Abstract
BackgroundThe health transition theory argues that societal changes produce proportional changes in causes of disability and death. The aim of this study was to identify long-term changes in main causes of hospitalization in working-age population within a nation that has experienced considerable societal change.MethodologyNational trends in all-cause hospitalization and hospitalizations for the five main diagnostic categories were investigated in the data obtained from the Finnish Hospital Discharge Register. The seven-cohort sample covered the period from 1976 to 2010 and consisted of 3,769,356 randomly selected Finnish residents, each cohort representing 25% sample of population aged 18 to 64 years.Principal FindingsOver the period of 35 years, the risk of hospitalization for cardiovascular diseases and respiratory diseases decreased. Hospitalization for musculoskeletal diseases increased whereas mental and behavioral hospitalizations slightly decreased. The risk of cancer hospitalization decreased marginally in men, whereas in women an upward trend was observed.Conclusions/SignificanceA considerable health transition related to hospitalizations and a shift in the utilization of health care services of working-age men and women took place in Finland between 1976 and 2010.
Highlights
Change in population-wide disease patterns is a major public health issue
Previous studies examining sex-specific trends in hospitalization have typically focused on specific diseases or diagnostic categories, including diabetes [2], stroke [3], heart failure [4,5], myocardial infarction [6,7,8], acute coronary syndromes [9], coronary heart disease [10], peripheral artery disease [11], asthma [12], chronic obstructive pulmonary disease [13], and carpal tunnel syndrome [14]
The risk of hospitalization for mental and behavioral disorders decreased slightly (HR 0.63; 95% confidence intervals (95% CI): 0.61, 0.66 in 2006–2010 in men and hazard ratios (HR) 0.81; 95% CI: 0.78, 0.85 in 2006–2010 in women)
Summary
Change in population-wide disease patterns is a major public health issue. Information on sex-specific patterns is important as different strategies may be needed for women and men. Research on sex-specific national trends in all-cause hospitalization and hospitalization for main diagnostic categories is rare and information on long-term trends is lacking. In Germany, Nowossadeck [15] analyzed changing rates of hospitalization for individual diagnoses between 2000 and 2009 and found increased rates for congestive heart failure and diseases for spine and back; whereas the hospitalization rates for ischemic heart disease, cerebrovascular diseases and certain cancers decreased. There were notable differences; lung cancer hospitalizations decreased in men but sharply increased in women [15]. The aim of this study was to identify long-term changes in main causes of hospitalization in working-age population within a nation that has experienced considerable societal change
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