Hospital Use in

Poland and the

United States

This report presents national statistics on

hospital use from the U.S. National Hospital

Discharge Survey and the Polish General

Hospital Morbidity Study. Comparisons are

made of discharge rates, average lengths of

stay, rates of patient care days, and fatality

rates by sex, age, and diagnostic category.

The similarities and differences between the

two countries in population characteristics,

health status, health services systems, and

health care resources are also descyibed.

Comparative International VW and

Health Statistics Reports

Series 5, No. 2

DHHS Publication No. (PHS) 88–1 478

U.S. Department of Health and Human

Services

Public Health Service

Centers for Disease Control

National Center for Health Statistics

Hyattsville, Md.

March 1988
The National Center for Health Statistics has obtained permission from the

copyright holders to reproduce certain quoted material in thts report. Further

reprodutilon of this material is prohhitad without specific permission of the

copyright holders. All other material contained in the report is in the public

domain and may be used and reprinted without special permission; citation as

to sourc8, however, is appreciated.

National Center for Health Statistics, L. J. Kozak, W. E. Bacon, M.

Krzyzanowski, and B. Wojfyniak. 1988. Hospital use in Poland and the

United States. Mtal arrd Haaith Statiatica. Series 5, No. 2. DHHS Pub. No

(PIIS) 88-1478. Washington: U.S. Government Printing Office.

UbrarYofcowe$aca ~Daia “

Kozak, Lola Jean.

Hospital use in Poland and the United States.

(Vital & health atatiiics. Series 5, Comparative international vital and haalth

statistics rapxts ; no. 2) (DHHS publ&Mon ; no. (PHS) 88-1478)

1. Hospital uOlization-Poland-SMatica. 2. Ho@tal utilization-United

States-statistics. 3. Medical cara-poland. 4. Mediil care-Unitad States. 5.

PUMIC health-Poland. 6. Public healfh-United States. 1. National Center for

Health Stsdistii (U.S.) Il. Title. Ill. series: Vial and health statiatii.

Series 5, Comparative international vital and health statistics refmrts ; no. 2. IV.

series DHHS publication; no. (PHS) 88-1478. [DNLM: 1. Hoapitalautilizafiin-+oland. 2. Hospitals--+Ailizatiin-Unitad States. W2 A N1 48ve no.

2]

RA989.P55G3S t 986 362.1 ‘1‘0S438 87-24790

ISBN 0-8408+-3

For sale by the Superintendent of Documents, U.S. Government Printing Ottke, Washington, D. C!. 20402

-——
National Center for Health Statistics

Manning Feinleib, M.D., Dr.P,H., Director

Robert A. Israel, Deputy Director

Jacob J. Feldman, Ph. D., Associate Director for Analysis

and Epidemiology

Gail F. Fisher, Ph. D., Associate Director for Planning and

Extramural Programs

Peter L. Hurley, Associate Director for Vital and Health

Statistics Systems

Stephen E. Nieberding, Associate Director for Management

George A. Schnack, Associate Director for Data Processing

and Services

Monroe G. Sirken, Ph. D., Associate Director for Research

and Methodology

Sandra S. Smith, Information O@cer

Division of Health Care Statistics

W. Edward Bacon, Ph. D., Director

Joan F. Van Nostrand, Deputy Director

Mary Moien, ChieJ Hospital Care Statistics Branch

Manoochehr K. Nozary, Chiej Technical Services Branch

Cooperation ufthe U.S. Bureau ofthe Census

Under the legislation establishing the National Health Survey, the Public Health

Service is authorized to use, insofar as possible, the services or facilities of other

Federal, State, or private agencies.

In accordance with specifications established by the National Center for Health

Statistics, the U.S. Bureau of the Census, under a contractual arrangement,

participated in planning the survey and collecting the data.
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...1

Highlights, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...2

Genemlcomparisons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Health status , ,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Healthcaresystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Healthresources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Datasources . . . . . . . . . . . . . . . . . . . . . . . . . .“. . . . . . . . . . . . . . . . . . . . . . . . . . . . IO

Hospitalusecomparisons. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Discharge rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Average lengthsofstay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Ratesofpatientcaredays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...13

Diagnosisby ageandsex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...14

Fatalityrates . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Discussion, ,, .,,...... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...39

References , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

Listofdetailedtables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Appendixes

I. Sourcesofdata , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

H. Technicalnotesonmethods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

HI. Definitionsofterms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .’. . . . . . . . . . 78

Listof text tables

A.

B.

c.

D,

E.

F.

G.

H,

J.

K.

L.

M.

N.

0!

Percent distribution ofhouseholds bysize: Poland, 1978, andthe United States, 1980 . . . . . . . . . . . . . . .

Percent of thepopulation inthelabor force bysexmdage:Polmd, 1978, rmdthe United States, 1980 . . . . . .

Percent distribution of theemployed labor force byindust~: Poland andthe United States, 1980 . . . . . . . . .

Percent distribution ofphysicims byspecialty: Polmdand the United States, 1980 . . . . . . . . . . . . . . . .

Percent distribution ofgeneral andspecial~ hospitals by bedsize: Polmdand the United States, 1980 . . . . . . .

Selected chmactetistics ofnursing andrelated cmehomes: Poland andthe United States, 1980. . . . . . . . . . .

Number ofcetiain inpatient facilities andaverage bedsize, bytypeof facility :Poland, 1980 . . . . . . . . . . . .

Number ofcetiain inpatient facilities andaverage bedsize, bytypeof facility : United States, 1976 . . . . . . . . .

Rate and percent distribution of inpatients discharged from hospitals by age, according to sex: Poland and the

UnitedStates, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ratio ofdischwge rates inthe United States totisch~ge rates in Polmd, byage and sex, 1980 . . . . . . . . . .

Average length of stay in days for inpatients discharged from hospitals in Poland and the United States, and ratio

of average length ofstayin Pokmd to average length ofstay in the United States, byage and sex, 1980 . . . . . .

Rate and percent distribution ofpatient care days for inpatients discharged from hospitalsby age, accordingto sex:

PolandandtheUnitedStates,1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ratio of therate ofpatient cmedays in Poland totherate inthe United States, byagemd sex, 1980 . . . . . . .

Rate ofdischarge forinpatients bydiagnostic chapter andsex: Polmdand the United States, 1980. . . . . . . . .

3

5

5

8

8

9

9

9

11

13

13

15

15

18

.

Ill
P.

Q.

R.

s.

T.

u.

w.

Y.

z.

AA.

BB.

cc.

DD.

EE.

FF.

GG.

HH.

JJ.

KK.

LL.

Average length of stay for discharged inpatients by diagnostic chapter and sex: Poland and the United States,

1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of patient care days for discharged inpatients by diagnostic chapter and sex: Poland and the United States,

1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of discharge for inpatients under 1 year of age by diagnostic chapter and sex: Poland and the United States,

1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Average length of stay for discharged inpatients under 1 year of age by diagnostic chapter and sex: Poland and the

UnitedStates, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of patient care days for discharged inpatients under 1 year of age by diagnostic chapter and sex: Poland and

theUnitedStates, 1980. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of discharge for inpatients 1–14 years of age by diagnostic chapter and sex: Poland and the United States,

1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,

Average length of stay for discharged inpatients l–14years of age by diagnostic chapter and sex: Poland and the

UnitedStates, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of patient care days for discharged inpatients l–14years of age by diagnostic chapter and sex: Poland and the

UnitedStates, 1980, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of discharge for inpatients 15-44 years of age by diagnostic chapter and sex: Poland and the United States,

1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Average length of stay for discharged inpatients 154.4 years of age by diagnostic chapter and sex: Poland and the

UnitedStates, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of patient care days for discharged inpatients 15-44 years of age by diagnostic chapter and sex: Poland and

theUnitedStates, 1980. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of discharge for inpatients 45-64 years of age by diagnostic chapter and sex: Poland and the United States,

1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Average length of stay for discharged inpatients 45–64 years of age by diagnostic chapter and sex: Poland and

theUnitedStates, 1980..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of patient care days for discharged inpatients 45-64 years of age by diagnostic chapter and sex: Poland and

theUnitedStates, 1980. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of discharge for inpatients 65 years of age and over by diagnostic chapter and sex: Poland and the United

States, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Average length of stay for discharged inpatients 65 years of age and over by diagnostic chapter and sex: Poland

andtheUnitedStates, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of patient care days for discharged inpatients 65years ofage and overby diagnostic chapter andsex: Poland

andtheUnitedStates, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate and percent distribution of inpatients discharged dead by age, according to sex: Poland and the United States,

1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of inpatients of all ages discharged dead by diagnostic chapter and sex: Poland and the United States,

1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rate of inpatients under 65 years of age discharged dead by diagnostic chapten Poland and the United States,

*non

170U . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

MM. Rate ofinpatients65 years of age and over discharged dead by diagnostic chapter and sex: Poland and the United

. . . . . . . . . .

States, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

List of text figures

1,

2.

3.

4.

5.

6.

7.

8.

9.

10.

iv

Percent distribution of thepopulation byage, according tosex:Polmd mdthe United States, 1980 . . . . . . . . .

Percent distribution of the population 15 years of age and over by marital status, according to sex: Poland and the

UnitedStates,1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent distribution ofpopulationby level of education: Poland andthe United States, 1978 . . . . . . . . . . . .

Percent ofpopulation inlabor force bysex:Poland andthe United States . . . . . . . . . . . . . . . . . . . . . .

Death rates perlOO,OOOpopulation byage:Poland andthe United States, 1980 . . . . . . . . . . . . . . . . . . .

Discharge rates byage:Poland andthe United States, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Average length ofstayby age: Poland andthe United States, 1980 . . . . . . . . . . . . . . . . . . . . . . . .

Rate ofpatient c~edays byage:Poland andthe United States, 1980 . . . . . . . . . . . . . . . . . . . . . . . .

Discharge rates forleading diagnostic categories: Poland andthe United States, 1980 . . . . . . . . . . . . . . . .

Percent distribution of patients under 1 year of age, excluding healthy newborn infants, discharged from hospitals, by

diagnostic category :Poland andthe United States, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18

19

19

21

21

23

2?!

24

25

26

27

28

29

30

31

33

33

34

36

36

38

4

5

6

6

7

12

14

16

17

20
11. Discharge rates for children 1–14 yemsofage forselected diseases of therespirato~ system: Polmdand the United

States, 1980, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

12. Discharge rates for patients 154yews ofagefor selected diagnoses: Poland mdthe United States, 1980 . . . . . 26

13, Discharge rates for patients 45-64 years of age for selected diagnoses, by sex: Poland and the United States,

1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

14. Discharge rates for patients 65 years of ageandover for selected diseases of the circulatory system: Poland and the

UnitedStates, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

15. Percent ofalldeaths that occur inhospitals byage:Poland andthe United States, 1980 . . . . . . . . . . . . . . . 35

16. Fatality rates forselected conditions: Poland andthe United States, 1980 . . . . . . . . . . . . . . . . . . . . . . 37

Symbols

..- Data not available

. . . Category nonapplicable

Quantity zero

0.0 Quantity more than zero but less than

0.05

z Quantity more than zero but less than

500where numbers are roundedto

thousands

* Figure does not meet standardsof

reliabilityor precision

# Figure suppressed to comply with

confidentiality requirements
Hospital Use in Poland and

the United States

by Lola Jean Kozak and W. Edward Bacon, Division of Health

Care Statistics, US. Nationai Center for Heaith Statistics, and

Michal Krzyzanowski and Bogdan Wojtyniak, Department of

Medical Statistics, Polish Nationai Institute of Hygiene

Introduction

Marked differences exist among countries in the way

health services are organized and provided. Fueled at least

partly by current concerns about the high cost of health care,

there have been numerous cross-national studies in recent

years comparing health delivery systems (Maxwell, 1981).

By comparing the delivery of health care across countries,

new approaches may be discovered for providing health care

in a more efficient manner. Particularly important are crossnational comparisons of systems in which health services are

provided and financed in different ways, but the health status

of the populations being compared does not vary markedly.

Studies comparing hospital use among countries have been

particularly popular partly because hospital care typically represents a large proportion of total health care costs but also

because hospital statistics are generally more available than

are data on other components of health care. Further, it is

often assumed that hospital statistics are more comparable

from country to country than are statistics on other components

of health care, However, a major problem with most crossnational studies including comparisons of hospital use has

been the comparability of data sources. Typical problems

in comparing hospital use include differences in the way facilities are classified, differences in coverage (particularly for

long-term care and private hospitals), differences in the definition of use measures such as hospital discharge and bed day,

and differences in disease classification and coding systems

(NCHS, 1980a),

The use of hospitals in Poland and the United States

was compared for three main reasons, First, few international

comparisons of hospital care have involved countries of Eastern

Europe. Second, Poland and the United States organize and

finance health care in very different ways, yet both are developed, industrial countries and do not appear to differ markedly in the health status of their respective populations. Third,

both countries collect very comparable national data on hospital

use.

This report is organized into three main sections. The

first section deals with a general description of the similarities

and differences between the two countries in population characteristics, measures of health status, the health care system,

and health resources. This section focuses on factors that

are known to affect hospital use and is based on 1980 statistics

wherever possible. Unless otherwise noted, the Polish data

in this section were taken from the Demographic Yearbook

(Glowny Urzad Statystyczny, 1982a) or the Statistical Yearbook of Health Care (Glowny Urzad Statystyczny, 1982b)

published by the Polish Central Statistical OffIce. The sources

of the U.S. data, except as otherwise noted, were the Statistical

Abstract of the United States (U.S. Bureau of the Census,

1985), or Vital Statistics of the United States (NCHS, 1985a).

The second section describes the two sources of data

on hospital use—the 1980 Polish General Hospital Morbidity

Study and the 1980 National Hospital Discharge Survey. The

third section reports the results of the comparisons of discharge

rates, average lengths of stay, rates of patient care days,

and fatality rates between Poland and the United States, by

age, sex, and diagnostic category.
Highlights

●

●

●

●

●

U.S. patients were discharged from the hospital at a 62-

percent higher rate than Polish patients.

Higher U.S. discharge rates held for patients of all ages

except those 5–14 years of age, and the U.S. discharge

rate for patients 85 years of age and over was four times

the Polish rate.

The average length of stay was more than twice as long

in Poland as in the United States.

Total hospital use, as measured by rates of patient care

days, was 37 percent higher in Poland than in the United

States. Children used hospital care at a higher rate in

Poland, but patients 75 years of age and over used more

hospital care in the United States.

The diagnostic category responsible for the most discharges in Poland was diseases of the respiratory system,

but diseases of the circulatory and digestive systems were

leading diagnostic categories in the United States.

Although U.S. discharge rates were higher for most diagnostic categories, the Polish rate was higher for infectious

and parasitic diseases because of much higher discharge

rates for tuberculosis and hepatitis.

For infants under 1 year of age, diseases of the respiratory

system accounted for 46 percent of discharges in Poland,

but certain conditions originating in the perinatal period

accounted for 50 percent of dkcharges in the United

States,

The discharge rate for circulatory diseases was higher

for infants under 1 year of age in the United States,

but higher for children 1–14years of age inPoland.

Children 1–14 years of age were more often hospitalized

in Poland for acute respiratory infections, pneumonia,

and bronchitis and emphysema. In the United States they

were more often hospitalized for chronic disease of tonsils

and adenoids, and asthma.

●

●

●

●

●

●

●

●

●

●

For diseases of the ear and mastoid process, U.S. children

1–14 years of age had a discharge rate four times that

of Polish children, but the Polish average length of stay

was more than seven times the U.S. average.

Appendicitis was a more frequent diagnosis in Poland

than in the United States for patients 1–14 and 154.4

years of age.

In Poland, the discharge rate for patients 15-44 years

of age with gastric and duodenal ulcers was three times

the rate in the United States.

U.S females 15-44 years of age had a discharge rate

10times that of Polish females for disorders of the breast,

U.S discharge rates for diabetes mellitus, rheumatism, and

dislocations, sprains, and strains were from 2.6 to 13 times

Polish rates for the three age groups 15years and over.

The average lengths of stay for cataract for Polish patients

aged 45-64 years and 65 years and over were more than

seven times those for U.S. patients,

Polish rates of patient care days for the individual age

groups for bronchitis and emphysema were from 4 to

37 times U.S. rates.

For patients 65 years of age and over, the U.S. discharge

rate for acute cerebrovascular disease was three times

the Polish rate, but the Polish rate for atherosclerosis

was more than four times the U.S. rate.

One of every four Polish patients 85 years of age and

over was discharged dead, compared with one of every

eight U.S. patients.

Fatality rates were higher in Poland for most diagnostic

categories, but the rates were not very different in the

two countries for neoplasms.

Fatality rates for patients 65 years of age and over were

higher in the United States for infectious and parasitic

diseases and for respirato~ diseases.
General comparisons

Population

The Polish People’s Republic covers an area of approximately 120,700 square miles and lies primarily in the great

European lowland. In 1980, 35.6 million people lived in

Poland, or 295 persons per square mile. The population residing in the United States in 1980 was 226.5 million people,

but the population density was 64 persons per square mile.

Although the population density was much less in the United

States, the population tended to be concentrated in urban

areas. Only 26 percent of the U.S. population lived in rural

areas, compared with 41 percent of the Polish population.

Further, fewer than 3 percent of the U.S. population were

farmers, although 45 percent of the land was farmed. In

Poland, 23 percent of the population were considered farmers,

and 61 percent of the land was farmed.

Compared with the United States, the Polish population

is relatively homogeneous. Virtually all are white and of Polish

origin, and most are Roman Catholic. A relatively large part

of the U.S. population (17 percent) is not white, and residents

come from many ethnic backgrounds and hold different religious beliefs, People of European ancestry-primarily English,

German, and Irish-represent the larger ethnic groups. About

60 percent of the population are church members, with Protestants representing the largest religious body and Roman Catholics the next largest.

