, PhD, Chief AssiMant Prof. Department of Social Medicine and Public Health Medical University - Plovdiv, Bulgaria
Mihaylova Vanina Kratfeva
PhD, Assoc. Prof. Department of Preventive Medicine, Faculty of Public Health, Sofia; Chief AssiMant Department of Healthcare Management, Faculty of Public Health, Medical University,
Plovdiv, Bulgaria
Stoeva Teodora Radeva
Senior health care University Hospital "Sv. George " - Plovdiv Bulgaria
ABSTRACT
The malignant diseases are an essential problem of the contemporary society.
The present article analyzes the morbidity rate related to neoformations in different organs of the body in people from the diflrict of Plovdiv for a 5-year period from 2010 to 2014 inclusive. The demographic flatus has been traced. The following facts were eflablished:
- the total number of the population is decreasing;
- the relative share of the people capable of working is decreasing;
- the relative share of elderly people over 65 is increasing.
The frequency of newly discovered cases of malignant diseases is increasing, the predominant ones being breafl cancer and proflate gland cancer.
Keywords: malignant diseases, population, demographic indices, birth rate, death rate, natural population growth
Introduction:
The malignant diseases are a serious problem of our contemporary society. They are the second leading cause of death in the developed countries. There is an upward trend of death caused by cancer worldwide.(1;3) The prognoflication shows that in 2030 about 12 million people would die from this insidious disease.(4;7) Statiflics marks a sharp increase in the morbidity rate and decrease in the age of people suffering from cancer. The malignant diseases cause much suffering, loss of working capacity and are a heavy economic burden for
the society, the individual and the family.(5;9) They require increased need of medical services and often have a lethal exit. Almofl 80% of the malignant diseases are caused by the environmental factors, the lifeflyle of the people, habits and cufloms. The frequency of diflribution of malignant diseases in Bulgaria is conflantly increasing.(8;12) Cancer is a tragedy but the experts point out that now the causes of cancer are well-known and this enables prevention of around one third of the new cases.(16) With the increase in the duration of life and age of the people, the number of patients with cancer is expected to
increase. The good news is that about 40% of the cancer diseases are potentionally preventable.(23)
Objective: The objective of the present article is to fludy the morbidity rate of malignant new formations with different locations in the body in the population of the diflrict of Plovdiv.
Materials and methods:
Subject of observation is Plovdiv diflrict. The logical unit is the population of Plovdiv. The fludy is retrospective for a 5-year period from 2010 to 2014 inclusive. Quantitative and qualitative indices have been used for the analysis. The input information has been derived from the annual reports of the Miniflry of Health and the Regional Health Inspectorate in Plovdiv. The Satirical processing of the collected input information has been performed with the help of the Satirical package SPSS version 19 and MicrosoftExcel.
Results and discussion:
Plovdiv diflrict is located in the central part of Southern Bulgaria and occupies 5972,9 sq.m., equal to 5.4% of the
territory of the Republic of Bulgaria. It is one of the regions mofl favoured by nature. The diflrict has a convenient transportation geographic position, high natural, economic and human potential, favourable bio-climatic resource, protected territories, highly productive cultivated land, thermal waters, and very rich cultural heritage. The favourable geographic location of the diflrict is complemented by the availability of eflablished infraflructure for easier access. The territory of the diflrict covers the southern Balkan slopes, the field of Pazardzhik-Plovdiv, the forefl areas of the Sredna Gora and the northern part of the Rhodope, mountain rivers and valleys. In a climatic aspect the region is not uniform - in the plain parts it is transitory-continental and in the highefl parts - mountainous.
The population of Plovdiv diflrict as of 31 December 2014 is 675 586 people and conflitutes 9.4% of the population of the country. There is a tendency of decrease in the number of the population in the diflrict - from 696300 in 2010 to 675 586 people in 2014. (Chart 1)
Chart 1
The long-term tendency of prevailence of the women over men continues and for 2014 there are 1075 women per 1000 men.
The age flructure of the population in the diflrict of Plovdiv corresponds to the general specification of the country (Chart 2). The process of demographic aging continues. The following facts are reported for the 5-year period of fludy:
- the children and juvenile's age is relatively fleady during the fludied period;
- At the age 18-64 the number of people decreases: from 458 279 in 2010 to 428 981 in 2014 - 29 298 people less (4.33% of the total population).
- The relative share of people aged 65 and more is increasing from 124 055 in 2010 to 134 737 in 2014 - 10 682 people more (1.5% of the total population). The relative share of the people with capacity to work is decreasing.
The tendency of the birth rate in the diflrict of Plovdiv marks leads to decrease in the natura population growth, which in the a downward trend: from 10.3% in 2010 to 9.8% in 2014 (Chart analyzed period of time (2010-2014 inclusive) has a negative 3). The unfavourable dynamics of the birth and death rates value. During the lafl year the population growth rate is (-4.3).
Age structure of the population in the district of Plovdiv
500000
-♦—0-17year
400000 300000 200000 100000 0
■- -■—
--■-■--
-- -▼-
2009 year 2010 year 2011 year 2012 year 2013 year 2014year
114209 113966 109969 110129 110843 111868
464076 458279 441021 437729 434692 428981
123399 124055 129894 131002 132662 134737
18-64year 65+ year
Chart 2
Chart 3
The newly discovered and regiflered malignant diseases are presented in Chart 4 and as a basis of comparison, the average values for Bulgaria are also indicated. The morbidity rate in respect to malignant diseases in Plovdiv diflrict outlines a fleady upward trend. The frequency of new cases is increasing
and in 2014 it is 496.6 per 100 000 people while in 2010 it was 465.7 per 100 000 people. During the entire period (20102014 inclusive) the number of newly discovered and regiflered malignant diseases of the population in the diflrict of Plovdiv is higher than the average for the country.
