title: Regional inequalities of hospital morbidity and associations with mortality in Lithuania.
abstract: OBJECTIVE
  In Lithuania, hospitalization was planned to be reduced with the approval of the national healthcare restructuring program. The aim of this study was to describe regional inequalities of hospitalization and hospital morbidity in Lithuania and to associate them with mortality in the regions.
  
  
  METHODS
  Routine hospital discharge data of Lithuanian hospitals, reimbursed by the Compulsory Health Insurance Fund and registered in database SVEIDRA, was used. Age-adjusted general hospitalization and hospital morbidity rates (per 1000 population) due to cardiovascular diseases (CVD), malignant neoplasms and external causes were calculated. Contribution of diseases, causing major public health problems, to general hospitalization was evaluated by analysis of components. Association of general hospitalization or hospital morbidity and mortality of respective causes was evaluated using non-parametric Spearman correlation.
  
  
  RESULTS
  General hospitalization and hospital morbidity of CVD, malignant neoplasms and external causes had increased from 2005 to 2011. Inequalities of hospitalization and hospital morbidity existed between regions of Lithuania. In Šiauliai, Klaipėda, Utena and Panevėžys regions, general hospitalization remained higher than national level. In Marijampolė, Alytus and Kaunas regions, general hospitalization became lower than Lithuanian average. There was no statistically significant correlation between variation in hospitalization and mortality rates in the regions.
  
  
  CONCLUSIONS
  Despite national efforts to decrease hospital care, our study detected the failure of hospitalization reduction and revealed an increase of hospitalization with the existing regional inequalities in Lithuania.
authors.affiliation: Department of Health Management, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. Electronic address: skirmante.jureviciute@lsmuni.lt.
authors.forename: Skirmantė
authors.initials: S
authors.lastname: Jurevičiūtė
authors.affiliation: Department of Health Management, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Ramunė
authors.initials: R
authors.lastname: Kalėdienė
mesh_terms: D005260:Female; D054625:Healthcare Disparities; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D009017:Morbidity / Q000639:trends*
keywords: Hospital care; Hospital morbidity; Hospitalization; Regional inequalities