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Objectives: The aim of the present study was to assess the incidence of larynx cancer in Lithuania in the years 1978--2001 and to outline possible future trends. Materials and Methods: The number of new laryngeal cancer cases in 1978--2001 was obtained from the Lithuanian Cancer Registry. The Lithuanian Department of Statistics provided data on the population being at the same age in the same years. The data were adjusted for age, using the direct method in accordance with the European standard; a linear regression analysis of trends in the larynx cancer incidence was performed. Results: After standardization of data for the period of 1978--2001, an upward trend was registered for both men and women: in 1978 the incidence was 10.73 for men and 0.26 for women per 100 000 population, in 2001 the corresponding data were 11.6 and 0.7. Throughout the study period the incidence was higher in men than in women and the mean age of male and female larynx cancer patients was increasing: mean age for men was annually increasing by 0.1566 years and for women by 0.0602 years. The forecast for men in 2006 is 13.88 and for women 0.54 cases per 100 000 population. Conclusions: The increase in larynx cancer incidence is growing more rapidly among women than among men, and the mean age of the patients is also increasing. The forecast is that in 2006 the incidence rate will be increasing, and both men and women will get ill at an older age. [ABSTRACT FROM AUTHOR]

The aim of the study was to analyze self-rated health among physicians depending on their sex, age, workplace (hospital or polyclinic), and specialty. MATERIAL AND METHODS. The studied group consisted of 377 26-70-year-old physicians randomly selected from various county hospitals and polyclinics of Lithuania. There were 85 men and 292 women. The inquiry was performed using the complemented (by the authors of the study) version of the WHO anonymous questionnaire of the quality of life (1995). Responses were evaluated based on physicians' evaluation of their own health, which was rated as very good, good, satisfactory, poor, and very poor. RESULTS. Only 8.2% of males and 5.8% of females evaluated their health as very good (P>0.05). More men, compared to women, evaluated their health as good (62.3% and 53.1%, respectively; P<0.05), whereas more females evaluated their health as satisfactory, compared to males (36.0% and 25.9%, respectively; P<0.05); 2.4% of males and 5.1% of females (p>0.05) stated that their health was poor. In most cases, physicians of different age groups presented equal evaluations of their health except for physicians in the age groups of 26-37 and 38-43 years - those who evaluated their health as very good comprised a significantly higher percentage (P<0.05), compared to other age groups. As expected, a higher percentage of older physicians evaluated their health as satisfactory. In addition to that, more hospital physicians, compared to those working in polyclinics, evaluated their health as good (12.8% and 1.8%, respectively; P<0.05) and vice versa - significantly more physicians working in polyclinics evaluated their health as satisfactory, compared to those working in hospitals (38.1% and 26.8%, respectively; P<0.05). A significantly higher percentage of surgeons, compared to general practitioners or therapists, evaluated their health as very good (15.8%, 4.5%, and 6.1%, respectively; P<0.05) and a significantly lower percentage - as satisfactory (P<0.05). CONCLUSIONS. Irrespectively of sex, 6.4% of the studied physicians evaluated their health as very good; 55.2%, as good; 33.7%, as satisfactory; 4.7%, as poor; and 0.3%, as very poor. A higher percentage of physicians who evaluated their health as very good or good were 26-37 and 38-43 years of age, whereas more physicians in older age groups evaluated their health as satisfactory. A higher percentage of physicians working in hospital evaluated their health as very good, whereas more physicians who worked in polyclinics evaluated their health as satisfactory. Compared to general practitioners and therapists, surgeons more frequently evaluated their health as very good and significantly less frequently - as satisfactory.

Unlabelled: The aim of the study was to assess the inpatients' opinion on the quality of hospital care based on the factor analysis and to identify the problem-oriented fields in quality of care., Material and Methods: A multistage stratified probability sampling was performed in 22 general hospitals in Lithuania. A total of 2060 questionnaires were distributed during November 2006 and February 2007. The response rate was 97.38%; 2006 inpatients responded to the questionnaire; 1917 questionnaires (93.06%) were eligible for analysis. The modified survey instrument of Picker Institute Europe was used for inpatients. The method of survey was follows: each discharged inpatient filled out the questionnaire on the day of his/her discharge. The assessment of quality of care involved such aspects as patients' communication with medical personnel, organizational issues and coordination of care, patients' possibility of participation in medical decision-making, physical environment, accessibility to services, and safety of health care., Results: Six dimensions were identified from the factor analysis, explaining 51.48% of the variance. Cronbach alpha was 0.7931 for all dimensions. The majority (91.9%) of respondents evaluated health care services as good and very good. Inpatients were most satisfied with communication with their doctors. Even 91.5% of respondents noted that the doctors provided enough information about their health and treatment. The majority of inpatients gave high positive responses on respect showed to them and confidence with doctors. Correlation analysis confirmed a stronger positive correlation among three items of the global assessment of the quality and patients' ratings on respect and confidence. Several problems were highlighted in the field of patients' autonomy. The possibility of participation in medical decision-making was the dimension with the lowest level of patients' rating. Less than half (42.3%) of inpatients noted that they did not have a possibility of participation in medical decision-making to the extent they were willing., Conclusions: Patients gave highly positive responses on the overall evaluation of the quality of health care services. The priority field in the improvement of health care quality is to create more possibilities for patients' participation in medical decision-making. Results of the present study indicate that future studies need to include more detailed measurements of patients' autonomy as dynamic changes are observed today in this field.