Chart 4
Table 1
Year 1 2 3 4 5 6 7 8 9 10 11 12
2010 22,6 35 25 52,8 75,1 99,6 14,9 34 51,8 22,5 5,6 19,9
2011 20,5 33 24,3 47,8 74,8 119,4 19,8 33,7 83,5 23,6 5,3 20,2
2012 19,1 36,3 20,7 51,6 83,8 108,3 17,1 30,7 108,2 20,9 4,4 17,8
2013 23 29 20,5 49,1 82,7 115,3 20,2 33,9 95,3 23,3 7,1 14,4
2014 18,5 34,6 21,9 49,3 89,2 115,3 19,1 27,7 80,6 23,8 6,4 15,5
Legend:
1. Stomach
2. Colon
3. Rectosigmoidal area, rectum, anus
4. Trachea, bronchi, lungs
5. Melanoma and other malignant skin diseases
6. Mammary gland in women
7. Cervix
8. Uterus body
9. Prolate
10. Bladder
11. Thyroid gland and other endocrine glands
12. Lymph, haemopoietic and related tissues
Table 1 presents the frequency of the newly discovered malignant diseases according to their organ location.
The highefl frequency in 2014 in Plovdiv diflrict belongs to the newly discovered breafl cancer - 115.3 per 100 000 people, followed by the newly discovered proflate cancer - 80.6 per 100 000 men.
The main reason for deaths is in 2014 in Plovdiv diflrict remains the diseases of the blood circulattion organs, whose intensity is 883.6 per 100 000 people, which index is considerably higher than that for the country - 993.4 /0000-. The relative share of the diseases of the bodies of blood circulation from all causes of death in Plovdiv diflrict is 62.5%о. The second place is occupied by deaths from malignant new formations with intensity 279.4 per 100 000 people and a relative share of 19.8% compared to 21.5 for the previous year. For the country this index is 250.7 per 100 000 people and the relative share is 16.6%.
Conclusions:
1. The demographic indices in Plovdiv diflrict within the period 2010-2014 inclusive, show the following:
- the total number of the population is decreasing;
- the relative share of the people capable of working is decreasing;
- the number of people over 65 is increasing
- negative population growth
2. The morbidity rate in terms of malignant diseases in the diflrict of Plovdiv outlines a permanent upward tendency.
3. The highefl frequency in 2010-2014 inclusive have newly discovered cases of breafl cancer in women, followed by newly discovered diseases of the proflate gland in men.
4. For the purpose of prevention, early finding and treatment of the disease prophylaxis is necessary, as well as improved diagnoflics and more efficient methods of treatment.
5. The number of people suffering from cervix cancer after application of population screening and vaccine againfl the human papilloma virus (HPV) is decreasing. As for the mammary gland cancer, death rate is decreasing after the application of population screening and complex treatment, including target therapy. In Bulgaria prophylaxis and early discovery (including screening) of malignant diseases is less frequent.
6. The good practices of the flates with traditions in cancer control show that the limitation of this socially significant disease is only possible with the joint efforts of experts, politicians and the society in general.
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9. Anasflasiou-Fotaki, P. et al. The cardasal vaccine can prevent cervical carcinoma caused by human papilloma virus (HPV) (Results from our participation and from the fludy carried out in Greece) Akush. i ginekol., 46, 2007, N 3,17-20
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CONCEPTUAL MODEL FOR CAPACITY DEVELOPMENT OF
BULGARIAN HEALTHCARE
Trendafilova P. D. 1, Kehayov A. V. 2
1 PhD, Associate Professor at the Faculty of Public Health, Medical University - Sofia, Sofia, Bulgaria 2 PhD, President of South EaMern European Medical Forum (SEEMF), Sofia, Bulgaria
ABSTRACT
The purpose of this article is to develop a prognoflic conceptual model for capacity development of Bulgarian healthcare by year 2030 based on a comparative analysis, a conducted survey among healthcare managers and an expert appraisal. The expenditure per capita is an important element in building the capacity of healthcare. In 2006 public expenditure for healthcare per capita in Bulgaria amounted to 245 Levs. In 2013 the public expenditure per capita is respectively 463 Levs or there is an almofl double increase.
Keywords: capacity, conceptual model, healthcare, Bulgaria.
Introduction
The Bulgarian society and the economy in our country have to achieve some tasks in order to accomplish successful development of the healthcare syflem. Comparing to the other European countries Bulgarian healthcare is quite behind the level it should be. The prognosis about its development should take into account the level of the economic development and the conflruction of the capacity of Bulgarian healthcare. This model, relevant to the environment, shows the development of the healthcare syflem until year 2030.
Capacity building of Bulgarian healthcare is defined as a syflematic approach for continuous learning how to improve its potential, how to be used in the mofl effective way its labor,
material and financial resources in order to achieve its main objectives.
Objective
The objective of this fludy is to develop a prognoflic conceptual model for capacity development of Bulgarian healthcare by year 2030 based on a comparative analysis, a conducted survey among healthcare managers and an expert appraisal.
Methods
1. Comparative analysis.
2. Critical analysis.
3. Sociological method - a survey conducted among healthcare managers.
4. Statiflical methods.