Comparisons of the age and sex structures of the Polish

and U.S, populations are presented in figure 1. Overall, the

age and sex structures of the two populations are fairly similar.

A larger proportion of the population in the United States

than in Poland is 85 years of age or older, and a larger

proportion in Poland is under 5 years of age. Also, a greater

proportion of males in the United States is 55 years of age

and older. Population data for the two countries are provided

in table 1,

Marital status of the two populations is shown in figure 2, (U.S. Bureau of the Census, 1981). Nearly the same

percents of men are either widowed or single in both countries.

Similarly, nearly the same percents of women in both countries

are either widowed or single. More males and females are

married in Poland and more are divorced in the United States,

but this would be expected given the cultural and religious

differences between the two countries.

Differences exist between the two countries in household

composition and size. In Poland, one or more families live

in 82 percent of the households, compared with 74 percent

in the United States, Average size of the family in family

households is about the same in the two countries, 3.3 persons

per household. In both countries, the vast majority of nonfamily “households are composed of one person. However, subfamilies are twice as likely to live in Polish households. One

in 20 family households has at least one related or unrelated

subfamily, compared with 1 in 40 family households in the

United States. Because of the greater proportion of family

households and subfamilies within households, household size

is larger in Pokmd—3. 1 persons, compared with 2.8 persons

in the United States. Table A shows the percent distribution

of households by number of persons.

Table A. Percent distribution of households by SQIX Poland, 1978, and

the United Ststea 1980

Size of household Poland Urrifed Stales

Percent of households

All households . . . . . . . . . . . . . . . . . .

I -person households . . . . . . . .

2-person households . . . . . . . . .

3-person households . . . . . .

4-person households . . . . . . . . . .

5-person households . . . . . . . . . . .

6-person households . . . . . . . . . .

7-person households . . . . . . . . .

100 100

17 23

22 31

23 17

21 16

10 8

4 3

3 2

The educational levels of the citizens of the two countrie@

differ, at least in terms of the number of years of schoo,

completed. In the United States, the median number of years

of school completed for persons 14 years of age and over

is 12.4 (U.S. Bureau of the Census, 1984). In Poland, three

of four persons 15 years of age and older have less than

a high school education. Figure 3 shows the percents of the

population having less, exactly, or more than a high school

education, for both Poland and the United States. Although

the U.S. population has completed more years of school on

the average, the educational systems in the two countries

diffeq therefore, the quality of the education received may

also differ.

The proportion of the population in the labor force is

slightly higher in Poland than in the United States, 67 versus

64 percent. However, as seen in figure 4, this difference

is due to the larger proportion of females in the labor force

in Poland. The proportion of males is the same in both countries. In the United States, about 5 percent of the population

is unemployed, which is defined as actively seeking work

or as being on a temporary layoff. Unemployment by this

3
Male

I

Female

•1

12zi

Poland

United States

20 10 0 10 20

.

Percent

F&ure 1. Percent distributionof the population by age, sccording to sex: Poland and the United States, 1980

definition does not exist in Poland. Table B shows the percent

of the population in the labor force by age and sex for Poland

and the United States (U.S. Bureau of Labor Statistics, 1983).

The percent of males 25 to 64 years of age in the labor

force is similar in the two countries. However, a greater

proportion of males under the age of 25 years are occupationally active in the United States, and a greater percent of

males 65 years of age and over are in the labor force in

Poland. The proportion of females in the labor force is greater

inPoland for all age groups over 25 years,

There also are differencesbetween the two countriesin

the distribution of the labor force by industry or occupation.

Table C indicates that about 1 in 4 members of the Polish

labor force is a farmer, compared with 1 in 25 members

of the United States labor force. On the other hand, substantially greater proportions of the labor force are employed

in trade and service industries in the United States than in

Poland. Caution should be observed in interpreting small differences in table C because of the different classification systems

used to group industries.

Healthstatus

The 1980 mortality statistics suggest that residents of

the United States are healthier than are residents of Poland.

Life expectancy at birth was 74 years in the United States,

4
Divorced 2%

Widowed 2% ~ }

Divorced 3%

\

Widowed 140/.+

Male Female

United

Widowed 3°A ~

Divorced 5%

Married 63%

Male

States

Widowed

Divorced 7%

\

12%+

Female

Figure2. Percent distribution of the population 15 yeare of age and over by marital status, according to sex Poland and the United States, 1980

Table C. Percent distributionof the employed labor force by industw

Poland and the United States, 1980

Industry Poland’ United States

Table B. Percent of the population in the labor force by eex and age

Poland, 1978, and the United States, 1980

Male Female

United United

Age Poland States Poland States

Percent of population

15-19 yearsl . . . . . . . . . . . . 29.0 60.5 21.1 52.9

20-24 years . . . . . . . . . . . . 82.2 85.9 68.4 68.9

25-34 years . . . . . . . . . . . . 96.6 95.2 69.6 65.5

35-44years . . . . . . . . . . . . 95.5 95.5 82.3 65.5

46-54years . . . . . . . . . . . . 89.7 91.2 75.0 59.9

55-64years . . . . . . . . . . . . 74.3 72.1 50.0 41.3

65yearsandover . . . . . . . . . 34.9 19.0 19.4 8.1

116-19 years for the United Statea.

NOTE: Thelakr force lnPoland iaallpersons 15yeara ofageadoverwho are

occupationally active. The labor force in the United Statea ia all persona 16 years of age and

over who are employed, actively aeeldngwork, or on a temporary layoff.

Total . . . . . . . . . . . . . . . .

Manufacturing and mining . . . . . . . .

Agricultureandforestry. . . . . . . .

Trade . . . . . . . . . . . . . . . . . . . . .

Construction . . . . . . . . . . . . . . . . . . .

Transportation and communication. . .

Finance, insurance, and real estate . .

Services . . . . . . . . . . . . . . . . . . . . . .

Education . . . . . . . . . . . . . . . . .

Health andsocial . . . . . . . . . . . . . . . .

Entertainmentand recreation . .

Other . . . . . . . . . . . . . . . . . . . .

Public administration . . . . .

Percent distribution

100 100

32 23

27 24

8 20

8 6

7 7

35 6

12 29

45 8

4 9

% 1

2 11

1 5

‘In Poland the Iatmrforce is all persons 15 years of age and over who are occupationally

active. All mamberaof the labor force are employed.

‘Includes tiaheriea.

‘Includeasommunal servicas.

afncludearesearch.

‘Includes culture and art.

5
❑ Poland

~ UnitedStates

76

139

—

Less than High school More than

high school high school

Level of education

lU.S. population ispersens aged 14 years and oven Polkhpopulatkmisparwns

15 years of age and over.

❑ Poland

❑ UnitedStates

77 77

59

Female

Sex

‘The Polish pqwlationi aallpersons 15 years ofage andover in 1978. The U.S

population is all noninstitutionafizedcivilisns 16 years of age and over In 1980

Figure 3. Percent dwtribution of population by level of aducatiin: Pokmd Fgure4. Percent ofpopulation inleborforce bysex Poland and the

and the United State% 1978

compared with 71 years in Poland. Females were expected

to live approximately 8 years longer than males in both countries. The overall mortality rate was somewhat higher in Poland

than in the United States (9.8 versus 8.8 per 1,000 population),

but the infant mortality rate was substantially higher (21.3

versus 12.6 per 1,000 live births), Death rates by age are

shown in figure 5. Rates were higher in Poland for all age

groups except for 15–24 years. U.S death rates were much

higher in this age group for motor vehicle traftlc accidents

and homicide. Leading causes of death were dkeases of the

circulatory system and malignant neoplasms, which account

for approximately two of three deaths in both countries. Causes

of death for the two countries for each sex and for five

age groups are compared in tables 2 and 3,

Although mortality statistics favor U.S. residents, researchers using other indicators in studies of elderly populations have concluded that there is little difference in health

status among industrialized countries. For example, Shanas

(1974) reported that 4 percent of the noninstitutionalized population aged 65 years and older were bedfast in Poland, compared with 2 percent in the United States, and that 6 percent

were housebound in both countries.

Health care system

Almost all health care in Poland is provided through

a multi-tiered, nationalized system. With few exceptions, medUnited Statea

ical care is free to Polish citizens. Some ambulatory medical

care is provided by cooperatives and physicians (physicians

are allowed a private practice on a part-time basis in addition

to their full-time practice in the nationalized system) on a

fee-for-service basis, but the care that is paid for by a patient

represents a small proportion of the total (2 percent of office

and home visits). All hospital care is provided through the

nationalized system.

With the exception of a few special populations such

as the military, the whole health care system is the responsibility of one central government agency, the Ministry of Health

and Social Welfare. The Ministry works through regional

units in each of the 49 provinces, which in turn oversee

the programs in the health service areas within the province.

In addition to administrative responsibilities at the regional

level, many specialized services that are not available at the

local level are provided directly to patients through regional

facilities and programs. The regional hospitals also fulfill

important functions in medical research and education.

In theory, health services are integrated at the local level.

Each health service area has at least one hospital and several

ambulato~ and long-term care facilities, all under a medical

director. I%mary care is provided in the towns through physicians and in rural areas through small health centers. Special

preventive care is provided to such defined population groups

as infants and children. More specialized care is provided

by dispensaries, outpatient clinics, emergency stations, and

6
oo,ooo___

&

7 ----

6----

5 ----

4----

3----

2 ----

10,000 ---

9 ---

6 ---

7 ---

6 ---

5 ---

4 ---

3.-.

1,000-.

9 -.

8 -.

7 -.

6 -.

5 -.

4 -.

3 -.

2 -.

100.

9

6

7,

6,

5%

4,

3,

2,

1,

Poland

‘——————— United Statee

1 I I

o

1 1 I I

10 20 40 60 60 100

Age in years

Fiiure 5. Death ratea per 100,000 population by aw. Poland and the United States, 1980

7
hospitals. Institutional long-term care is provided through

sanitariums, nursing homes, and homes for the chronically

ill. Visiting nurses provide home health care to the chronically

ill.

The stated objective of the Polish health care delive~

system is to provide a continuity of preventive, curative,

and rehabilitative services that are uniform, comprehensive

and accessible; that are based on the needs of society; and

that are managed and financed by the state. However, as

in many Western countries, there is an uneven distribution

of physicians between cities and rural areas, a shortage in

some specialties, and concern about travel distance and waiting

time (Webster, 1982).

The health care delivery system in the United States is

more complex and has been described in detail elsewhere

(Anderson, 1985;Starr, 1982). It differs from the Polish system

in that it is a decentralized, private, fee-for-service system

that is financed through a combination of public and private

funds. Medical care, however, is publicly financed only for

certain groups, such as the elderly and the poor, or for certain

diseases associated with exorbitant treatment costs, such as

end-stage renal disease,

Health resources

There are approximately 68,000 physicians in Poland,

compared with 458,000 in the United States (NCHS, 1986b).

Although the number of active physicians per 10,000 population is about the same in the two countries (18 in Poland

and 20 in the United States), the use of ambulatory care

is higher in Poland4.5 visits per person per year, compared

with 4.2 visits per person in the United States.

There are three levels of physician specialization in Poland. At the basic level is the general practitioner, who provides

much of the medical care within a health service area. A

general guideline is that one general practitioner be available

for about 4,000 persons. The second level involves specialists

in pediatrics, obstetrics, internal medicine, and general

surgery. One specialist at this level serves a number of different

health service areas. Specialists at the highest level practice

in specialty clinics, of which there is usually only one per

specialty within a province. Specialty clinics are usually part

of a central hospital that provides highly specialized care.

Table D shows the percent distribution of active physicians

by specialty for both countries. It should be noted that a

specialist is defined differently in the two countries. In Poland,

a physician must be fully trained and registered to practice

a specialty to be counted a specialist. In the United States,

physicians are classified as specialists if they spend the majority

of their professional hours practicing a specialty. Thus, residents in specialty training were counted as specialists in the

United States but as general practitioners in Poland. If residents

were switched to the general p~actice category in the United

States, general practice would account for 27 percent of U.S.

physicians, which is similar to the 30 percent reported for

Poland. In spite of the more restricted definition, Poland has

a higher percent of physicians in the specialties of pediatrics

and otolaryngology.

Two levels of nurses are found in Poland, full nurse

and assistant nurse, which are comparable in terms of education

and training with registered nurses (RN’s) and licensed practical nurses (LPN’s) in the United States. The supply of active

nurses per capita for each skill level was smaller in Poland.

There were 41 full nurses and 3 assistant nurses per 10,000

population in Poland; 51 RN’s and 25 LPN’s per 10,000

population in the United States (Bureau of Health Professions,

1981). However, Poland also had 4.5 midwives and feldshers

(physician’s assistants) per 10,000 population. In the United

States the small number of midwives was included in the

statistics on RN’s, and there were only 0.3 physician’s assistants per 10,000 population (Bureau of Health Professions,

1984).

The 641 general and specialty hospitals in Poland equate

to approximately 2 hospitals per 100,000 population. In the

United States, there are 6,229 short-stay hospitals (Federal

and non-Federal), or nearly 3 per 100,000 population (NCHS,

1985b). However, hospitals in Poland tend to be larger than

hospitals in the United States (table E), and therefore more

hospital beds are available per capita—5.6 per 1,000 versus

4.8 per 1,000.

Table D. Percent distributionof physicians by specia~. Poland and

the United States, 1980

Specially Poland 1 United States2

Percent distribution

Total . . . . . . . . . . . . . . . . . . . . . . . . 100 100

General practice . . . . . . . . . . . . . . . . . 30 14

Internsl medicine . . . . . . . . . . . . . . . . . 13 17

Pediatrics . . . . . . . . . . . . . . . . . . . . . 10 7

Obstetrics and gynecology . . . . . . . . . . . . 7 6

Ophthalmology . . . . . . . . . . . . . . . . . . 3 3

Otolaryngology . . . . . . . . . . . . . . . . . . 3 2

Other surgical specialties . . . . . . . . . . . . . 9 16

Psychiatry . . . . . . . . . . . . . . . . . . . . . 2 7

Anesthesiology . . . . . . . . . . . . . . . . . . 3 4

Radiology . . . . . . . . . . . . . . . . . . . . . 2 3

Other specialties . . . . . . . . . . . . . . . . . 18 21

1Physicians by specialty in which registered.

‘Active physicians classified by specialty in which Iargeat number of professional hours were

spent. Excludes phyaiciana whose specialties were unknown. SOURCE Bidese. C. M., snd

Danais, D. G., Department of Survey and Data Reaourcas. 1982. FYrysIcian Characferfsks

and Distributionin the U.S., 1W Edilion. Chfcago: American Medical Asscdation.

(Copyright 1982: Used with the permission of the American Medical Association).

Table E. Percent distributionof general and specialty hospitals by

bedsizs Poland and the United Statea, 1980

Bedsize Poland United States’

Percent distribution

All hospitals . . . . . . . . . . . . . . . . . . . . 100 100

0-99 beds . . . . . . . . . . . . . . . . . . . . 13 47

10D-199 beds . . . . . . . . . . . . . . . . . . 26 23

200-499 beds . . . . . . . . . . . . . . . . . . 46 24

500 beds ormore . . . . . . . . . . . . . . . . . 16 6

1Data are for community hospitals, which are short-stay, non-Federal hospitals, excluding

institutional hospitals. SOURCE Amarican Hospital Association. 19el. HospitalS1.sMfcs,

1981 Edition.Chicago Amarican Hospital Association. (Copyright 19el: Used with the

permission of the American Hospital Association).

8
Of the 641 Polish hospitals, 506 are hospitals providing

care within a particular health service area. The remaining

hospitals are primarily referral hospitals or provide care to

a specific subpopulation, These include 72 regional hospitals,

46 hospitals that are associated with medical academies and

research institutes, and 17 hospitals operated by the Ministry

of Transportation that are mainly for transportation workers

but that also provide care to victims of traffic accidents.

In addition to the hospitals described above, 40 Polish hospitals

provide primarily psychiatric services, and 30 sanitariums specialize in the treatment of tuberculosis and other respiratory

diseases, In the United States, there are 558 psychiatric hospitals, 11 hospitals specializing in the treatment of tuberculosis

and other respiratory diseases, and 167 long-term general

and other special hospitals.

In Poland, 170 homes for the chronically ill and 101

homes for the aged provide long-term care comparable to

that provided by 23,065 nursing and related care homes in

the United States, Table F indicates that nursing homes in

Poland are, on the average, nearly twice as large as in the

United States; still, many fewer beds are available to the

elderly on a per capita basis.

Besides hospitals and nursing homes, a variety of facilities

provide medical, nursing, or personal care on an inpatient

basis in Poland. Table G shows the number and average

bedsize of these Polish facilities by type of facility, and table

H shows the number and average size of other inpatient health

facilties in the United States (NCHS, 1976). Like hospitals

and nursing homes, other inpatient facilities tend to be larger

Table F. Selected characteristics of nursing and ralated ewe homes:

Polend end the United Statee, 1980

Characteristic Poland United States

Number of homes . . . . . . . . . . . . . . . . . 271 23,065

Average number of bade . . . . . . . . . . . . . 117.6 66.7

Beds per 1,000 population 65 years and over . . 6.9 60.2

in Poland than in the United States. However, the number

of beds per capita is lower in Poland (1.1 beds per 1,000)

than in the United States (1.7 beds per 1,000) because of

the relatively small number of other inpatient health facilities

in Poland.

