Introduction:This paper aims to estimate the value-added loss attributable to premature deaths from breast, colorectal and lung cancer in Slovenia using a novel methodology using linked employer-employee data, enabling value-added decomposition by occupation-gender groups. Methods:The analysis is based on population-level microdata for the 2016-2022 period matched from several sources. Premature mortality costs are estimated using occupation- and gender-specific output losses rather than assuming uniform productivity across working-age individuals. We approximate intangible capital using each firm's occupational and gender structure and estimate productivity losses due to premature mortality by specific occupation, revealing differences in the economic footprint of different cancer types. Results:On average, the loss of value added from a premature death due to colorectal cancer is between €352,000 and €392,000, from lung cancer, on average, between €150,000 and €178,000 and from breast cancer, around €436,000. In total, given that Slovenia's GDP in 2024 was around €66 billion (€52 billion at constant 2015 prices), the total value-added loss associated with these three cancer types amounted to about 0.5% of Slovenia's 2024 GDP. Over the study period, premature mortality attributable to these cancers translated into an estimated cumulative (current and future) GDP loss of roughly €371 million. Conclusions:Results indicate that notable reductions in indirect costs could be achieved in Slovenia through efficient and effective measures to manage the burden of cancer, including cancer screening programmes, other primary prevention approaches, timely access to diagnostics and treatment, and return-to-work policies.
Introduction:Osteoporosis is a common metabolic bone disease that increases fracture risk, particularly among older adults, and imposes a substantial global burden. Despite advances in risk assessment and treatment, a large treatment gap remains, with many high-risk individuals not receiving care. Methods:We conducted a systematic review of English-language studies published up to April 2025, identified through searches in multiple databases (PubMed, Scopus, Web of Science, ScienceDirect, Europe PMC). 43 studies were included. Due to the heterogeneity of study designs and treatment gap definitions, a narrative thematic synthesis was performed. Results:Reported treatment gap estimates varied widely (38.8-94.6%) across countries and study populations. Lower treatment rates were associated with patient factors (male sex, lower socio-economic status, comorbidities) and healthcare system factors (limited physician awareness, institutional barriers, poor interprofessional communication). Higher treatment rates were associated with older age, family history of osteoporosis, prior diagnosis or bone mineral density testing, and participation in structured care programmes. Conclusions:Substantial global treatment gaps in osteoporosis care persist, particularly following fragility fractures. These gaps arise from multiple patient, physician, and system-level factors, with persistent disparities by sex, ethnicity, comorbidities, and socio-economic status. Findings highlight the need for standardised definitions of the treatment gap and suggest areas for future research and intervention development.
Introduction:Ill-defined deaths (IDDs) are deaths assigned non-specific or insufficiently informative causes that do not identify a distinct underlying disease or injury. They reduce the accuracy of mortality statistics. In Slovenia, the overall proportion, structure and distribution of IDDs have not yet been comprehensively evaluated. This study examined the most frequent IDDs and their demographic and regional patterns in Slovenia from 2010 to 2021. Methods:Individual-level mortality data from 2010 to 2021 were analysed. Deaths assigned ICD-10 codes denoting vague/non-specific conditions were classified as IDDs using the GBD 2019 cause list. Frequencies and distributions were examined overall and by sex, age group, and regions. Results:Of 243,166 deaths, 53,020 (21.8%) were IDDs. The proportion was higher in females and increased with age. Heart failure was the most frequent IDD and showed a distinctly higher share among females. Other common IDDs included unspecified stroke, unspecified lower respiratory infections, unspecified cancers, and R99-coded (Ill-defined and unknown cause of mortality) deaths. Clear variation in age groups was observed: poisoning-related IDDs were concentrated in young adults, R99 predominated in working age groups, and cardiovascular-related IDDs dominated in older adults. Regional distributions of the top categories of IDDs resembled the national one, except for unspecified cardiomyopathy, which appeared prominently in two north-eastern regions. Conclusions:Heart failure is the major contributor to IDDs in Slovenia, with demographic and regional variation. The findings highlight the need to strengthen death certification and improve the quality of mortality data to support burden-of-disease analyses.
Introduction:The high incidence of violence directed at healthcare workers is a major public health concern. The purpose of the study was to investigate the incidence of various forms of aggression at the University Psychiatric Clinic Ljubljana from 2018 to 2021, stratified by perpetrator gender, time of occurrence, and ward type. Methods:Data were collected using completed standardised forms (the OAS and BVC scales) during 2018-2021. A total of 4,392 episodes of various forms of violent behaviour were detected. Descriptive and bivariate statistics were performed using IBM SPSS. The level of statistical significance was set at p < 0.05. Results:The total aggression score was significantly higher in men (t = 8.471, p < 0.001). Wards differed in the forms of aggressive behaviour (p < 0.05). The total aggression score (AS score) was significantly higher during the evening shift than during the morning shift (p < 0.001) or the night shift (p = 0.037). A positive correlation was found between OAS and BVC scores (r = 0.672, p < 0.001). Conclusions:Our findings are consistent with previous international research, confirming that violence remains a common challenge in psychiatric inpatient settings. The positive association between BVC and OAS scores supports the complementary use of both instruments for violence risk assessment and incident evaluation. In line with previous research, the results support recommendations that violence prevention should extend beyond assessment tools and staff training to include a culture of safety and organisational commitment to preventing and managing aggression.
Introduction:We assessed inpatient burden, costs, demographics, comorbidity patterns, and outcomes of peripheral artery disease (PAD) in Slovenia. Methods:We included patients hospitalised for PAD (primary diagnosis, International Classification of Diseases, 10th revision, code I70.2-I70.9) in Slovenia between January 1st, 2015, and December 31st, 2022. We estimated crude and age-standardised hospitalisation rates, hospitalisation reimbursement costs, patient characteristics (age and sex distribution, disease severity and prevalence of comorbidities), uptake of revascularisation, major amputations and in-hospital mortality. Results:We included 15,978 patients (60% men, median age 72 years, 32% chronic limb-threatening ischaemia) with 27,139 hospital episodes, yielding a mean of ~3,400 hospitalisations per year (hospitalisation rate 161 per 100,000/year). Median direct cost (inflation-adjusted to 2025) per hospital episode was €3,177, yielding total costs of €10.8 million/year. The most common comorbidities were arterial hypertension (35%), dyslipidemia (21%) and diabetes mellitus (19%), with a significantly higher prevalence in patients with chronic limb-threatening ischaemia. During the observation period, revascularisation procedures increased from 77.5% to 80.2%, while major amputations decreased from 13.2% to 7.9%, and mortality decreased from 5.0% to 3.3%. Conclusions:The inpatient burden of PAD is considerable in Slovenia. Patients hospitalised for PAD have a high burden of comorbidities, especially when presenting with chronic limb-threatening ischaemia; nonetheless, in-hospital major amputations and mortality decreased substantially over the last decade.
