CATCHING GAPS WITH HEALTHCARE MAPS CARDIOLOGY AND ONCOLOGY A Map of Healthcare Needs for Mazowieckie Voivodeship – Cardiology 1 CATCHING GAPS WITH HEALTHCARE MAPS CARDIOLOGY AND ONCOLOGY Table of Contents Demographic and Epidemiological Aspects ...................................................................................... 3 1.1 Voivodeship Population Breakdown .............................................................................................. 3 1.2 Demographics in counties ............................................................................................................. 9 1.3 New Cases of Cardiac Diseases ................................................................................................. 15 1.4 Mazowieckie Voivodeship in the national context ....................................................................... 18 1.5 Deaths due to cardiac diseases in the region ............................................................................. 22 1.6 Hospital morbidity: cardiac diseases in adults............................................................................. 32 1.7 Hospital morbidity: cardiac diseases in children ......................................................................... 39 Status and Use of Resources: the Analysis ..................................................................................... 42 2.1 Hospitalisation ............................................................................................................................. 43 2.1.1 General Information .............................................................................................................. 43 2.1.2 Adult Cardiology ................................................................................................................... 57 2.1.3 Paediatric Cardiology ........................................................................................................... 74 2.1.4 Adult Cardiac Surgery .......................................................................................................... 77 2.1.5 Paediatric Cardiac Surgery................................................................................................... 82 2.2 Specialist Outpatient Care ........................................................................................................... 87 2.3 Primary Care (POZ) ..................................................................................................................... 92 2.4 Medical Staff ................................................................................................................................ 95 Healthcare Needs Forecasts ............................................................................................................ 107 3.1 Projected Population Breakdown for Mazowieckie Voivodeship............................................... 108 3.2 Projected demographics of counties (poviats) .......................................................................... 113 3.3 Incidence Forecast for the years 2015-2025 ............................................................................. 143 3.4 Adult Cardiac Surgery Forecast ................................................................................................ 150 3.5 Paediatric Cardiology and Cardiac Surgery Forecast ............................................................... 155 2 CATCHING GAPS WITH HEALTHCARE MAPS CARDIOLOGY AND ONCOLOGY Part I Demographic and Epidemiological Aspects In 2013, Mazowieckie Voivodeship was inhabited by 5.3 million people, i.e. by 13.8% of all population of Poland (population as at 31 December 2013). It was the largest Polish region in terms of population (Figure 1). Figure 1: Population in Poland by voivodeship (2013) millions Share in population in general Source: compiled based on data provided by the Central Statistical Office The population of Mazowieckie Voivodeship was, in demographic sense, older than the population of Poland in general. In 2013, the region was inhabited by almost as many as 820 thousand people aged 65 and more, which accounted for 15.4% of all population (Figure 2). This share was higher than the Poland's total (14.7 %). In turn, the region was inhabited by approx. 1.1 million young people (under 20 years old), which accounted for 20.7% of all population (more by 0.2 pp than the national share). The group aged 20-64 was formed by 3.4 million people, which accounted for 63.9% of all population, and its share for Mazowieckie Voivodeship was lower by 0.8 pp than for Poland in general (Figure 3). 3 Figure 2: Population structure according to sex and age for Mazowieckie Voivodeship (2013) Men (in thousands) Age group Women(in thousands) Surplus of men over women (in thousands) Surplus of women over men (in thousands) Source: compiled based on data provided by the Central Statistical Office 4 Figure 3: Population breakdown according to age group in Mazowieckie Voivodeship and in Poland (2013) Difference in relation to the breakdown of Poland: Greater share in the Greater share in Poland voivodeship Source: compiled based on data provided by the Central Statistical Office The analysis of population breakdown shows that there are more men then women aged below 30, and that in any other group there are more women than men (Figure 2). It is worth noting that in the group aged 30-39 there was also a surplus of women over men. The differences in the size of the population of women and men are the largest among the elderly (over 60 years of age) and they increase with age. It is related with higher mortality rate for men in Poland (cf. Figure 2, Figure 4). 5 Figure 4: Population breakdown according to sex and age for Mazowieckie Voivodeship and for Poland (2013) Difference in relation to the breakdown of Poland: Greater share in the Greater share in Poland voivodeship Source: compiled based on data provided by the Central Statistical Office The life expectancy of a newborn in Mazowieckie Voivodeship is slightly bigger than national one (Figure 5). In 2013, this parameter oscillated at 73.4 years for boys and 81.6 years for girls. It is worth noting that it was higher by, respectively, 0.3 and 0.5 year than the corresponding values for Poland. As far as male newborn life expectancy is concerned, Mazowieckie Voivodeship placed itself at 6th position in Poland, and as far as female newborn life expectancy is concerned - at 4th position (among regions arranged from the highest to the lowest life expectancy for both sexes). The situation is quite different in the case of life expectancy of +60-year-olds: it oscillated at 19.5 years for men and 24.2 for women. The parameter is higher for Poland in general by 0.6 year for men and 0.3 year for women. The region placed itself at 3rd position in the case of men and at 5th position in the case of women (Figure 6). 6 Figure 5: Average life span by voivodeship (2013) Female Male Years Source: compiled based on data provided by the Central Statistical Office Figure 6: Average life expectancy of a 60-year-old by voivodeship (2013) Years Female Male Source: compiled based on data provided by the Central Statistical Office 7 In 2013, over 55,400 live children were born in Mazowieckie Voivodeship, and the fertility rate (that is the number of live births per 1,000 women of childbearing age, i.e. 15-49 years of age) exceeded 43 children per one thousand women of childbearing age, placing the voivodeship first in Poland (in descending order) as far as this index is concerned. This result exceeds the national figure by nearly 4 children per one thousand women of childbearing age (Figure7). Figure 7: Fertility rate and live births by voivodeship (2013) 49 - Thousands Births Births per one thousand women aged 15 Difference versus average value for Mazowieckie Voivodeship Number of births Higher average value in the voivodeship Higher value in the county In 2013, the population density in Figure 8: Population density by voivodeship Mazowieckie Voivodeship was 150 people (2013) per km2, so that the Voivodeship ranked third in terms of this index (in descending order) (Figure 8). Population per 1 km2 Source: compiled based on data provided by the Central Statistical Office 8 1.2 Demographics in counties According to the administrative division, Mazowieckie Voivodeship is divided into 42 counties, including 5 city counties. In 2013, the highest number of people inhabited Warsaw (over 1.7 million), which accounted for 32.4% of all Mazovian population. In turn, the lowest number of people (32 thousand) in 2013 inhabited Łosice county, which constituted 0.6% of all Mazovian population. (Figure 9). Figure 9: Population in the counties of Mazowieckie Voivodeship (2013) Thousands Share in population in general Source: compiled based on data provided by the Central Statistical Office The results of the analysis of the population structure by sex and age in some of the counties (poviats) of Mazowieckie Voivodeship are similar to those described for the voivodeship as a whole. In certain counties, the surplus in the population of men over women aged under 60 years old is observed. The surplus of women over men dominates the remaining age groups and grows with age. In some counties, this surplus of women is visible in much younger age groups, i.e. over 30 or 34 years old (e.g. in Siedlce City or Pruszków County). In other, the difference is visible only in older age groups, i.e. over 60 years old (e.g. in Ostrów Mazowiecka County or Siedlce County) It is worth