Table G. Number of certain inpatient facilities and average bedsize, by

type of facili~ Poland, 1980

Number of Average

Type of faci/ity facilities bedsize

Total . . . . . . . . . . . . . . . . . . . . . . . . 543 72

Blind . . . . . . . . . . . . . . . . . . . . . . . . 3 111

Neuropsychiatric diseases of children . . . . . 5 229

Rehabilitation . . . . . . . . . . . . . . . . . . . 35 127

Tuberculosis (students) . . . . . . . . . . . . 9 60

Alcoholics . . . . . . . . . . . . . . . . . . . . . 7 108

Preventoriums’ . . . . . . . . . . . . . . . . . . 12 114

Neurologically handicapped . . . . . . . . 69 115

Mentally handicapped . . . . . . . . . . 198 103

Birthing . . . . . . . . . . . . . . . . . . . . . . 205 10

1Facilities designed to prevent certain tiseases, mainly tuberculosis, in persons at high risk.

Treatment Is generally not medical but climatic and nutritional.

Table H. Number of certain inpatient facilities and average bedsize, by

type of facili~ United Statea, 1976

Number of Average

Type of facility facilities bedsize

Total . . . . . . . . . . . . . . . . . . . . . . . . 6,280 60

Blind ordeaf . . . . . . . . . . . . . . . . . . . 125 152

Emotionally disturbed . . . . . . . . . . . . 1,543 41

Physically handicapped . . . . . . . . . . 87 53

Alcoholics . . . . . . . . . . . . . . . . . . 798 30

Drug abusers . . . . . . . . . . . . . . . . . . . 65 51

Neurologically handicapped . . . . . . . . 44 72

Mentally handicapped . . . . . . . . 1,875 97

Dependent children . . . . . . . . . . . . . . . . 667 46

Unwed mothers . . . . . . . . . . . . . . . . . . 105 29

Multiple and other disordera . . . . . . . . . 751 43

9
Data sources

The hospital discharge data used in this report for the

United States are from the 1980 National Hospital Discharge

Survey (NHDS) and, for Poland, from the 1980 General Hospital Morbidity Study (GHMS), The two data systems contain

basic demographic and diagnostic information about discharged patients collected on a national basis, allowing comparisons of discharge rates, average lengths of stay, rates

of patient care days, and fatality rates by age, sex, and

diagnosis.

The NHDS encompasses all short-stay, non-Federal hospitals located in the 50 States and the District of Columbia.

Short-stay hospitals are defined as all general and specialty

hospitals with patient stays of less than 30 days on the average.

In 1980, this category included 177 psychiatric hospitals and

1tuberculosis hospital (American Hospital Association, 1981).

Hospitals operated by the Department of Defense, Veterans’

Administration, and Indian Health Service are excluded, as

are hospital units of such institutions as prisons. A sample

of discharges is selected using discharge lists from the hospitals

included in the NHDS sample. All discharges, including newborns, are eligible for selection except patients discharged

from long-term or psychiatric care units of short-stay hospitals

that maintain separate medical records—that is, hospitals that

have decentralized medical record systems.

Information about ‘sampled discharges is abstracted from

medical records onto an abstract form (appendix I, figure

I) by either staff of the hospital’s medical records department

or field staff of the Bureau of the Census. Medical information

is coded centrally using the International Classification of

Diseases, 9th Revision, Clinical Modzjication (ICD-9-CM)

(U.S. Public Health Service and Health Care Financing Administration, 1980). In 1980, information was collected on a

sample of approximately 224,000 discharges from 420 hospitals that participated in the NHDS.

In the GHMS, which was initiated in the mid- 1950s,

information is obtained on a 10-percent sample of discharges

from each hospital operated by the Ministry of Health and

Social Welfare and the Ministry of Transportation. The few

hospitals under the control of the Ministries of National Defense, Internal Affairs, and Justice are excluded, All discharges

from 641 general hospitals are eligible to be sampled, except

women with normal deliveries, healthy newborn infants, and

patients discharged from psychiatric wards. Women with complicated deliveries or other conditions that lengthened their

hospitalization, newborn infants with conditions that required

treatment during hospitalization, and psychiatric patients discharged from other than psychiatric wards are in scope. In

addition to discharges from general hospitals, necrologic patients discharged from 40 psychiatric hospitals and all patients

discharged from 30 tuberculosis sanitariums are also in scope

for the GHMS.

Nonmedical information about the patient is collected

on an abstract form (appendix I, figures II and 111)at the

time of admission. Medical information is added to the form

after discharge and coded by the ward physician using the

ninth revision of the Manual of the International Statistical

Classj?cation of Diseases, Injuries, and Causes of Death

(World Health Organization, 1977). In 1980, information was

collected on approximately 364,000 discharges from the hospitals and sanitariums operated by the Ministry of Health and

Social Welfare and the Ministry of Transportation. A more

detailed description of the NHDS and the GHMS is contained

in appendix I.

To improve the comparability of the two data sources,

the 1980 NHDS data file was adjusted. All discharges with

a single-listed diagnosis of normal delivery and all discharges

with a single-listed newborn code were excluded from the

file. Any discharge with a newborn code or with a normal

delivery code and one or more secondary diagnoses remained

in the file. No attempt was made to adjust for possible differences in the psychiatric patient populations covered by the

two surveys.

10
Hospital use comparisons

According to the General Hospital Morbidity Study, an

estimated 3.6 million inpatients were discharged from Polish

hospitals during 1980. These patients were hospitalized for

a total of 59.7 million days of inpatient care. The estimate

from the National Hospital Discharge Survey was that 37.2

million patients were discharged in 1980. These patients used

a total of 276.7 million patient care days.

IYscharge rates

Table J shows discharge rates and percent distributions

of discharges by age and sex for Poland and the United States.

Overall, patients were discharged at a 62-percent higher rate

from U.S. than from Polish hospitals in 1980. These higher

U,S, discharge rates held across age groups, except for the

group 5–14 years of age, and were particularly pronounced

for the older age groups (figure 6). For example, the discharge

rate in the United States for the age group 85 years and

over was four times the rate in Poland. In both countries,

discharge rates were high for the group under 1 year of age,

lowest for the age groups 1-4 and 5–14 years, and then

generally increased with age. However, in Poland, the discharge rate was lower for the age group 85 years and over

than for either patients 65–74 or those 75–84 years of age.

The discharge rate was higher for females than for males

in both countries. For all ages, the difference in the rates

for the two sexes was greater in the United States, but in

both countries higher female rates were seen primarily for

the three age groups encompassing the childbearing years,

15-44. In Poland, discharge rates for males were higher for

all the age groups other than 15-44. In the United States,

sex differences in discharge rates for the other age groups

were generally not statistically significant.

Percent distributions of the number of discharges by age

Table J. Rate and percent distributionof inpatients discharged from hospitals by age, according to sex Poland and the United Stateej 1980

[Dala are for short-slay non-Federal hoepitals in the United States and for all general hospitals in Poland. Data exclude healthy newborn infants and normal deliveries]

Both sexes Male Female

United United United

Age Poland States Poland States Poland States

All agee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Underl year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

I+years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-14years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15-24 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26-34 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

46-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6%74years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7&64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85years Andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

All agee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Uoderl year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

l-4years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-14years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15-24yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26-34years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

75-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85yearsandover ...,..... . . . . . . . . . . . . . . . . . . . . .

102

296

66

58

78

99

95

121

133

159

176

144

100.0

5.7

4.7

8.6

13.1

16.7

10.3

14.2

10.6

10.4

5.1

0.7

165

516

66

50

118

147

142

175

215

316

464

576

100.0

4.9

3.0

4.7

13.2

14.6

9.6

10.7

12.6

13.3

9.7

3.5

Rate per 1,000 population

97 144

329 550

77 100

63 53

54 77

69 91

89 117

126 165

159 228

194 347

219 510

200 635

Percent distribution

100.0 100.0

6.9 6.4

5.9 4.2

10.3 6.0

10.1 10.1

12.5 10.5

10.3 9.3

15.4 11.5

12.0 i4.e

11.2 15.0

4.7 9.4

0.5 2.6

107

266

55

52

103

131

100

117

113

135

152

122

100.0

4.6

3.6

7.1

15.7

20.4

10.3

13.3

9.3

9.7

5.4

0.6

184

481

73

46

158

202

165

185

204

292

437

550

100.0

3.9

2.1

3.7

15.4

17.7

10.1

10.1

11.0

12.0

10.0

4.1

11
600-

United

/ States

/

525- //

I

I

/

I

I

I

450- I

/’

I

I

/’

I

I

//

I

375- I

/

c

I

: I

/’

a

5

I

/?

I

I

r-

/’

b

0. /’

a

2

//

225-

150- Poland

75-

i I I I I I I I I

o 10 20 30 40 50 60 70 80 90

Age in yeara

F~ure6. Discharge rateaby agc Ptiandand the Untiti Statea, 1960

were fairly similar in the two countries, with more than 60

percent ofdischarges for patients 15-64 years ofage in both.

Patients under 15 years of age constituted a smaller percent

of the hospital population in the United States, approximately

13 percent, than in Poland, where they accounted for 19

percent. Patients 65 years of age and over composed a much

larger percent of U.S. than of Polish discharges. Approximately 27 percent of the U.S. patient population was 65

years of age and over, compared with 16 percent of the

patient population in Poland. Although the age composition

of the total population does vary between the two countries

(see figure 1), it does not account for these differences in

patient population.

Table K presents ratios of U.S. discharge rates to Polish

discharge rates by age and sex. For each of the age groups

35 years and over, the ratios were significantly larger for

females than for males, showing that the variation in discharge

rates between the two countries was greater for females than

for males. The largest difference in ratios by sex was for

the age group 85 years and over, which resulted from the

low discharge rate for Polish females in this age group.

Average lengths of stay

Average lengths of stay for inpatients discharged from

Polish and U.S, hospitals and ratios of average stays in Poland

to those in the United States are shown in table L by age

and sex. For all patients, the average length of stay was

12
Table K. Ratio of discharge rates in the United Stetea to discharge rates

in Poland by age and sex, 1980

[Data ars for short-stay non-Federal hospitals in the United States snd for all general

hospitals in Poland. Data exclude healthy newbm infants and normal deliveries]

Age Both sexes Male Female

All agee . . . . . . . . . . . . . . . . . . 1.6 1.5 1.7

Under l year . . . . . . . . . . . . . . . . . 1.7 1.7 1.8

l-4years . . . . . . . . . . . . . . . . . . . 1.3 1.3 1.3

5-14years . . . . . . . . . . . . . . . . . . 0.9 0.8 0.9

16-24years . . . . . . . . . . . . . . . . . 1.5 1.4 1.6

25-34years . . . . . . . . . . . . . . . . . 1.5 1.3 1.5

35-44years . . . . . . . . . . . . . . . . . 1.5 1.3 1.6

46-54years . . . . . . . . . . . . . . . . . 1.5 1.3 1.6

55-64years . . . . . . . . . . . . . . . . . 1.6 1.4 1.8

65-74years . . . . . . . . . . . . . . . . . 2.0 1.8 2.2

75-64years . . . . . . . . . . . . . . . . . 2.6 2.3 2.9

85yearsand over . . . . . . . . . . . . . . 4.0 3.2 4.5

mcrre than twice as long in Poland as in the United States.

Longer Polish stays were found for every age group and

for both sexes, although the magnitude of the differences

wwiedbyage(figure 7)andsex.

The relative differences in average stay, as measured

by the ratios, were greatest for children l-4and 5-14 years

of age. The stays of Polish children in these age groups

were 3,5 t03.7times the stays ofU.S. children. The smallest

clifference was for patients 85 years of age and over, whose

srays were 70 percent longer in Polish than in U.S. hospitals.

The relative differences in average stay were larger for males

as a group than for females as a group, and the differences

for males in the age groups 25–34, 35-44, and45–54 years

were significant y larger than for females in those age groups.

However, the ratio was larger for females 85 years of age

and over than for males in that age group.

Inthe United States, theshortest average lengths of stay

were for children 14and 5-14 years of age. Stays generally

increased for the successive age groups, with the longest

stays for the three age groups 65 years and over. In Poland,

though, the shortest average lengths of stay were for the

age groups 15–24 and 25–34 years. This was due to the

short average stays of the females inthese age groups. Among

Polish males, the average stay was shortest for patients 1-4

years of age. The longest average stays for males in Poland

were for patients 65–74 years of age. Both the 65–74- and

75–84-year groups had the longest average stays for Polish

females.

Rates of patient care days

Although patients in the United States were discharged

from hospitals at ahigherratethsn were patients in Poland,

their shorter average length of stay resulted in a lower rate

of patient care days (discharge rate times average length of

stay) forthe United States. Patients in Poland used 37 percent

more hospital care per person than did U.S. patients. As

is shown in tables M and N, the higher Polish rates held

for both sexes, but the difference was greater for males,

who used 60 percent more cere in Poland, than for females,

who used 19percent more care.

The rate of patient care days was higher for males than

for females in Poland, but it was higher for females in the

United States. Like discharge rates, U.S. rates of patient

care days for females were higher for the three age groups

in the childbearing years, 15–24, 25–34, and 35-44 years.

In Poland, higher rates for males were found for every age

group except 15–24 and 25–34 years, which were two of

the three age groups in which females had higher discharge

rates.

Besides sex differences, there were striking differences

between the two countries in rates of patient care days by

age (figure 8). Children used hospital care at a higher rate

in Poland than in the United States. Polish rates of patient

care days were nearly three times U.S. rates for the age

group 1-4 years and more than four times U.S. rates for

the group 5–14 years. On the other hand, patients in the

two oldest age groups used more hospital care in the United

States. The U.S. rate of patient care days was 35 percent

higher for patients 75–84 years and more than twice the Polish

rate for patients 85 years of age and over.

Table L. Average length of stay in days for inpatients discharged from hospitals in Poland and the United States, and ratii of average length of stay in

Poland to average length of stay in the United Stateaj by age and sexj 1980

[Data are for shorl-slay non-Fedaral hoepitale in the United States and for all general hospitals in Poland. Data exclude healthy newborn infante and norrrraldeliveries]

Both sexes Male Female

United United United

Aae Poland States Ratio Poland States Ratio Poland States Ratio

Average length of Average length of Average length of

stay in days stay in days stay in days

All agas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.4 7.4 2.2 16.1 7.6 2.4 15.0 7.3 2.1

Under l year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.0 6.5 2.5 16.0 6.1 2.6 15.9 7.0 2.3

l-4years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.8 3.9 3.5 13.3 3.9 3.4 14.6 3.7 4.0

5-14years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.6 4.2 3.7 15.4 4.1 3.8 15.8 4.2 3.8

15-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.9 4.9 2.4 14.7 6.0 2.5 10.4 4.4 2.4

26-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.9 5.3 2.3 15.3 6.2 2.5 10.1 5.0 2.0

35-44 yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.6 6.6 2.4 16.2 6.9 2.6 13.4 6.3 2.1

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.3 7.5 2.4 20.2 7.6 2.7 16.3 7.5 2.2

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.9 S.8 2.4 21.6 6.6 2.5 20.0 9.0 2.2

66-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.3 10.0 2.2 22.2 9.7 2.3 22.3 10.2 2.2

75-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.8 11.2 2.0 21.2 10.7 2.0 22.3 11.5 1.9

85yearsandover . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.4 12.0 1.7 18.6 12.1 1.5 21.6 12.0 1.8

13
24-

21-

Poland

18-

15-

12-

United

/“”H ~ States

//

//’

///

0“

9-

//

/“’”

/ /“”

6- \

,/””

,/

\

\

/“

-----

\

#//-

L

.ti~

&~--

3-

1 1 I I 1 I 1 1 I

0 10 20 30 40 50 60 70 60 90

Age in years

F~ure7. Average length ofstayby ege:Pofand sndthe UnkfState~ 1980

Percent distributions of the number of days of care in

each country also differed by age. The percent of patient

care days was higher for each age group under 55 years

of age in Poland but higher for each age group 55 years

and over in the United States. These differences were especially

great in four of the age groups: Children 1-4 and 5–14 years

of age accounted for 12 percent of patient care days in Poland

but only 4.2 percent in the United States. Patients aged 75–84

years and 85 years and over used 20.3 percent of patient

care days in the United States but only 7.6 percent inPoland.

Diagnosis by age and sex

Allages

U.S. and Polish discharge rates are shown by sex for

major diagnostic groups in VdbleO. A detailed list of diagnoses

within these groups is given in Vdble4. The leading diagnostic

category in Poland was diseases of the respiratory system,

followed by diseases of the circulatory and of the digestive

systems and injury and poisoning. These four groups accounted

for half of all discharges. In the United States, diseases of

14

the circulato~ and digestive systems were the leading diagnostic categories. Together with diseases of the genitourinary

system and injury and poisoning, these four groups accounted

for nearly half of all U.S. discharges.

Diseases of the circulatory and of the digestive systems

were leading categories for both males and females in the

two countries. Injury and poisoning and respiratory diseases

were also leading categories for males in both countries. Complications of pregnancy, childbirth, and the puerperium and

diseases of the genitourinary system were also leading groups

for females in both countries.

Discharge rates were higher in the United States than

in Poland for most leading diagnostic categories (figure 9).

There also were particularly large differences for three other

categories. The U.S. discharge rate was more than eight times

the Polish rate for certain conditions originating in the perinatal

period, even though the death rate for this catego~ was higher

in Poland (see table 2). This difference in discharge rates

is thought to result from incomplete reporting of perinatal

conditions by Polish physicians in the General Hospital Morbidity Study. Likewise, the previously noted exclusion of
Table M, Rate and percent distributionof patient wire days for inpatients dscharged from hospitals by age, aeoording to sex Poland and the

Unfted Ststes, 1980

[Dataamforshort-staynonfederalhospitalsin the United States and for all general hospitals in Poland. Data excluda healthy newborn infanta and normal deliveries]

Both sexes Male Female

United United United

Age Poland States Poland States Poland States

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under l year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

l-4years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5-14years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15-24years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3+44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4S-54years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

66-74yt?ars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

75-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85yearsand over.....,.. . . . . . . . . . . . . . . . . . . . . . .