This article analyzes the spatial accessibility of primary healthcare services, i.e. the population's possibilities to receive healthcare services within an acceptable period of time in healthcare institutions situated in a certain territorial-administrative unit--the municipality. The aim of the study was to develop the technique for the quantitative evaluation of the spatial accessibility of primary healthcare services in different territories. The object of the study was the network of primary healthcare institutions and their subdivisions in the municipalities of Klaipeda, Taurage, and Vilnius districts. The methods of the study were geometrical modeling and applied graphics used for the quantitative determination of the ratios between the total zone area of the accessible primary healthcare institutions and the area of the respective municipal territory. The result of the study was the developed and proposed technique allowing for the evaluation of the spatial accessibility of primary healthcare institutions. The proposed technique of the evaluation of the spatial accessibility of primary healthcare services may be valuable in solving the problems of the development of primary healthcare institutions primarily in the rural regions of Lithuania. The quantitative expression of the evaluation could be used in decision-making related to investments into the development of the primary healthcare institution network in different administrational units of the country. The method of geometrical modeling involving the application of digital graphics may create preconditions for the creation of the geographical information system of the primary healthcare institution network in Lithuania.

Unlabelled: The article AIMS to evaluate mortality from external causes in Lithuania in 1990 and in 1997 and influence of age and gender on it., Material and Methods: The primary data of official demographic statistics were used for analysis, after adjustment by age - European standard. Four external causes of death (suicides, homicides, traffic accidents and all external causes) were examined. Years of potential life lost (YPLL) due to premature death from external causes were calculated. THE RESULTS obtained showed that age adjusted male suicides mortality increased by 7.7%, from homicides - by 3.0% and from all external causes - by 3.2% per year. Female suicide mortality increased by 5.9%, from homicides - by 1.7% and from all external causes increased by 2.0% per year. Male traffic accidents decreased approximately by 4.8% and those of females approximately 5.0% per year., Conclusions: Males had higher mortality in almost all age groups. Male suicides and all external causes mortality increased from 10-14 years to maximum at the age of 50-54 years and then decreased. Female mortality from these two reasons from 10-14 years increased with age. Maximal female homicide mortality was found at the age of 35-49 years. Male traffic accident mortality at the age of 20-24 years and that of females at the age of 10-14 and 20-29 years increased from 1990 to 1997 despite decline in other age groups. The YPLL per 100000 due to all external causes increased from 4598 in 1990 to 5297 in 1997 for males and from 940 to 1106 for females.

To assess the relation between air pollution with airway irritants, including sulfuric acid and lung cancer, a case-control study was performed near an industry producing sulfuric acid and fertilizers in Kedainiai county, central Lithuania. The county had the highest lung cancer rates of the country among men. Between 1967 and 1973, the levels of sulfuric acid exceeded 500 microg/m(3) within 2 km of the industry and 100 microg/m(3) more than 5 km away. A total of 277 men who were diagnosed as having lung cancer during 1981-1991 in Kedainiai county were included as well as 1,108 population controls. Information on residential history since 1960, smoking habits, occupations and workplaces during lifetime was obtained from questionnaires mailed to next-of-kin. The relative risk of lung cancer associated with living within approximately 5 km from the plant was 1.02 (95% CI: 0.76-1.38) compared to those who had never lived in this area. No relation with distance or duration of residence was observed. Furthermore, workers at the plant did not have an increased lung cancer risk. The relative risk of lung cancer associated with smoking was 21.2 (95% CI: 7.51; 60.1) for current smokers and 14.0 (95% CI: 4.88; 40.3) for exsmokers. The duration of smoking, a low age at start and amount of cigarettes smoked daily were positively associated with lung cancer risk. Smoking levels appeared more pronounced among study controls than in the rest of the country. Our study could not confirm earlier evidence of an association between exposure to airway irritants, such as sulfuric acid and lung cancer. Smoking is the major determinant of the risk of lung cancer in men in Kedainiai county. It is probable that higher smoking rates constitute the main reason for the increased lung cancer risk among men in this area., (Copyright 2002 Wiley-Liss, Inc.)

Introduction: The purpose of this study was to determine the reasons of the queues, which patients meet in clinic and to determine the spent time of patients in different places of clinic. We wanted to figure out the opinion of patients about the work of the personnel, to find the ways of reducing the queues in the clinic., Methods: Study was done in November 2000-January 2001. Total or 1000 questionnaires were given to every third visitor over the age of 16. After return of 67.8% of questionnaires, 222 new questionnaires were sent to people, who didn't answer the first time. The overall response rate was 77.8%; 40 questionnaires were inapplicable for study, therefore a sample of 738 respondents was studied. Statistic data analysis was made using SPSS for Windows. The differences between respective indexes were assumed as statistically significant, then the mistake probability was p < or = 0.05., Results: The aim of our study--to determine the time spent in different places of clinic, and to figure out patient's opinion about work of the personnel. In registry office every patient spent on average 16 minutes. Every patient spends on average 30 minutes waiting to doctor. Consultations via telephone different groups of respondents evaluated differently: the older the patient, the worse his attitude towards consultation. Besides the fact, that 40% of elderly respondents are benevolent to consultations by the telephone, they assume, that they wouldn't use such kind of service. Waiting time for procedures, is on average 17 minutes. In all cases we can say, that the more patients face the queues, the more they think, that those queues should not exist. But the majority of respondents meet the queues very rarely, and most of them think, that the queues are imperative, or at least short waiting is inevitable.