title: Epidemiology of asthma in Poland in urban and rural areas, based on provided health care services.
abstract: BACKGROUND
  Asthma is a serious health and social problem, also in Poland. The epidemiological data indicate that the problem of asthma concerns approximately 4 million people in Poland, whereas almost approximately 70% of them have no diagnosis and are not aware of their illness, and on the other hand in 39% of persons who declared the diagnosis of asthma in a survey the diagnosis was negatively verified (overdiagnosis of asthma). So far, no detailed comparative studies for asthma incidence rate in urban and rural areas were conducted in Poland. The aim of the study was to analyze patients with asthma in Poland in the years 2008-2012, with regard to province and type of commune (rural/urban).
  
  
  METHODS
  The study used data from National Health Fund (NFZ) - reported by health care providers regarding the patients diagnosed with asthma. Using structured query language (SQL) a set of patients was selected and created, for whom at the same time ICD-10 code: J45.X-bronchial asthma was reported. In order to estimate the number of patients with asthma we used the PESEL social security number as a unique identifier of the patient. Code of the patient's commune of residence in conjunction with the Central Statistical Office data formed the basis for the division of municipalities into urban and rural areas. The analysis of asthma incidence trends in Poland was performed on the basis of health services provided to patients. The analysis was performed by using the Statistica 10 software using a negative binomial regression model.
  
  
  RESULTS
  In 2009 a significant increase in the number of patients with asthma was observed compared with the previous year, whereas after 2009 the number of patients diagnosed with asthma remained relatively constant. A significant increase of predominance of women among asthma patients in recent years can be noticed: from 107% in 2008 to almost 115% in 2012 (F:M ratio). Regardless of the analyzed year and the diagnosis the incidence rate remained constant: approximately 55-57% for urban areas and about 43-45% in rural areas.
  
  
  CONCLUSIONS
  The average prevalence rate for rural areas is significantly lower than for urban areas. The use of adjusted incidence rate leads to the conclusion that the number of sufferers in urban areas is higher (about 10%) of the number of sufferers in the rural areas. The results of the analysis are consistent with information from previous studies in Poland and in the world.
authors.affiliation: Department of Public Health, Faculty of Health Science, Medical University, Łódź. andrzej.sliwczynski@nfz.gov.pl.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Śliwczyński
authors.forename: Melania
authors.initials: M
authors.lastname: Brzozowska
authors.forename: Petre
authors.initials: P
authors.lastname: Iltchew
authors.forename: Tomasz
authors.initials: T
authors.lastname: Czeleko
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Kucharczyk
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Jędrzejczyk
authors.forename: Karina
authors.initials: K
authors.lastname: Jahnz-Różyk
authors.forename: Michał
authors.initials: M
authors.lastname: Marczak
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*