Alleges, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under l year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

l-4years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5-14years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15-24years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25–34years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

75-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65yearsandover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,678

4,766

911

901

931

1,181

1,479

2,211

2,763

3.552

3;830

2,934

100.0

5.5

3.9

8.1

9.5

12.1

9.6

15.6

13.4

14.1

6.8

0.6

1,227

3,344

333

206

579

788

932

1,317

1,690

3,148

5,182

6,927

100.0

4.3

1.6

2.6

8.7

10.5

8.6

10.8

14.9

17.8

14.6

5.7

Rate per 1,000 population

1,759 1,100

5,265 3,328

1,014 391

972 216

798 460

1,046 561

1,610 811

2,540 1,250

3,442 1,956

4,315 3,370

4,639 5,477

3,726 7,675

Percent distribution

100.0 100.0

6.1 5.0

4.4 2.2

6.8 3.2

8.2 7.9

10.6 6.5

10.4 8.4

17.2 11.4

14.4 16.6

13.8 19.1

5.6 13.2

0.6 4.4

1,601

4,239

803

627

1,072

1,318

1,350

1,904

2,259

3,018

3,401

2,640

100.0

4.9

3.4

7.5

10.9

13.6

9.2

14.4

12.4

14.4

8.0

i .1

1,345

3,362

272

196

697

1,006

1,046

1,380

1,831

2,977

5,009

6,599

100.0

3.7

1.1

2.1

9.3

12.1

8.6

10.3

13.5

18.8

15.6

6.7

psychiatric patients from the Polish data probably accounts

for the much higher discharge rates for mental disorders in

theUnited States,

Discharge rates were also much higher in the United

States, particularly for females, in the supplemental classification, factors influencing health status andcontact with health

service. This difference is associated primarily with the use

of U.S. hospitals for contraceptive management, especially

sterilization. One of two discharges in this category is for

contraceptive management (ICD-9 code V25) in the United

States, compared with 0.3 percent inPoland.

Table N, Ratio of the rate of patient eere days in Poland to the rate in

the United States, by age and se~ 1980

[Data are for ehort-stay non-Faderal hospilala in the United States and for all genaral

hospitals in Poland. Data exclude haal!hy newborn infants and normal deliveries]

Age Both sexes Male Female

Allage& . . . . . . . . . . . . . . . . . . . . 1.4 1.6 1.2

Under l year . . . . . . . . . . . . . . . . . 1.4 1.6 1.3

l-4years . . . . . . . . . . . . . . . . . . . 2.7 2.6 3.0

6-14years . . . . . . . . . . . . . . . . . . 4.4 4.5 4.2

16-24years . . . . . . . . . . . . . . . . . 1.6 1.7 1.5

25-34years . . . . . . . . . . . . . . . . . 1.5 1.9 1.3

3!i-44years . . . . . . . . . . . . . . . . . 1.6 2.0 1.3

45-54years . . . . . . . . . . . . . . . . . 1.7 2.0 1.4

5S-64years . . . . . . . . . . . . . . . . . 1.5 1.8 1.2

65-74years . . . . . . . . . . . . . . . . . I.I 1.3 1.0

75-64years . . . . . . . . . . . . . . . . . 0.7 0.9 0.7

85yearsandover . . . . . . . . . . . . . . 0.4 0.5 0.4

U.S.-Polish differences in discharge rates for males were

not statistically significant for diseases of the respiratory system

or for diseases of the skin and subcutaneous tissue. Discharge

rates for females were higher for both categories in the United

States.

Discharge rates for both males and females were higher

in Poland in one category, infectious and parasitic diseases.

Discharge rates in Poland for tuberculosis and hepatitis were

more than nine times the rates in the United States. These

two diagnoses represented 50 percent of discharges with an

infectious or parasitic disease in Poland, but only 8 percent

in the United States. One reason for this difference was that

patientsdischarged fromtuberculosissanitariums wereinscope

for the Polish survey. In the United States, 10 of the 11

hospitals that specialized in the treatment of tuberculosis and

other respiratory diseases in 1980 were long-stay institutions

that were out of scope for NHDS. In addition, the death

rate in Poland for tuberculosis was nine times that in the

UnitedStatesin 1980; further, hospitalization forviralhepatitis

ismandatoryin Poland.

Average lengths of stay by diagnostic category and sex

are summarized in table P. Polish average stays were two

to three times as long as those in the United States for most

categories. The longest average length of stay in Poland,

that for infectious and parasitic diseases, was 34.1 days—nearIyfivetimes the average U.S. stay for the category. Tuberculosis patients in the category stayed in Polish hospitals

15
8,000-

7,000-

United

/ States

/’

6,000 -

/’

//

5,000-

/“

/’

/’

4,000- /’

I

3,000- !

I

Poland

I

.

I

I

2,000- 1

I

I

I

I

I

1,000- I

I

~_. -

1

---

~--

I

//

/0

--..+-

1 I I I I I I i I

0 10 20 30 40 50 60 70 80 90

Age in years

Fgure 8. Rate of patient care daya by age: Poland and the UnitedState$ 1980

an average of 76.0 days, nearly five times the average in

the United States of 15.6 days. The Polish average stay for

viral hepatitis of 30.2 days was nearly four times the U.S.

average of 7.7 days.

Other categories with average lengths of stay of more

than 20 days in Poland were neoplasms, diseases of the musculoskeletal system and connective tissue, and congenital

anomalies. In the United States, only three categories had

average lengths of stay of 10 days or more: mental disorders,

neoplasms, and diseases of the circulatory system.

Average stays for mental disorders were similar in the

United States and Poland. As previously noted, though, patients in psychiatric wards were excluded from the Polish

data. In both countries, the shortest stays were for the supplementary classification and for complications of pregnancy,

childbirth, and the puerperium. Even for these categories,

average lengths of stay were about twice as long in Poland

as in the United States.

Males stayed in the hospital an average of 3 days longer

than did females in Poland, but in the United States, average

lengths of stay did not differ significantly by sex. Even when

complications of pregnancy, childbirth, and the puerperium

16

was excluded, the average length of stay remained shorter

for females (16.9 days) than fo; males in-Poland. When the

pregnancy category was excluded, the average U.S. stay for

females became 7.9 days, which was still not significantly

different from the average stay for males.

Nevertheless, there were sex differences in lengths of

stay for specific diagnostic categories. For example, in both

countries males had longer average stays than did females

for diseases of the genitourinary system, and males in Poland

had stays an average of 7 days longer for infectious and

parasitic diseases. Females in both countries had longer average

stays for diseases of the musculoskeletal system and connective

tissue. The stays of Polish females also were nearly 7 days

longer than those of Polish males for congenital anomalies.

U.S. females had significantly longer stays than U.S. males

had for certain conditions originating in the perinatal period

and injury and poisoning.

Rates of patient care days by diagnostic category and

sex are shown in table Q. The highest rate in both countries

was for diseases of the circulatory system. The circulatory

diseases accounted for the most patient care days for both

sexes in the United States and for females in Poland. Males
Digestive

diseases

20.7

Injury and

poisoning

16.0

Genitourinary

diseases

16.0

Respiratory

diseases

5.3

L

1

I 1 I 1 I I I

1 2 3 45 10 20 30

Rate per 1,000 population (log scale)

Figure 9, Dischsrge retes for leading dmgnostic categories Poland and the United Statea, 1980

in Poland spent the most days in the hospital for diseases

of the respiratory system.

Because of the much longer stays in Polish hospitals,

rates of patient care days were higher in Poland for most

diagnostic categories, Notable exceptions were endocrine, nutritional, and metabolic diseases and immunity disorders; mental disorders; certain conditions originating in the perinatal

period; and the supplementary classification. Discharge rates

for these four diagnostic categories were considerably higher

in the United States than in Poland, resulting in higher rates

of patient care days as well,

More than half of patients discharged with endocrine,

nutritional, and metabolic diseases and immunity disorders

had had a diagnosis of diabetes mellitus in both countries.

The death rate for diabetes was somewhat higher in the United

States than in Poland (15.4 versus 12.5 per 100,000 population

in 1980), This may at least partially explain the greater utilization of U.S. hospitals for the endocrine category. Possible

reasons for the higher discharge rates for the latter three classes

have already been discussed.

Under 1 year

Table R presents discharge rates for infants under 1 year

of age in Poland and the United States by diagnostic category

and sex. Additional diagnostic data on infants are shown

in table 5. Hospitalized infants in Poland were most often

treated for a disease of the respiratory system (figure 10).

Infectious and parasitic diseases, certain conditions originating

in the perinatal period, and diseases of the digestive system

were also leading diagnostic categories in Poland. In the United

States, half of infants hospitalized during their first year had

diagnoses that fell into the category of certain conditions

originating in the perinatal period. As in Poland, diseases

of the respiratory system and digestive system also were leading categories. However, congenital anomalies, rather than

infectious and parasitic diseases, was a leading cause for

U.S. infants,

The overall discharge rate for children under 1 “year of

age was higher in the United States than in Poland, and

higher U.S. rates were reported for most diagnostic categories.

17
Table O. Rate of discharge for inpatients by diagnostic chapter and sex Poland and the United States, 1980

[Data are for short-stay non-Federal hospitals inthe UnitedStatesandforall generalhospitalsin Poland. Data exclude healthy newborninfanteand normaldeliveries.Diagnosticchaptersand

codenumbersare fromthe NinthRevision,InternationalClassificationof Diseasea,1975]

Both sexes Male Female

United United United

Diagnostic chapter and ICD-9 code Poland States Poland States Poland States

Allconditione . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectiousand parasiticdiseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001–139

Neoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Endocrine, nutritional andmetabolic dseases andimmunity dsorders . . . . . . . . . . 240-279

Diseasesoftheblood andblood-forming organs . . . . . . . . . . . . . . . . . . . . . 28c-2E9

Mentaldisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..29&3l9

Diseasesofthenervoussystemand sense organs . . . . . . . . . . . . . . . . . . . . 320-389

Oiseasesofthecirculatorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3g0459

Oiseasesofthe reapiratorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460_51g

Diseasesofthedigesfivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseasesofthegenitourinarysyatem . . . . . . . . . . . . . . . . . . . . . . . . . . . 58fj_82g

Complications ofpregnancy, childbirth andthepuerperium . . . . . . . . . . . . . . . . 630--676

Oiseases of theskin and subcutaneous tissue . . . . . . . . . . . . . . : . . . . . . . 68&709

Useases of themusculoskeletal system and connective tissue. . . . . . . . . . . . . . 71o-739

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...740-759

Certain conditions originating intheperinatal period . . . . . . . . . . . . . . . . . . . 760-779

SYMptOMS, SignSand ill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . . 780_7gg

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..8rJ0-ggg

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI-V82

Rate per 1,000 population

102.2 164.7 97.4 144.0 106.7 184.1

5.3 2.9 6.2 2.9 4.5 2.9

6.1 11.0 5.4 9.5 6.7 12.5

1.8 5.1 1.3 3.6 2.3 6.4

0.6 1.5 0.6 1.3 0.7 1.6

1.1 7.5 1.0 8.1 1.1 6.9

4.8 7.8 5.3 7.3 4.4 8.3

13.4 22.e 14.7 23.6 12.2 21.9

13.6 15.3 16.4 16.2 10.9 14.5

13.4 20.7 14.1 20.0 12.7 21.3

9.9 16.0 5.5 10.1 14.1 21.4

10.5 13.0 ... ... 20.5 25.0

2.6 2.7 2.9 2.7 2.2 2.7

3.5 10.0 3.5 8.9 3.5 11.0

1.0 1.9 1.1 1.9 0.9 1.9

0.5 4.1 0.6 4.5 0.5 3.7

1.6 2.9 1.7 2.8 1.6 3.1

11.8 16.0 16.9 18.6 6.9 13.5

0.6 3.6 0.5 1.7 1.0 5.4

.

Table P. Average length of stay for d=charged inpatients by diagnostic chapter and sex Poland and the United States, 1980

[Dataare forshort-staynon-Federalhospitalsin fha United Statea and for all general hospitals in Poland. Data exclude healthy newborninfantsandnormaldeliveries.Diagnosticchaptersand

codenumbersare fromthe NinthRaviaion,InternationalClassificationof Diseases,1975]

Both sexes Male Female

United United United

Diagnostic chapter and ICD-9 code Polend States Poland States Poland States

Allcondifions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectious andparasific diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001–13g

Neoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Endocrine, nutritional andmetabolic dseases andimmuni~ disorders . . . . . . . . . . 24f)-27g

Oiseases of the blood and blood-forming organs . . . . . . . . . . . . . . . . . . . . . 260-289

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...290-319

EfLseases of thenervoue system and sense organs . . . . . . . . . . . . . . . . . . . . 320-369

Diseases of the circulatory system.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 39H59

Oiseases of the respiratory system.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Oiseasea of the digestive system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Oiseases of thegenitourinary syatem . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Complications ofpregnancy, childbhfha ndthepuerperium . . . . . . . . . . . . . . . . 630-676

Diseases of theskin and subcutaneous tissue . . . . . . . . . , . . . . . . . , . . . . 680_70g

Useases of themusculoskeletal system and connective tissue. . . . . . . . . . . . . . 710-739

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 740-759

Certain conditions originating in the perinatal period . . . . . . . . . . . . . . . . . . . 760-779

Symptoms, signs and ill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . , 78c_7gg

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...80&999

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VO1-V82

There were particularly large differences in discharge rates

for conditions originating in the perinatal period, diseases

of the circulatory system, and diseases of the musculoskeletal

system. U.S. discharge rates were seven to nine times Polish

rates for these categories.

Part of the difference in the rates for perinatal conditions

was due to differences in data collection procedures in the

two countries. All newborn infants were sampled for the U.S.

survey, and abstracts for healthy newborns were excluded

when the data” were tabulated. On] y sick newborn infants

Average length of stay in days

16.4 7.4 1s.1 7.6 15.0 7.3

34.1 6.9 37.1 6.6 30.0 7.2

22.5 10.5 24.4 11.1 21.0 10.1

19.1 9.6 19.4 9.3 19.0 9.7

16.8 7.2 15.1 6.5 18,2 7.8

12.3 11.6 12.4 11.0 12.3 12.2

19.6 5.5 19.2 5.5 20.0 5.4

18.8 10.0 18.7 9.6 18.9 10.4

17.7 6.3 16.3 6.3 16.6 6.2

14.3 7.0 14.0 6.5 14.6 7.4

10.4 5.6 13.1 6.4 9.4 5.2

7.1 3.8 7.1 3.6

19.1 8.0 17.6““” 7.6““” 20.9 8.4

24.8 8.3 23.0 7.6 26.5 8.9

22.3 6.2 19.2 6.0 25.9 6.3

14.0 7.8 13.6 7.1 14.1 8.5

9.6 4.5 9.6 4.4 9.6 4.6

13.5 7.7 13.3 6.9 14.0 6.7

8.8 3.4 10.4 4.2 6.0 3.1

were reported in Poland. When the Polish survey was revised

in 1985 to sample all newborn infants without regard to their

health status, the rate of reported perinatal conditions nearly

doubled. However, even doubling the 1980 Polish rate would

not bring it close to the U.S. rate, and the 1980 death rate

for perinatal conditions was higher in Poland (915.8 per

100,000 live births) than in the United States (629.7 per

100,000 live births), suggesting that U.S. physicians report

more minor perinatal conditions for newborn infants than do

Polish physicians.

16
Table Q. Rate of patient care days for discharged inpatients by diagnostic chapter and sex Pofsnd and the United States, 1980

[Data are for ehorl-stay non-Federal hospitala in the United States and for all general hospitals in Poland. Data exclude healthy newborn infanta and normal deliveries. Diagnosticchaptera and

code numbers are from the Ninth Revision, Intsmational Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnostic chapter and /CD-9 code Poland States Poland States Poland States

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectlousand paraslticdieeaees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Endocrine, nutdtional andmetabolic diseaaes andimmunity dsorders . . . . . . . 240-279

Diseasesofthe bloodandblood-forming organs . . . . . . . . . . . . . . . . . . 280-289

Mentaldisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..29~19

Dlseaaesofthenervouasystemand sense organs . . . . . . . . . . . . . . . . . 320-389

Diseasesofthecirculatoryaystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Dieeaeesofthe respiratorysystem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Dleeaeeeofthedigestivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseaseeofthegenitourinarysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Complications ofpregnancy, childbirth andthepuerpetium . . . . . . . . . . . . . 630-676

Dlseasee of theskin and subcutaneous tissue . . . . . . . . . . . . . . . . . . . . 680-709

DIeeaees of themusculoekeletal system and connective tissue. . . . . . . . . . 710-739

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..74~759

Certain conditiona originating intheperinatal pefiod . .. . . . . . . . . . . . . . . . . . 760-779

Symptoms, eignsand ill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . . 780-79g

Injury andpolsoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..80G999

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Vol-V82

1,677.6

181.9

136.9

34.5

10.1

12.9

93.9

251.7

240.4

191.4

102.4

75.0

48.8

87.1

22.1

7.4

15.6

158.8

6.9

Rate per 1,000 population

1,226.9 1,758.8 1,099.9 1,600.5

20.1 231.7 19.0 134.6

115.4 132.7 104.7 140.8

48.7 25.2 34.0 43.3

10.8 8.3 8.7 11.8

66.6 12.0 89.2 13.8

42.7 100.7 40.4 67.3

228.2 274.8 229.0 229.7

96.2 300.1 102.1 183.7

143.6 196.7 129.4 186.3

69.0 71.4 84.3 131.7

49.3 ... ... 146.2

21.4 50.8 20.3 46.6

82.9 60.6 67.9 93.3

11.7 20.4 11.6 23.8

31.9 7.5 32.2 7.2

13.2 15.9 12.1 15.2

122.6 224.1 128.1 96.7

12.2 5.5 7.1 6.2

1,345.4

21.2

125.4

62.6

12.6

84.7

44.9

227.4

90.7

156.9

112.2

95.2

22.4

96.9

11.6

31.7

14.3

117.6

17.0

Table R. Rate ofdischarge forinpatienta underl yearofage bytiagnostk chapter andaex Pobndand the Untied States, 1980

[Data are for short-stay non-Federal hospitals in the United Ststes and for all general hospitals in Poland. Data exclude healthy newbem infants (codes V3GV39). Diagnostic chapters and code

numbers are from the Ninth Revision, Intamafional Classification of Diaeasea, 1975]

Both sexes Male Female

United United United

D/agnostic chapter and ICD-9 code Poland States Poland States Poland States

Allconditlone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectious and parasitic diseases . . . . . . . . . . . . . . . . . . . . . . . . . . .

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Endocrine, nutfltlonal andmetabolic diseaaes andimmunity disorders . . . .

Diseaees of the blood and blood-forming organs . . . . . . . . . .

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Diseases of thenervous system and sense organs . . . . . . . .

Dieeaees of theclrculatory system... . . . . . . . . . . . . . . . . . . . . . . .

Dieeases of thereeplratory eyetem . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dieeaees of the digestive system... . . . . . . . . . . . . . . . . . . . . . . . . .

Dleeases of thegenitourinary system . . . . . . . . . . . . . . . . . . . . . . . . .

Complications ofpregnancy, childbirth andthepuerperium . . . . . . . . . . . . .

Diseases of theskin and subcutaneous tissue . . . . . . . . . . . . . . .

Diseases of themusculoskeletal system and connective tissue. . . . . . . . . .

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Certain conditione originating intheperinatal period . . . . . . . . . . .

Symptoma, slgnsand ill-defined conditions . . . . . . . . . . . . . . . . . . . .

Injury andpoleoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

001–139

140-239

240-279

28C-289

290-319

320-389

390+59

460-519

52e-579

5eo-629

630-676

680-709

710-739

740-759

760-779

78C-799

coo-999

VOI–V62

296.3

49.2

1.2

2.2

3.5

.

17.2

0.9

138.2

23.7

4.8

.

6.1

0.5

13.3

27.2

3.4

5.6

3.1

506.a

19.7

5.1

4.2

‘2.0

.

21.4

8.0

59.6

43.6

5.7

...

5.1

3.5

41.5

254.9

13.5

10.1

8.0

Rate par 1,000 live births

328a

53.9

1.1

2.4

3.7

.

18.7

1.1

156.9

27.8

3.6

...

6.1

0.5

13.3

27.0

3.3

6.5

2.8

538.5

19.4

5.4

●4.5

●

.

23.0

6.8

71.4

50.9

6.6

...

‘4.7

●

42.1

265.0

13.6

10.3

8.3

266.0

44.2

1.4

2.0

3.3

.

15.7

0.8

114.3

19.4

6.1

...

6.1

0.6

13.2

27.4

3.5

4.6

3.4

473.3

19.9

“4.8

“3.8

.

.

19.7

9.2

47.2

36.0

“4.4

...

‘5.4

●4.6

40.7

244.2

13.4

9.9

7.7

It% not clear why U.S. discharge rates are substantially

higher than are Polish rates for diseases of the circulatory

and musculoskeletal systems. However, neither is a very frequent cause of hospitalization for infants under 1 year of

age in either country.

Polish discharge rates were more than double U.S. rates

for infectious and parasitic diseases and diseases of the respiratory system. Intestinal infectious dkeases accounted for more

than 85 percent of Polish discharges in the infectious and

parasitic categoqr, and the Polish discharge rate for these

diseases was more than seven times the U.S. rate. Among

the respiratory diseases, the Polish discharge rate was 4.7

times the U.S. rate for bronchitis and emphysema and 4

times the U.’S. rate for pneumonia. The infant mortality rates

for these conditions were also considerably higher in Poland

than in the United States.

Differences in discharge rates for males and females under

1 year of age were generally not statistically significant in

19
Poland United States

Congenital

anomalies4.4%

?

o@?StiVr3 dk?FiSSE 7.$% <

Perinatal

conditions 9.1% *

All other

conditions

16.4% w

Infectious and

parasitic diseases 16.5% 4

Infectious and

parasitic diseases 3.9%

Congenital ~

t

anomalies 8.2%

digestive diseases 8.6% +

Respiratory

diseases 11.8%+

Fiiure 10. Percent diatnbution ofpatientsunderl yesrofage, excluding healthy newkrninfants, discharged from hospihls, bydwgnoaticcat~o~

Potandand the United States, 1980

the United States. Only males had significantly higher rates

for diseases of the respiratory and digestive systems. In Poland,

males under 1 year had higher discharge rates than females

had for these two diagnostic categories and for infectious

and parasitic diseases, dkeases of the nervous system and

sense organs, and injury and poisoning, Polish females had

a higher discharge rate for diseases of the genitourinary system,

primarily because of their higher rate for diseases of the urinary

system.

Average lengths of stay for children under 1 year of

age are shown by diagnostic category and sex in table S.

Comparatively long stays for Polish infants were evident for

both sexes in all diagnostic categories. The differences ranged

from stays 3.4 days longer for Polish males with a diagnosis

in the supplementary classification to stays 23 days longer

for Polish females with diseases of the circulatory system.

It is not clear why the average stays were so much longer

in Poland, but it may reflect poorer health of Polish infants.

The infant mortality rate in Poland was nearly twice the U.S.

rate (21.3 versus 12.6 per 1,000 live births) during 1980.

Circulatory diseases and endocrine, nutritional, and

metabolic diseases and immunity disorders required longerthan-average stays for children under 1 year of age in both

countries. Hospitalizations for the supplementary classification

and for symptoms, signs, and ill-defined conditions were

among the shortest in both countries; however, patterns of

average lengths of stay were not similar for all the diagnostic

categories. For example, stays for diseases of the genitourinary

system were relatively long in Poland and relatively short

in the United States. Conversely, certain conditions originating

in the perinatal period required relatively long stays in the

United States but relatively short stays inPoland.

Because of the long lengths of stay for Polish infants,

they used more patient care days per person than did U.S.

infants (table T), Substantially higher rates of patient care

days were seen in Poland for two diagnostic categories, diseases of the respiratory system and infectious and parasitic

diseases. These were the categories for which Polish infants

also had higher discharge rates. Within the categories, diagnoses for which there were large differences in discharge

rates were also ones for which large differences existed in

rates of patient care days, namely pneumonia, bronchitis,

and emphysema and infectious intestinal diseases, Rates of

patient care days in Poland for infants with these diagnoses

were 13 to 26 times rates in the United States.

Rates of patient care days were higher in the United

States for certain conditions originating in the perinatal period

and diseases of the circulatory system. The reasons for the

difference in rates for perinatal conditions were discussed

previously. The greater use of hospitals for infants with diseases of the circulatory system may reflect the use of more

advanced technology for the treatment of pediatric heart diseases in the United States.

1-14 years

The leading cause of hospitalization for children 1–14

years of age in both Poland and the United States was diseases

of the respiratory system (table U). The specific respiratory

diseases responsible for the most discharges varied between

the two countries (table 6 and figure 11), Polish children

were hospitalized at a higher rate for acute respiratory diseases,

pneumonia, and bronchitis and emphysema. U.S. children

were more often hospitalized for chronic diseases of the tonsils

and adenoids and for asthma.

20
Tabk S. Average length of stay for discharged inpatients under 1 yesr of age by dmgnostic chapter and sex Poland snd the United State% 1980 -

[Data are for short-stay non-Faderal hospitals in the United States and for all general hospitals in Poland. Data exclude healthy newkm infants (males V30-V39). Diagnostic chspters and code

numbers are from the Ninth Revision, International Classificationof Diseases, 1975]

Both sexes Male Female

United United United

Diagnostic chapter and ICD-9 code Poland States Poland States Poland States

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

lnfectiousand paraslticdLseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001–139

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Endocrine, nutdtional andmetabotic deeases andimmunity daorders . . . . 240-279

Dleeasesofthe bloodand blood-forming organe . . . . . . . . . . . . . . . . 280-289

Mental dlsordere . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...29&319

Dlseasesofthenervousayatemand sense organs . . . . . . . . . . . . . . 320-389

Diseases oftheclrculatorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Dlseasesofthereepiratorysyatem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46fJ-519

Diseasesofthedigestiveeystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Dlseaeesofthegenitourinarysystem . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Complicatlonsofpregnancy,childbirth andthepuerperium . . . . . . . . . . . . 630-676

Diseaaesoftheskinand subcutaneous tissue . . . . . . . . . . . . . . . . . . . 68C-709

Dlaeases of themusculoekeletal system and connective tissue. . . . . . . . . . . . 710-739

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...740-759

Certain conditions originating in the perinatal period . . . . . . . . . . . . . . . . . . . 760-779

Symptoms, signs and ill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . . 780-799

Injury andpoisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 800-999

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI-V82

16.0

17.6

20.2

24.3

10.9

27.9

15.9

23.1

16.1

13.2

23.5

...

11.0

24.5

20.9

13.9

9.9

11.6

6.4

Average length of stay in days

6.5 16.0 6.1 15.9

5.1 17.7 5.1 18.0

6.2 22.3 5.3 18.5

9.3 26.1 ‘8.3 22.0

‘6.6 12.2 ●

9.3

.

32.9 .18.3

5.1 15.7 5.4 16.2

7.4 18.1 7.6 30.3

4.8 16.4 4.9 15.6

5.0 13.0 4.7 13.4

4.3 22.3 3.7 24.3

. ... ... ...

4.7 11.2 ‘4.4 10.7

5.2 31.6 ●

17.3

5.7 20.6 5.6 21.2

7.7 13.6 7.1 14.3

3.9 9.7 4.0 10.1

6.0 10.9 4.8 12.5

3.4 7.1 3.7 9.6

7.0

5.2

‘7.3

‘10.5

.

.

4.7

7.3

4.7

5.6

5.2

...

“5.0

‘4.8

5.8

8.5

3.8

7.4

3.1

Tsble T. Rate of patient oare days for discharged inpatients under 1 year of age by diagnostic chapter and sex Poland and the United States, 1980

[Data are for short-etay non-Federal hospitala in the United States and for all general hospitals in Pokmd. Data exclude healthy newlmm infants (codes V30-V39). Diagnostic chapters and cede

numbers are from the Ninth Revision, International Classificationof Diseases, 1975]

Both sexes Male Female

United United United

Diagnostic chapter and ICD-9 code Poland States Poland States Poland States

Rate per 1,000 live births

Allconditlons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,766.1

infectious and parasitic diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Endocrine, nutritional andmetabolic dseaees andimmunity dsorders . . . . . . 240-279

Dieeases of the blood end blood-forming organs . . . . . . . . . . . . . . . . 280-289

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..29H19

Diseases of thenervous aystemand sense organs . . . . . . . . . 32C-369

Diaeaees of the circulatory system.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Diseaeee of thereepiratory system . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Dieeases of thedigeetiveeystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52C!-579

Diseases of thegenitourinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-829

Complications ofpregnancy, childbirth andthepuerperium . . . . . . . . . . . . . 630.+76

Diseases of the ekin and subcutaneous tissue . . . . . . . . . . . . . . . . 68C-709

Dlseaees of the mueculoskeletal system and connective tissue . . . . . . . . . . . . 710-739

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 740-759

Cerlaln conditions originating intheperinatal period . . . . . . . . . . . 760-779

Symptoms, signs and ill-defined conditions . . . . . . . . . . . . . 7e0-799

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 800-999

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI-V82

877.8

24.5

53.7

37.8

.

274.3

21.7

2,186.3

312.0

113.5

.

66.9

13.0

277.6

378.4

33.5

64.7

26.0

3,264.8

100.9

31.7

3e.9

●12.9

.

1Oe.%

59.6

288.4

219.9

24.2

...

23.7

1e.4

235.2

1,974.6

53.0

61.2

27.4

5,265.2

954.2

23.8

83.2

44.5

.

293.0

19.4

2,569.0

361.0

81.0

...

68.3

16.1

275.2

367.7

31.7

71.2

20.1

3,260.1

99.2

28.8

‘37.9

.

.

124.0

51.6

352.7

237.9

25.2

...

‘20.6

.

235.0

1,873.2

54.5

49.5

30.8

4,238.9

797.1

25.3

43.8

30.7

.

254.6

24.2

1,782.0

280.2

147.9

...

65.4

9.7

280.1

389.7

35.5

57.7

32.2

3,310.7

102.8

●34.8

‘40.0

.

.

92.9

67.8

220.7

200.9

‘23.1

...

“27.0

“21 .8

235.4

2,081.5

51.3

73.5

23.6

Two other leading diagnostic categories in both countries

were injury and poisoning and diseases of the digestive system.

The major injury and poisoning diagnosis for both U.S. and

Polish children was fractures. Among the other diagnoses,

the discharge rate was higher in the United States for intracranial injury excluding skull fracture; but a higher rate was

reported in Poland for bums. In the digestive disease category,

discharge rates were similar in the two countries for hernia,

but Polish children were more often hospitalized for appendicitis and U.S. children for noninfective enteritis and colitis.

The fourth leading diagnostic category for children 1–14

years of age in Poland was infectious and parasitic diseases.

The Polish discharge rate was more than twice the U.S. rate

for this category. Diseases of the nervous system and sense

organs was one of the leading diagnostic groups for children

in the United States. The U.S. discharge rate was 67 percent

higher for the category as a whole, more than four times

the Polish rate for diseases of the ear and mastoid process.

Other categories for which discharge rates were higher

in Poland were diseases of the circulato~ system and diseases

21
7.0

Acute respiratory

infections

Chronic disease

of tonsils

and adenoids 6.3

5.1

Pneumonia

2.6

Bronchitis

and emphysema

❑ Poland

Asthma ❑ United States

2.4

0.1 0.2 0.3 0:4 0.5 1.0 2.0 3.0 4.0 5.0

Rate per 1,000 population (log scale)

Fiiure 11. Discharge ratea for children 1-14 years of age for aeleoted diseaaes of the respiratory system Poland and the United States, 1980

of the skin and subcutaneous tissue. In the circulatory category,

half of Polish discharges were for acute rheumatic fever and

chronic rheumatic heart disease, which accounted for very

few children’s discharges in the United States, U.S. discharge

rates were higher for endocrine, nutritional, and metabolic

diseases and immunity disorders; diseases of the blood and

blood-forming organs; mental disorders; and the supplementary

category. All six of these diagnostic categories together accounted for only about 7 percent of children’s discharges

inPoland and about 9 percent in the United States.

In fact, despite all these variations in rates for categories

and specific conditions, total discharge rates for children 1–14

years of age in Poland and the United States did not differ

significantly. This contrasts with higher U,S. discharge rates

for the other age groups.

Males 1–14 years of age in Poland were discharged at

a higher rate than were females, and they had higher rates

for all four of the leading diagnostic categories. It should

be noted that the discharge rate for females was higher for

diseases of the genitourinary system. As was the case for

22

patients under 1 year of age, this can be attributed to a higher

female rate for diseases of the urinary system.

Most of the differences in discharge rates by sex for

the United States were not statistically significant, but U.S.

males, like Polish males, had a higher rate of injury and

poisoning. In both countries, more males than females were

hospitalized for fractures, intracranial injuries, and lacerations.

The average length of a hospital stay for children 1-14

years of age in Poland was 3.8 times that in the United

States, a difference of 11 days (table W). Stays were longer

in Poland for both males and females and for every diagnostic

category except complications of pregnancy, childbirth, and

the puerperium.

The Polish average length of stay was more than seven

times the U.S. average stay for diseases of the nervous system

and sense organs. Within this category, the Polish average

stay was seven times that in the United States for diseases

of the ear and mastoid process, nearly nine times the U,S.

average for diseases of the eye, and nearly four times the

U,S. average for disorders of the central nervous system,
Tabte U. Rate of discharge for inpatienta 1-14 yeare of age by diignoatic chapter and aex Poland and the United Ststeq 1980

[Dala are for shorf.stsy non-Federal hospitals in the United States and for all general hospitals in Poland. Data exclude normal deliveries (coda 650). Diagnostic chapters and code numbers are

from the Ninth Revision, International Classification of Diseasss, 1975]

Both sexes Male Female

United United United

Diagnostic chapter and [CD-9 code Poland States Poland Statea Poland States

Allconditlone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infecliousand parasiticdiseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Endocrine, nutritional andmetabohc dseases andimmuni~dsorders . . . . . . . . . 240-279

Dlseaaesoftheblood andblood-forming organe . . . . . . . . . . . . . . . . . 280-289

Mentaldisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..29C+319

Diseasesofthe nervoussystemand sense organs . . . . . . . . . . . . . . . . . . 320-389

Dlseasesofthecirculatorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390459

Diseasesofthe respiratorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Dlseasesofthedigestivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseaees ofthegenitourinarysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . 5e0-629

Complicationsofpregnancy,childbirth andthepuerperium . . . . . . . . . . . . . . . 630-676

Dlseasesoftheskinandsubcutaneous tissue . . . . . . . . . . . . . . . . . . 660-709

~seaees of themusculoskeletal system and connective tissue. . . . . . . . . . . 71 C-739

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 740-759

Certain condition originating in the perinatal period . . . . . . . . . . . . . . . .. . 760-779

Symptoms, signs and ill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . 780-799

In]uryand poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...80&999

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VO1-V62

60.5 59.6

5.5 2.6

1.1 1.3

0.5 1.0

0.6 1.4

0.4 0.9

3.6 6.0

0.8 0.4

19.4 17.2

8.0 7.7

3.3 3.3

0.0 0.4

1.e 1.3

1.3 1.4

2.4 2.5

.

2.3 1.9

9.0 9.4

0.4 0.7

Rata per 1,000 population

67.4 65.4

5.9 2.9

1.2 1.2

0.5 1.0

0.6 1.5

0.4 o.e

3.9 6.9

0.8 0.5

22.0 18.4

9.1 8.7

2.6 3.4

... ...

2.0 1.5

1.4 1.4

2.6 3.0

.

2.4 1.9

11.4 11.4

0.4 0.8

53.2 53.4

5.0 2.3

1.0 1.4

0.5 1.1

0.5 1.2

0.4 1.0

3.2 5.1

0.8 “0.3

16.7 16.0

6.9 6.6

4.1 3.3

0.0 0.8

1.6 1.1

1.3 1.5

2.3 2.1

.

2.3 1.9

6.4 7.2

0.3 0.5

Table W. Average tength of stay for discharged inpatienta 1-14 years of age by dmgnostic chapter and sex Poland and the United States, 1980

[Data are for short-stay non-Fedaral hospilals in the United States and for all general hospitals in Poland. Data exclude normal deliveries (cede 650). Diagnostic chapters and code numbers are

from the Ninth Revision, International Classification of Oiseases, 1975]

Both sexes Male Female

United United United

Diagnostic chapter and ICD-9 code Poland States Poland States Poland States

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectious andparasitic diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Neoplasm, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...14&239

Endocrine, nutdtional andmatabotic dseases andimmuni~ disorders . . . . . . . . . 240-279

Diseases of the blood and blood-forming organs . . . . . . . . . . . . . . . . . . 280-289

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..29W319

Diseases of thenervous system and sense organs . . . . . . . . . . . . . . . . . 320-389

Dieeaaes of theckculatory aystem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Diseases of therespiratory system, . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Diseases of thedigestivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseases of thegenitourinary system . . . . . . . . . . . . . . . . . . . . . . . . . 560-629

Complications of pregnancy, childbirth and the puerperium . . . . . . . . . . . . . . . . 630-676

Diseasea of the skin and subcutaneous tissue . . . . . . . . . . . . . . . . 6e0-709

Diseases of the musculoskeletal system and connective tissue . . . . . . . . . . . . . . 71 C-739

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 740-759

Certain conditions originating intheperinatal period . . . . . . . . . . . . . . . . 760-779

Symptoms, signs and ill-defined conditions . . . . . . . . . . . . . . . . . . . . . 780-799

Injury andpoiaoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 800-999

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VO1-V62

Another large difference, a Polish average length of stay

six ti?nes that in the United States, was found for the supplementary classification, The length of stay for this category

was longer than the average for all diagnoses in Poland but

shorter than the average in the United States.

Longer than average lengths of stay were reported in

both countries for mental disorders; diseases of the circulatory

system; diseases of the musculoskeletal system and connective

tissue; neoplasms; and endocrine, nutritional and metabolic

Average length of stay in days

15.0 4.0 14.6 4.0 15.4 4.1

19.3 3.9 16.3 4.0 20.5 3.8

19.4 6.1 20.4 7.4 18.0 4.8

18.6 6.0 20.2 5.6 17.3 6.3

13.6 3.9 12.7 4.2 14.9 3.6

21.3 13.9 23.1 12.4 19.3 15.2

21.3 3.0 20.4 2.9 22.3 3.0

23.6 7.6 22.4 7.4 25.1 ●e.o

15.0 3.2 15.7 3.3 14.2 3.0

9.5 3.5 9.5 3.3 9.5 3.7

15.5 3.6 14.2 3.4 18.3 3.7

4.3 7.6 ... ... 4.3 7.6

12.2 4.3 11.6 4.5 13.0 4.1

27.6 6.8 26.7 7.1 28.4 6.6

23.1 4.9 18.5 4.5 28.6 5.5

. . ●

8.4 3.2 6.8 3.2 8.0 3.2

10.7 4.7 10.6 4.6 10.8 4.5

16.2 2.9 18.3 3.0 16.0 2.6

diseases and immunity disorders. Stays were also longer than

average in Poland for congenital anomalies and infectious

and parasitic diseases, the latter attributable to average stays

of 36.8 days for hepatitis and 72.9 days for tuberculosis.

Shorter than average stays were reported in both countries

for symptoms, signs, and ill-defined conditions.

The diagnostic categories that accounted for the most

patient care days for children 1–14 years of age were generally

the same as the leading discharge categories (table Y). In

23
TableY. Rateofpatientcaredaya for discharged inpatients 1-14 yeers of age by dmgnostic chapter and sex: Poland and the United States, 1980

[Data are for short-stay non-Faderal hospitals in the United Statea and for all general hospitala in Poland. Data exclude normal deliveries (cede 650). Diagnoatfc chaptera am! cafe numbara are

from the Ninth Revision, lntemational Clasaitication of Diseases, 1975]

Both sexes Male Female

United United United

Diagnostic chapter and ICD-9 code Poland States Poland States Poland States

Rate per 1,000 population

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 904.4 240.S 985.5 263.0 619.6 216.6

Infectiousand parasiticdiseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001–139 105.5 10.1

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . .. $..... . . . . . ..$ ..140-239

108.1 11.4 102.8 6.7

20.6 7.6 23.5

Endocdne, nutritional andmetabolic dseases and immunity disorders . . . . . . . . . . 241)-279 9.5

9.0 17.5 6.5

6.3 10.1

Oiseases ofthebloodand blood-forming organs . . . . . . . . . . . . . . . . . . . . . 26c-28g 8.7

5.6 8.8 7.0

5.3

Mentaldisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..2g&31g

9.8 6.3 7.8 4.3

8.5 12.8

Oiseasesofthenervoussystemand seneeorgans . . . . . . . . . . . . . . . . . . . . 320-36g

9.0 10.3 7.9 15.4

76.2 17.9 80.4

Oiseasesofthecirculatorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3913+59

20.4 71.7 15.3

18.4 3.3 16.1

Oiseasesoftherespiratorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519 292.2

3.8 18.8 “2.7

54.8 345.0

Oiseasesofthedigestivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

61.6 237.0 47.7

76.1 27.0 86.3

Oiseasesofthegenitourinarysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . 560-629

29.1 65.4 24.7

51.4 11.8

Complicationsofpregnancy,childbirfh andthepuerperium . . . . . . . . . . . . . . . . 630-676 0.1

36.2 11.6 67.2 12.1

3.0 ... ...

Oiseases oftheskinand subcutaneous tissue . . . . . . . . . . . . . . . . . . . . . . 680-709

0.2 6.2

22.1 5.7 23.0

Dseases of themusculoskeletal system and connective tissue. . . . . , . . . . . . . . 710-73g

6.9 21.1 4.5

37.0 9.8 38.5

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...740-759

9.8 35.5 9.6

56.1 12.4

Certain conditions originating intheperinatal period . . . . . . . . . . . . . . . . . . . 760-779 .

46.0 13.3 64.7 11.3

●

Symptoms, signe and ill-defined condition . . . . . . . . . . . . . . . . . . . . . . . . 780-799

. ●

i 9.5 6.1

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-999

20.9 6.1 18.1 6.1

95.8 44.1 121.2

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI-V62 6.7

55.0 69.1 32.6

2.0 7.3 2.5 6.1 1.4

the United States, diseases of the respiratory system, injury

and poisoning, and diseases of the digestive system were

responsible for 52 percent of children’s hospital days. In Poland, diseases of the respiratory system alone accounted for

athirdof children’s patient care days. Infectious and parasitic

diseases and injury and poisoning followed in importance,

and together these three leading diagnostic categories accounted for 55 percent of hospital days for Polish children

l–14yearsofage.

Rates of patient care days were higher in Poland for

almost all diagnostic categories. Two exceptions were mental

disorders and complications of pregnancy, childbirth, and the

puerperium. The higher U.S. rate for the pregnancy catego~

is probably due to the high incidence of teenage pregnancies

in the United States and to the greater incidence of complications in the very early reproductive years (NCHS 1980b,

1984a).

The Polish rate of patient care days was 10 times the

U.S. rate for infectious and parasitic diseases and more than

5 times the U.S. rate for diseases of the circulatory system,

For both categories, discharge rates were higher and average

lengths of stay longer in Poland. The Polish rate of patient

care days for diseases of the respiratory system was five

times the U.S. rate because of longer average stays. Discharge

rates for respirato~ diseases did’ not differ significantly between the two countries. Within the respiratory disease category, the Polish rate of patient care days for bronchitis and

emphysema was 37 times the U.S. rate. Polish patients with

bronchitis and emphysema had an average length of stay eight

times the U.S. average, and they were discharged at a rate

four times that in the United States.

15-44 years

Complications of pregnancy, childbirth, and the puerperium was the leading discharge diagnosis for patients 1544

years of age in both Poland and the United States (table Z). Although normal deliveries were excluded, one in

every five U.S. discharges and one in every four Polish discharges for this age group were related to childbearing. The

other leading diagnostic categories for females in both countries

were diseases of the genitourinary system and diseases of

the digestive system.

The leading diagnostic category for males 15-44 years

of age in both countries was injury and poisoning. Diseases

of the digestive system was also a leading diagnosis for males

in both countries, as it was for females. Other leading diagnostic categories for males in the United States were mental

disorders and diseases of the musculoskeletal system and connective tissue. In Poland, diseases of the respiratory and circulato~ systems were leading diagnostic categories for males.

Discharge rates for patients 1544 years of age were

higher in the United States for most diagnostic categories.

One of the largest differences was for diseases of the musculoskeletal system and connective tissue. The U.S. rate for this

catego~ was 3.6 times the Polish rate. Within this category

(table 7), an especially large difference was found in the

discharge rates for rheumatism, the U.S. rate being more

than five times the Polish rate (figure 12). Other diagnostic

categories with notably higher rates in the United States were

congenital anomalies; diseases of the blood and blood-forming

organs; and endocrine, nutritional and metabolic diseases and

immunity disorders. Whhin this last class, the U.S. discharge

rate for diabetes mellitus was 2.6 times the rate inPoland.

24
Table Z. Rate of dlacharge for inpetienta 1$44 yeare of age by diagnostic chepter and sex: Poland and the United Statea, 1980

[Dataare for shott-sk.y non-Faderelhospitalsin theUnitedStatesandfor all generalhospitalsIn Poland. Data exolude normal deliveries (cede 650). Diagnostic chaptere and code numbers are

from the Ninth Revision, International Cleesificationof Diseases, 1975]

Both sexes Male Female

United United United

Diagnostic chapter and ICD-9 code Poland States Poland States Poland States

Allcond[tion a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectlousand parasitlcdleeases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Neoplasm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Endocrine, nutritional andmetabolic dseasea andimmunity dieordera . . . . . . . . .

Dlseasesoftheblood andblood-forming organs . . . . . . . . . . . . . . . . . . .

Mentaldlsorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dlseasesofthe nervoussystemand sense organs . . , . . . . . . . . . . . . . . . . .

Diseaseeofthecirculatorysyetem. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dieeaaea oftheresplratoryayetem . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dleeasesofthedlgestivesystem, . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dieeasaeofthegenitourinarysystem . . . . . . . . . . . . . . . . . . . . . . . . . . .

Compllcatlons ofpregnancy, childbirth andthepuerperium . . . . . . . . . . . . . . .

Dleeasesoftheskln andeubcutaneoustissue , . . . . . . . . . . . . . . . . . . .

Diseases of themusculoskeletal system andconnective tiaaue. . . . . . . .

Congenital anomaiiee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Certain conditions orlglnatlng intheperinatal period . . . . . . . . . . . . . . . . .

Symptoms, slgnsand ill-defined conditiona . . . . . . . . . . . . . . . . . . . . . .

Injury andpoieoning .,....... . . . . . . . . . . . . . . . . . . . . . . . . . . .

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

001-139

140-239

240-279

280-289

290-319

320-389

390-459

460-519

520-579

5S0-629

630-676

6SC-709

710-739

740-759

760-779

7s0-799

80C-999

VO1-V82

Rate per 1,000 population

90.1 134.0 67.8 91.5

3.7 2.4 4.0 2.3

3.1 4.5 1.9 2.1

1.2 2.9 0.8 2.0

0.4 0.9 0.3 0.8

1.4 9.2 1.3 10.0

3.7 3.7 4.2 3.4

4.2 5.2 5.0 5.6

5.6 7.3 6.3 6.3

11.6 15.0 11.6 13.8

11.5 17.4 4.4 5.5

23.0 27.8 ... ...

2.5 2.3 3.0 2.6

2.6 8.8 3.0 9.3

0.3 0.9 0.3 0.6

. .

1.3 2.7 1.2 2.2

12.9 17.1 20.0 23.0

1.2 5.9 0.5 1.7

112.9

3.3

4.4

1.7

0.4

1.5

3.2

3.4

4.9

11.5

18.8

46.5

1.9

2.3

0.3

1.3

5.8

1.8

175.1

2.5

6.9

3.7

1.0

8.3

4.0

4.8

8.2

16.2

28.9

54.7

2.0

8.3

1.1

●

3.1

11.4

9.9

Another large difference was found within the genitourinary category, Females 15-44 years of age in the United

States had a discharge rate 10 times that for females in Poland

for disorders of the breast. Differences in discharge rates

for females were also reported in the injury and poisoning

category. Discharge rates for males with a diagnosis in the

in@y andpoisoning category didnotdiffer significantly between the two countries, but the rate for U.S. females was

nearly twice that for Polish females. Among the injury and

poisoning diagnoses, discharge rates for U.S. females were

more than nine times those for Polish females for dislocations,

sprains, and strains and for certain complications of surgical

and medical care, The U.S. rate for females for intracranial

injury excluding skull fracture was more than double the Polish

rate,

In contrast, the discharge rate for infectious and parasitic

diseases was higher in Poland, Polish males had a significantly

higher discharge rate than U.S. males had for diseases of

the nervous system and sense organs, including an 80-percent

higher rate for disorders of the peripheral nervous system.

Within thedigestive diseases category, thedischarge rate for

Polish patients for gastric and duodenal ulcers was three times

the rate in the United States, and the Polish rate for appendicitis

was more than twice the U.S. rate. However, the U.S. rate

for hernia of the abdominal cavity was nearly three times

the Polish rate,

The average length of stay for patients 15-44 years of

age was 2.3 times, or 7.4 days, longer in Poland than in

the United States (table AA). Average stays for both males

and females were more than twice as long in Poland as in

the United States. Average stays were shorter for females

than for males in both countries, but short stays for complications of pregnancy, childbirth, andthepuerperium accounted

formuch of the sex difference. When the pregnancy category

is excluded, the difference in average lengths of stay between

males and females is reduced to 2.4 days in Poland; and

in the United States it is not statistically significant.

Polish lengths of stay were at least twice U.S. lengths

of stay for nearly all diagnostic categories. For infectious

and parasitic diseases, the Polish average stay was more than

six times the U.S. average stay. Average stays in Poland

of 82.1 days for tuberculosis and of 29.8 days for hepatitis

were major contributors to the longer average stay in this

category.

Average lengths .of stay for congenital anomalies and

for diseases of the musculoskeletal system and connective

tissue were also especially long in Poland. The Polish average

stay for congenital anomalies was 3.7 times the U.S. stay,

or nearly 18 days longer. Polish females had average stays

that were more than 9 days longer than those for Polish

males for congenital anomalies, but in the United States,

average stays for the category did not differ significantly

by sex. In the musculoskeletal and connective tissue category,

the Polish average length of stay for arthropathies and related

disorders was 4.5 times the average stay in the United States,

or nearly 20 days longer.

Another contrast worth noting is in diseases of the respiratory system. The average stay for respiratory diseases was

longer than the average for all conditions in Poland, but it

was shorter in the United States. As a result, the Polish

stay was 3.7 times, or nearly 12 days, Ionger than the U.S.

stay. Within this category, the Polish average stay was more

than four times the U.S. average for asthma, chronic disease

of the tonsils and adenoids, and bronchitis and emphysema.

Average lengths of stay for diseases of the genitourinary

system were more similar than for most of the categories,

the Polish average being 80 percent, or 3.6 days, longer

than the U.S. average. Within this category, stays for disorders

25
Diabetes

melfitus

Gastric and

duodenal ulcer

2.1

Appendicitis

3.2

Hernia

Disorders

of breast

Rheumatism

I I

2.0

~il .Unitedstates

❑ Poland

1.7

J.1 0.2 0.3 0.4 0.5 1.0 2.0 3+0 4.0

Rate per 1,000 population (log scale)

Fiiure 12. Discharge rates for patients 15-44 yeara of age for selected diagnosex Poland and the United States, 1980

Table AA. Average length of stay for discharged inpatients 15-44 years of age by dngnostic chapter and serc Poland and the United States, 1980

[Data ars for short-stay non-Federal hospitals in the Unitsd States and for all general hospitals in Poland. Data exclude normal deliveries (sade 650). Diagnostic chapters and cede numbers are

from the Ninth Revision, International Claseificstion of Diseases, 1975]

Both sexes Male Female

United United United

Diagnostic chapter and /CD-9 code Poland States Poland States Poland States

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infecfiousand parasiticdiseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Neoplssms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Endocrine, nutdtional andmetabohc dseases andimmunity disorders . . . . . . . . . . 240-279

Diseases of the blood and blood-forming organs . . . . . . . . . . . . . . . . . . . . . 280-289

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...290-319

Diseasesofthenervoussystemandsense organs . . . . . . . . . . . . . . . . . . . . 320-389

Diseasesofthecirculatorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Diseasesofthe respiratorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Diseasesofthedigestivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

DLseasesofthegenitourinarysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . 560-829

Complications ofpregnancy, childbirth andthepuerperium . . . . . . . . . . . . . . . . 630-676

Diseases of thesldn and subcutaneous tissue . . . . . . . . . . . . . . . . . . . . . . 660-709

Dseases of themusculoskeletal system and connective tissue. . . . . . . . . . . . . . 71C-739

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 740-759

Certain conditions originating intheperinatal period . . . . . . . . . . . . . . . . . . . 780-779

Symptoms, signs andiil-defined conditions . . . . . . . . . . . . . . . . . . . . . . . . 760-799

Injury and poisoning . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...600-999

.%pplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI-V62

12.9

39.6

1S.3

16.4

14.9

10.6

16.2

16.5

16.2

12.8

8.1

7.1

15.8

23.1

24.6

8.0

12.4

7.0

Average length of stay in days

5.5 16.0 6.3 10.9

6.2 43.5 6.2 34.7

7.0 20.9 8.6 17.1

7.3 17.1 7.3 16.0

5.6 12.1 4.9 16.4

11.1 9.8 10.6 11.3

5.9 18.0 5.9 18.3

7.2 16.6 7.4 16.3

4.4 16.6 4.5 15.6

5.5 13.0 5.1 12.6

4.5 6.8 4.2 7.9

3.8 ... ... 7.1

5.7 16.0 5.8 15.6

6.6 21.4 6.4 25.3

6.7 19.7 7.5 29.1

* .

3.9 8.1 4.2 7.7

6.1 12.9 6.2 10.6

2.9 8.9 3.6 6.4

5.1

6.2

6.5

7.3

6.2

11.5

5.9

6.9

4.3

5.7

4.5

3.8

5.4

6.6

6.2

●

3.7

6.0

2.8

26
Tabfef3B. Rateofpatiant mredays fordschrgad inpatients lWyeamof age bydmgnostic chapter andsex: Poland andthe Unfid Stites, 19S0

[Dataare for short.stay non-Federal hospitals in the United Statea and for all general hospitals in Poland. Data exclude normal deliveries (code 650), Diagnostic chapters and code numbers are

from Ihe Ninth Revision, International Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnostic chapter and ICD-9 code Poland States Poland States Poland States

Rate per 1,000 population

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectiousand parasiticdiseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..14~239

Endocrine, nutritional andmetabohc diseases andimmunity &sorders . . . . . . . . . 240-279

Diseasesoftheblood andblood-forming organs . . . . . . . . . . . . . . . . . . . 280-289

Mentaldisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..29~19

Disew!softhenervoussystemand sense organs . . . . . . . . . . . . . . . . 320-389

Diseases ofthecirculatorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Dkxxmesoftherespiratoysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48~519

Diseases ofthedigestivesystem. . . . . . . . . . . . . . . . . . . . . . . . . . . ..52~79

Diswsesofthegenitourinarysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . 5S0-629

Complications ofpregnancy, childbktha ndthepuerpefium . . . . . . . . . . . . . . 630-676

Disswes of the skin and subcutaneous tissue . . . . . . . . . . . . . . . . . . . . 6eC-709

Diseases of the musculoskeletal system and connective tissue . . . . . . . . . . . 710-739

Congenital anomalies . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 740-759

Certain conditions originating inthe perinatalperiod . . . . . . . . . . . . . . . 760-7’7’9

Symptoms,signs and ill-defined conditions . . . . . . . . . . . . . . . . . . . . 780-799

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..- . . . .. SoQ-9g9

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VO1-V82

1,159.6

145.4

56.4

19.9

5.2

15.0

67.6

69.0

90.5

148.2

93.0

164.0

38.9

60.4

8.1

10.1

160.0

8.1

739.6 1,086.6

14.9 175.6

31.8 38.8

20.9 13.5

5.1 3.5

101.3 13.0

21.8 76.3

36.9 82.2

31.9 104.8

S2.O 150.8

78.0 39.1

105.1 ...

13.0 47.e

58.0 63.6

6.3 6.3

●

10.5 10.1

105.1 256.5

17.2 4.7

561.0 1,234.4

14.1 114.4

16.2 74.3

14.7 26.4

3.8 6.9

106.5 17.0

19.9 58.7

41.1 55.4

2e.1 75.9

71.2 145.6

23.1 14e.1

... 331.9

15.3 29.9

59.6 57.1

5.6 9.9

.

9.5 10.1

143.5 61.1

6.5 11.7

893.4

15.8

45.0

26.9

6.3

96.2

23.6

32.8

35.5

92.4

131.1

206.7

10.7

56.5

7.0

●

11.4

6S.0

27.5

of menstt-mtion and other abnormal bleeding from the female

gcnitid trwt averaged 43 percent (1.4 days) longer in Poland,

hut Polish stays for other diagnoses were two or three times

U.S. stays. The average stay in Poland for complications

of pregnancy, childbirth, and the puerperium was 87 percent,

or 3.3 dtiys longer than the average U.S. stay for this category.

The tiverage length of stay for induced abortion was nearly

the stimc in the two countries, but stays for other diagnoses

in this category were at least twice as long in Poland as

in the United States.

As can be seen in table BB, the leading cause of patient

ctirc duys for females 15-44 years of age in both Poland

urtd the United States was complications of pregnancy,

childbirth, and the puerperium. The leading cause for males

aged 15-44 years in both countries was injury and poisoning.

These two diagnostic categories accounted for approximately

2Spcrccnt of all patient care days in both countries.

Diseases of the genitourinary system and diseases of the

digestive system also were leading causes of patient care

dtiys for females in both countries, and mental disorders was

a hmling cause in the United States. Mental disorders also

was a leading cause of patient care days for males in the

United States, but in Poland, the other leading causes for

midcs were diseases of the digestive system and infectious

wtd parasitic diseases.

The rate of patient care days for the age group 15-44

years was 57 percent higher in Poland than in the United

Sttitcs, but there was considerable variation in the rate differences by diagnostic category. Rates were similar in the two

countries for four categories: diseases of the musculoskeletal

systtxn tind connective tissue; endocrine, nutritional, and

mcttibolic diseases and immunity disorders; symptoms, signs,

ml ill-defined conditions; and diseases of the blood and bloodforming organs. For two diagnostic categories, mental disorders and the supplementary classification, the rate of patient

days was higher in the United States.

In contrast, the Polish rate of patient care days for infectious and parasitic diseases was nearly 10 times the U.S.

rate. Polish rates for the categories of diseases of the skin

and subcutaneous tissue, diseases of the respiratory system,

and diseases of the nervous system and sense organs were

approximate y three times U.S. rates. Among the respiratory

diseases, the Polish rate of patient care days for bronchitis

and emphysema was nine times the U.S. rate. In the nervous

system and sense organ category, disorders of the eye and

adnexa led to a patient care day rate in Poland that was

six times that in the United States.

There also were variations in rates of patient care days

by sex. For example, the male rate for injury and poisoning

was 79 percent higher in Poland than in the United States,

but female rates were about the same. In Poland, the rate

of patient care days for diseases of the digestive system was

higher for males than for females, but in the United States,

females had a higher rate.

45-64 years

The most frequent discharge diagnosis for hospital patients

45-64 years of age in the United States and Poland was

a disease of the circulatory system (table CC). Circulator

diseases were responsible for about one in every five discharges

for both sexes and for one in every four discharges for males

in the two countries. The second leading diagnostic catego~

for the group 45-64 years of age was diseases of the digestive

system, which accounted for 15 percent of the discharges

in each country. Neoplasms and diseases of the genitourinary

system together caused 22 percent of hospitalizations in Poland, and 21 percent of those in the United States.

27
Table CC. Rate of dmcharge for inpatfenta 45-84 yeara of age by diagnostic chapter and aex Poland and the United State% 1980

[Data are for sfwt-stay non-Federal fwspitala in the United Stataa and for all genaral hospifsla InPoland.Dataexolude normal deliveries (de 650). Diagnosllc chaptera and code numbers are

from the Ninth Revision, International Classificationof Diseases, 1976]

Both sexes Male Female

United United United

Diagnostic chapter and ICD-9 code Poland States Poland States Poland States

Rate per 1,000 population

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126.1 194.6 138.8 195.4 114.9 194.2

Infectiousand parasiticdiseaees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139 4.8 2.0 6.5

Neoplasm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

2.0 3.3 2.0

13.5 20.2 12.3

Endocflne, nutritional andmetabohc deeasas andimmunity tiaorders . . . . . . . . . . 240-279 3.4

16.7 14.6 23.3

8.3 2.7

Diseaeesofthe bloodend blood-forming organs . . . . . . . . . . . . . . . . . . . . . 280-2S9 0.6

6.3 3.9 10.1

1.3 0.4

Mentel disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..2g0-31g 1.4

1.0 0.7 1.5

10.1 1.2

Diseases ofthanewoua system andaenae organs . . . . . . . . . , . . . . . . . . . . 320-389 6.3

11.7 1.5 6.7

9.2 7.0

Dlaeases of thecirculatory ayatem ... . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

8.2 5.7 10.1

27.2 38.5 34.3

Diseases of the respiratory system.,. . . . . . . . . . . . . . . . . . . . . . . . . . . 460-51g

48.3 20.9 29.6

11.0 15.0 14.6

Diseaaea of thecfigestive system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-57g

16,3 7.6 i 3.9

19.3 29.4 21.2

Diseasaa of thegenitourinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . 58rJ+2g

30.4 17.7 28.5

13.8 20.7 7.7

Complications ofpregnancy, childbirth andthepuerperium . . . . . . . . . . . . . . . . 830-676 0,3

15.6 19.2 26.3

“0.1

Diseases of theskin andsubcutanaous tissue . . . . . . . . . . . . . . . . . . . . . . 660-70g 2.8

0.5 “0.3

3.4 3.2““” ““”

Maaases of themusculoskeletal system and connective tissue. . . . . . . . . . . . . . 710-73g 7.4

3.1 2.5 3.7

16.4 7.4

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...740-759 0.2

14.4 7.5 16.1

0.9 0.2

Certain conditions orlginafing intheperinatal period . . . . . . . , . . . . . . . . . . . 760-779 .

0.7 0.2 1,0

●

Symptoms, aignsand ill-definad conditiona . . . . . . . . . . . . . . . . . . . . . . . . 780-7g9 1.3

● ●

3.3 1.4

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..60&ggg

3.3 1.2 3.2

12.4 14.1 16.1

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VO1-V82 0.4

15.7 7.5 12.7

1.9 0.5 1.7 03 2.1

The total discharge rate for patients 45-64 years of age

was 54 percent higher in the United States than in Poland.

The U.S. discharge rate was higher than the Polish rate for

13 of the 17 diagnostic categories, and it was more than

twice the Polish rate for seven of the categories. Most of

the seven accounted for only a small proportion of discharges.

However, the rate difference for the endocrine, nutritional,

and metabolic diseases and immunity disorders category should

be noted. Patients with diabetes mellitus made up more than

60 percent of discharges in this category, and the U.S, discharge rate for diabetes was 2.6 times the Polish rate (table 8). Also of interest is the category diseases of the musculoskeletal system and connective tissue, for which the U,S.

discharge rate was 2.2 times the Polish rate. As was the

case for patients 154.4 years of age, there was a major difference in the discharge rate for rheumatism: The U.S. rate

was more than five times the Polish rate.

The discharge rate for infectious and parasitic diseases

was higher in Poland for patients 45-64 years of age, as

it was for the younger age groups, The Polish rate was 2.4

times the U.S. rate. Discharge rates for diseases of the skin

and subcutaneous tissue and for injury and poisoning did

not differ significantly between the two countrieq. Within

the injury and poisoning category, though, Poland reported

40 percent more discharges for fractures; and the U.S. discharge rate for dislocations, sprains, and strains was 4.7 times

the Polish rate.

In addition, there were sex differences in the discharge

rates for diagnoses within the injury and poisoning category.

Males in Poland had a discharge rate more than twice that

for U.S. males for fractures, but rates for females were not

significantly different for the two countries (figure 13). The

discharge rate for U.S. males for dislocations, sprains, and

strains was 3.6 times the rate for Polish males, but the rate

for U.S. females was more than seven times that for Polish

females,

Another diagnostic category for which there were sex

differences in discharge rates was diseases of the respiratory

system. Discharge rates for males in the United States and

Poland for respiratory diseases did not differ significantly,

but U.S. females had a discharge rate 1,8 times that of Polish

females for these diseases. Among the respiratory diseases,

discharge rates for U.S. females were more than twice the

rates for Polish females for acute respiratory infections,

pneumonia, and asthma.

Average lengths of stay for patients 45-64 years of age

are shown by diagnostic category in table DD, Polish patients

in this age group had stays an average of 2.4 times the stays

of U.S. patients, or 11.2 days longer. Stays in Poland were

longer for nearly all diagnostic categories. One exception

was mental disorders, for which stays were virtually the same

length in the two countries. Lengths of stay for mental disorders

and neoplasms were significantly longer than the average for

all conditions in the United States. The length of stay for

neoplasms was also among the longest of any category in

Poland. The Polish average stay was 2.3 times, or 13.2 days,

longer than the U.S. average stay for neoplasms.

Other diagnostic categories for which average lengths

of stay were particularly long in Poland were infectious and

parasitic diseases and diseases of the musculoskeletal system

and connective tissue. The Polish average stay for infectious

and parasitic diseases was 5.7 times the U.S. average stay—

more than 40 days longer. As was the case for younger age

groups, this difference was largely attributable to long stays

for tuberculosis (72.9 days) and hepatitis (36.8 days) in Poland.

The average stay in Poland for diseases of the musculoskeletal

28
Females Males

3 8.5

Fractures

4,6

0.4

Dislocations, sprains,

and strains

2.9 3.6

1.5

3.1

1.1

2.6

3.6

Pneumonia

.2

~ Poland

❑ UnteclSfates

Asthma

1.9

I 1 I Ill I I i I I I I II I I I I I I ! I I I I Ill

1 I II I

1 I I

.9.6 .7.6.5 .4 .3 .2 .1 .1 .2 .3 .4 .5 .6.7 .8.9 ‘

II 111111~

5432 1

Rate per 1,000 population (log scale) 1 2 3 4 5 678910

F~ure 13. Discharge ratea for patients 45-64 years of age for selected dkxytoses, by sex: Poland and the United States, 1980

Table DD. Average length of stay for discharged inpatients 46-W yews of age by diagnostic chapter and sex Potend and the United States, 1980

[Dataare for short-stay non-Federal hospitala In the United States and for all general hosptale in Poland. Data exclude normal deliveries (code 650). Diagnostic chapters and code numbers are

from the Ninth Revision, [ntemational Classificationof Diseases, 1975]

Both sexes Male Female

United

Diagnostic chapter and ICD-9 code

United United

Poland States Poland States Poland States

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectiousand parasiticdiseases . . . . . . . . . . . . . . . . . . . . . . . . . . . 001–139

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Endocrine, nutritional andmetabohc diseases and immunity disorders 240-279

Dlseasesoftheblood andblood-forming organs . . . . . 280-289

Mentaldlsorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...29&319

Dlseasesofthe nervoussystemand sense organs . . . . . 32(?-389

Diseases ofthecirculatorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Diseasesofthe respiratorysystem . . . . . . . . . . . . . . . . . . . . . . . 46C-519

Dlseaaes ofthedigestivesystem . . . . . . . . . . . . . . . . . . . . . . . 520-579

Dlseasesofthegenitourinarysystem . . . . . . . . . . . . . . . . . . . . 560-629

Complicationsofpregnancy,childbkth andthepuerperium . . 630-876

Diseasesoftheskinand subcutaneouatissue . . . 660-709

Diseases of themusculoskeletal system and connective tissue. . 71C-739

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 740-759

Certain conditions originating in the perinatal period . 760-779

Symptoms, signs and ill-defined conditions . . . . . 7a0-799

Injury andpolsoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 800-999

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI–V82

19.4

49.4

23.6

19.6

20.9

11.7

20.0

18.5

21.9

16.8

10.4

6.5

22.7

24.1

11.6

11.9

15.1

10.2

Average length of stay in days

8.2 20.8 8.1 17.9

8.7 57.0 8.8 36.4

10.4 26.3 10.7 21.5

9.4 19.2 9.3 19.8

8.6 20.8 9.1 20.8

11.3 11.9 10.8 11.5

6.6 19.8 5.9 20.2

9.0 18.8 8.8 18.1

7.5 23.0 7.3 20.0

7.6 16.4 7.3 17.1

5.7 13.4 5.9 9.3

“4.0 6.7

9.4 228:“ 10.9..’ 22.7

8.3 22.8 7.8 25.3

8.5 15.6 10.0 10.0

. .

4.7 11.4 4.0 12.3

8.2 15.3 7.7 14.8

4.9 9.3 4.9 11.5

8.3

8.5

10.1

9.4

&2

11.9

5.7

$).4

7,%

7.8

5.6

“4.0

8.3

8.6

7.6

“

5.4

&7

4.9

29
Table EE. Rate of patient care daya for discharged inpatiinta 45-64 years of age by d~noatic chapter and sex Poland and the United States, 1980

[Data are for short-stay non-Federal hospitals in the United States and for all gsneral hospitals in Poland. Data exclude normal deliveries (code 650). Diagnostic chaptera and cede numbers are

from the Ninth Revision, International Classification of Diseases, 1975]

Both sexes Male Female

United

Diagnostic chaDter and ICD-9 code

United United

Poland States Poland States Poland States

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

lnfectiousand parasiticdiseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001–139

Neoplaams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Endocrine, nutritional andmetabohc tiseaaea andimmunity tiaordera . . . . . . . . . . 240-279

Diseasesofthebloodand blood-forming organs . . . . . . . . . . . . . . . . . . . . 280-289

Mental disordera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..29G319

Diseasea of thenarvous system and sense organs . . . . . . . . . . . . . . . . . 320-389

Diseases ofthecirculatorysyatam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Diseasesoftherespiratoryaystem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Diseasesofthedigestivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseasesofthegenitourinarysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Complications ofpregnancy, childbirth andthepuerparium . . . . . . . . . . . . . . . . 630-876

Diseases of theskin andsubcutanaous tisaue . . . . . . . . . . . . . . . . . . . . 680-709

Useases of themusculoskeletal system andconnective tissue. . . . . . . . . . . . . 710-739

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..74C-759

Certain conditions originating intheperinatal period . . . . . . . . . . . . . . . . . . 760-779

Symptoms, signs andill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . . 780-799

Injury andpoiaoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-999

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VO1-V82

2,440.9

237.2

316.4

65.7

11.9

15.9

125.5

503.7

240.1

323.9

143.1

1.7

64.2

179.3

2.2

15.8

187.8

4.4

Rate per 1,000 population

1,597.4 2,864.6 1,590.3 2,052.8 1,603.8

17.1 370.3 17.2. 120.9 17.0

208.8 324.5 179.2 313.2 235.6

77.4 51.6 56.2 77.9 94.7

10.8 8.3 9.2 15.0 12.3

114.4 13.9 127.1 17.6 102.9

53.1 138.3 48.0 114.2 57.8

346.5 647.0 422.9 378.5 277.3

113.2 340.4 118.5 152.4 108.4

222.8 346.5 222.5 304.1 223.0

117.1 103.3 91.2 178.0 140.6

“0.5 3.2 “1.0

31.8 72.6““” 33.4.“” 56.6 30.4

135.1 166.1 111.6 189.1 156.1

7.5 2.5 7.1 2.0 7.8

. ● ●

15.5 16.5 13.2 15.2 17.6

115.4 275.4 121.4 111.1 110.0

9.3 5.0 8.2 3.9 10.2

system and connective tissue was nearly three times the average

stay in the United States, or nearly 16 days longer. Polish

stays within this category were more than three times U.S.

stays for rheumatism and for arthropathies and related disorders

excluding osteoarthritis and allied disorders.

Also notable were differences between the two countries

in average lengths of stay fordlseases of the nervous system

and sense organs and for diseases of the respirator system.

The length of stay for the former category was shorter than

the average for all conditions in the United States but not

in Poland. Polish stays were more than eight times U.S.

stays for cataract and more than four times U.S. stays for

other disorders of the eye and adnexa. In the respiratory

disease category, the Polish length of stay was nearly four

times the U.S. stay fordiseases of theupper respiratory tract

other than acute infections, which includes conditions such

as deviated nasal septum and chronic sinusitis.

The leading cause of patient care days as well as the

leading discharge category for U.S. and Polish patients 45-64

years of age was diseases of the circulatory system (table

EE). Following circulatory diseases in importance in both

countries were diseases ‘of the digestive system and neoplasms.

These three diagnostic categories accounted for nearly half

of patient care days for the age group 45-64 years in both

countries. The three categories were leading causes of patient

care days for both males and females in the United States

and for females in Poland. Infectious and parasitic diseases

was the third leading category for Polish males, and neoplasms

was the fourth.

Polish males used three times more patient care days

per person than did Polish females for infectious and parasitic

diseases. Their patient care day rate was 2.5 times that for

Polish females for injury and poisoning and more than twice

the rate for Polish females for diseases of the respiratory

system. Patient care rates for males in the United States did

not differ significantly from those for females for any of

these diagnostic categories.

Although the total rate of patient care days was 53 percent

higher in Poland than in the United States, rates varied considerably by diagnostic category. For example, the Polish rate

for infectious and parasitic diseases was nearly 14 times the

U.S. rate, but the U.S. rate for mental disorders was more

than 7 times the Polish rate. U.S. rates were also significantly

higher than Polish rates for congenital anomalies and the

supplementary classification, but neither of these categories

was a major cause of patient care days in either country.

In addition to high rates for infectious and parasitic diseases, Polish rates of patient care days were more than twice

U.S. rates for diseases of the nervous system and sense organs,

diseases of the respiratory system, and diseases of the skin

and subcutaneous tissue. Among the nervous system and sense

organ diseases, Polish rates were more than three times U.S.

rates for disorders of the peripheral nervous system and disorders of the eye and adnexa. In the respiratory disease category,

the Polish rate was more than four times the U.S. rate for

diseases of the upper respiratory tract other than acute infections and more than 5.5 times the U.S. rate for bronchitis

and emphysema.

65 years and over

Patients 65 years of age and over, like the group 45-64

years of age, were most often hospitalized for a disease of

the cardiovascular system (table FF). Cardiovascular diseases

30
Tabfe FF. Rate of dischsrge for inpatients 65 years of age and over by diagnoatii chapter and sex: Poland and the United States, 1960

[Dataarefor short-staynon-FederalhospitalsIntheUnitedStsteaandfor all genaralhospitalsInPoland.DiagnosticchaptersandcodenumbersarefromtheNinthRevialon,International

Clsss.lficatlonof Dlseaaea,1975]

Diagnostic chapter and ICD-9 code

Both sexes Male Female

United United United

Poland States Poland States Poland States

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectlousand parasitlcdfeeasea. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Neoplasm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Endocrine, nutritional andmetabollc dieeaees andlmmunity dsorders . . . . . . .

Dlseaaesofthe blood andblood-forming organs . . . . . . . . . . . . . . . . . . . .

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Diaeaaea ofthenervouseyatem and sense organs . . . . . . . . . . . . . . . . . . . .

Dlseasesoftheclrculatoryaystem.. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dlseaaeaofthe reaplratorysyatem . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Diseasesofthedlgestlve system.. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Diseasesofthegenitourfnarysystem . . . . . . . . . . . . . . . . . . . . . . . . . . .

Compllcatione ofpregnancy, childbirth andthapuerperium . . . . . . . . . . . . . . . .

Diseases of theskln andsubcutaneous tissue , , . . . . . . . . . . , . . . . . , . . .

Dlaeaees of themueculoakeletal system andconnective tiasue. . . , . . . . . . . . . .

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Certain conditions orlglhatlng intheperinatal period . . . . . . . . , . . . . . , . . . .

Symptoma, elgnsand ill-defined conditlone . . . . . . . . . . . . . , . . . . . . . . . .

In]ury and poisoning..,..,,,.,,. . . . . . . . . . . . . . . . . . . . . . . . .

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . .

001 –139

140-239

240-279

2SC-289

290-319

320-3S9

390459

460-519

520-579

560-629

630-676

660-709

710-739

740-759

760-779

780-799

600-999

VOI –V82

Rate per 1,000 population

163.3 3s3.7 200.8 411.8 139.6 364.7

5.2 4.7 7.4 4.7 3.8 4.8

16.8 40.3 23.7 51.0 12.5 33.0

4.2 16.2 3.1 12.3 4.9 1s.s

1.1 4.5 1.0 4.2 1.2 4.7

0.4 9.4 0.3 9.9 0.4 9.1

7.0 23.6 7.5 22.6 6.6 24.0

57.5 110.6 66.7 121.9 50.5 103.4

15.3 3s.5 27.1 49.4 12.s 31.1

19.7 49.1 22.6 49.9 17.6 46.6

10.0 26.9 15.3 36.3 6.6 19.3

...

3.4 5.2‘.” 33:“. 4.3““” 3.4““” 57:“”

5.1 20.4 4.2 14.7 5.7 24.3

0.0 0.8 .

“0.7 0.1 0.6

. . .

1.9 3.7 2.1 4.4 1.7 3.3

12,5 27.4 14.1 20.9 11.5 31.7

0.3 2.1 0.3 2.3 0.2 2.0

were the leading discharge diagnoses for both males and

females 65 years of age and over in both Poland and the

United States, These diseases accounted for 29 percent of

discharges in the United States and 35 percent inPoland.

Other common diagnostic categories were diseases of the

digestive system, diseases of the respiratory system, and neoplasms, which together were responsible for one-third of discharges of patients 65 years of age and over in both countries.

The leading diagnoses did not differ by sex in Poland, and

the only difference in the United States was that injury and

poisoning was also a leading diagnosis for females.

Thedischarge rate for patients 65 years of age and over

in the United States was twice the rate in Poland, Higher

U.S. rates were reported for both sexes and for all the diagnostic categories except infectious and parasitic diseases, for which

discharge rates were similar in the two countries.

U,S, discharge rates were three or four times Polish rates

for endocrine, nutritional, and metabolic diseases andimmunity disorders; diseases of the blood and blood-forming organs;

diseases of the nervous system and sense organs; and diseases

of the musculoskeletal system and connective tissue. In the

category of endocrine, nutritional, andmetabolic disekses and

immunity disorders, the U.S. discharge rate for diabetes reelIitus was2.6times the Polish rate (table 9). Diabetes mellitus

accounted for 85 percent of discharges in this category in

Poland butonly 58percent inthe United States. Nearly onefourth of U.S. discharges in this category were for disorders

of fluid, electrolyte, andacid-base balance, principally dehydration and other volume depletion.

Cataract was responsible for 52 percent of U.S. discharges

in the nervous system and sense organs category, compared

with 30 percent of Polish discharges, The U.S. discharge

rate for cataract was nearly six times the Polish rate. In addition, the U.S, discharge rate for diseases of the central nervous

system was nearly four times the Polish rate, Particularly

large differences in the musculoskeletal system and connective

tissue category included a U.S. discharge rate that was 13

times the Polish rate for rheumatism and one that was more

than 21 times the Polish rate for disorders of bone and cartilage.

The U.S. discharge rate for diseases of the circulatory

system was nearly twice the rate in Poland, but there was

considerable variation between the countries for specific circulatory diseases (figure 14). For acute myocardial infarction,

the U.S. rate was twice the Polish rate; for other ischemic

heart disease, it was 3.6 times the Polish rate; and for cardiac

dysrhythmias, it was 6.8 times the Polish rate. The U.S.

rate for acute cerebrovascular disease was three times the

Polish rate, but the Polish rate for atherosclerosis was more

than four times the U.S. rate. The high Polish rate for

atherosclerosis may reflect a difference in the way the disease

is classified and coded in the two countries. Polish physicians

may classify coronary atherosclerosis, a subcategory of chronic

ischemic heart disease, asthe more generalized atherosclerosis.

In the injury and poisoning category, the discharge rate

for U.S. females was 2.8 times the rate for Polish females;

but for males the U.S. rate was only 50 percent higher.

The most frequent diagnosis in the category was fractures,

for which U.S. females had a discharge rate 2.5 times that

for Polish females. Discharge rates for U.S. and Polish males

for fractures were about the same as the rate for Polish females.

Fracture of the neck of the femur accounted for nearly half

of all fracture discharges for both males and females in the

United States. The discharge rate for U.S. males for such

hip fracture was three times that for Polish males, and U.S.

females had a rate nearly six times that for Polish females.

In addition, the discharge rate for females in the United States
Acute myocardial

infarction

9.3

❑ Poland

❑ United States

Other ischemic

heart disease

26.5

Cardiac

dysrhythmias

8.8

Acute

cerebrovascular

disease 18.3

13.7

Atherosclerosis

1 2 3 ‘ii 10

Rate per1,000 population(logscale)

20 30

Fiiure 14. Mscharge rates forpatients 65yesmof ageandover forselected tiseaaes of thecircukto~ systm:Poland andthe United SWtes, 1980

for dislocations, sprains, and strains was more than six times

the rate for females in Poland. The discharge rate for U.S.

males for these conditions was 3.2 times the Polish rate.

The average lengths of stay for both male and female

patients 65 years of age and over were twice as long in

Poland as in the United States (table GG). Polish average

lengths of stay were longer for each diagnostic category,

ranging from 50 percent longer for injury and poisoning to

4.6 times the U.S. average for infectious and parasitic diseases.

The longest average lengths of stay in Poland were for

infectious and parasitic diseases, Once again, prolonged hospitalizations for tuberculosis (65.4 days, on average) and

hepatitis (an average of 40.6 days) were the main reasons

for the long average length of stay for this category. The

second longest average stay in Poland was for diseases of

the skin and subcutaneous tissue. The length of stay for this

category in the United States was longer than the average

for all conditions, but the Polish length of stay was 2.7 times

the U.S. average, or 21.8 days longer. Other categories for

which U.S. stays were significantly longer than average were

mental disorders, injury and poisoning, and neoplasms.

32

One large difference in lengths of stay between the two

countries was im diseases of the nervous system and sense

organs. As was the case for patients 45-64 years of age,

the length of stay for this category was significantly shorter

than the average for all conditions in the United States but

not in Poland. As a result, the Polish average stay was 3.5

times the U.S. average stay, or 15.8 days longer. The major

difference within the category was that the Polish average

stay was 6.6 times the U.S. average stay for the diagnosis

of cataract.

Further, the Polish average stay for diseases of the musculoskeletal system and connective tissue was 2.5 times the

U.S. average, or 17.5 days longer. Polish stays for rheumatism

were three times U.S. stays, and patients in both countries

had particularly long stays for disorders of bone and cartilage.

The average length of stay for circulatory diseases was

80 percent longer in Poland, and Polish stays were more

than 2.5 times U.S. stays for angina pectoris and for diseases

of the veins and lymphatic, and other diseases of the circulatory system. The average length of stay for this last category

was especially long in Poland, more than 29 days. Average
Table GG. Average Lengthof atey for discharged inpatients 65 yesrs of age and over by dmgnostic chapter snd sex Poland and the United States, 1960

[Data are for short-stay non-Faderal hospitals in the United Statea and for all general hospitals in Poland. Diagnoafic chaptera and code numbers are from the Ninth Revision, International

Claasltication of Dlaeaaea, 1975]

Both sexes Male Female

United United United

Diagnostic chapter and lCD–9 code Poland States Poland States Poland States

All conditions . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectloueand parasiticdiaeasea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Endocrine, nutritional andmetaboKc dseases andimmunity disorders . . . . .

Diseasesoftheblood andblood-forming organs . . . . . . . . . . . . . .

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Diseasesofthe nervous system andeenaeorgans . . . . . . . . . . . . .

Dlseasesofthecirculatorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Diseaseeoftherespiratorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Diseasesofthedigestivesystem. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Diseasesofthegenltourinarysystem . . . . . . . . . . . . . . . . . . . . . . . . . . .

Complicationsofpregnancy,childbirth andthepuerperium . . . . . . . . . . .

Diseaees oftheekln and subcutaneous tissue . . . . . . . . . . . . . . . .

Dleeaaes of themusculoskeletal system and connective tissue. . . . . . . .

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Certain conditions originating intheperinatal period . . . . . . . . . . . . . .

Symptoms, signs andill-defined conditions . . . . . . . . . . . . . . . . . . . . . . .

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . .

001-139

140-239

240-279

28C-289

290-319

320-389

390-459

460-519

520-579

580-629

830-676

6eo-709

710-739

740-759

760-779

780-799

800-999

VOI-V82

22.1

52.1

24.7

21.4

23.8

24.9

22.0

19.7

23.3

17.9

17.5

.

34.7

29.0

18.2

14.9

20.3

11.5

Average length of stay in days

10.7 21.8 10.3 22.3

11.3 55.0 10.7 48.6

12.5 24.2 12.1 25.4

11.9 21.1 11.8 21.5

9.8 23.6 8.7 24.1

13.7 40.3 12.6 18.4

6.2 21.8 6.9 22.2

11.2 19.4 10.9 19.9

9.8 23.8 9.8 22.8

9.4 17.0 8.9 18.6

8.8 18.7 9.0 15.7

. . ... ...

12.8 28.0 11.5 38.7

11.6 26.1 11.2 30.4

10.1 ,

‘9.2 20.0

. .

7.5 14.3 6.7 15.3

13.2 17.8 12.0 22.2

6.4 9.4 6.0 13.8

11.0

11.6

12.9

11.9

10.4

14.5

5.8

11.4

9.8

9.8

8.6

...

13.5

11.8

10.7

.

8.2

13.7

6.7

Table HH. Rate ofpatient mredays fordsc~rged inpatients 65years ofageand over by@agnostic chapter andaex: Pobndand the Untied SWte~

1960

[Data are for shorf-stay non-Federal hospitala in the United States and for all general hospitals in Poland. Diagnostic chapters and code numbers are from the Ninth Revision, International

Classification of Dieeaaea, 197S]

Both sexes Male Female

United United

Diagnostic chapter and ICD-9 code

United

Poland States Poland States Poland States

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

infectious and parasitic diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Neoplaems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140--239

Endocrine, nutritional andmetabofic diseases andimmunity dsorders . . . . . . 24C-279

Diseases of the blood and blood-forming organs . . . . . . . . . . . . . . 280-289

Mental disordere . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...290-319

Diseases of thenervous syetemand sense organs . . . . . . . . . . . . 320-389

Diseases of thecirculatory system... . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Diseases of the respiratory system.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Diseases of thedigestive system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseases of thegenltourinary system . . . . . . . . . . . 580-629

Complications ofpregnancy, childMflh andthepuerperium . . . . . . . . . 630-676

Diseases of theskin and subcutaneous tissue . . . . . . . . . . , . 680-709

~aeases oflhemueculoskeletal system andconnective tisaue. . . . . 710-739

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 740-759

Certain conditions originating intheperinatal period . . . . . . . . . . 780-779

Symptoms, slgnaand ill-defined conditions . . . . . . . . . . . . . . . 760-799

Injury andpoieoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-999

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI–V82

3,604.0

271.4

418.4

89.6

26.4

9.7

153.4

1,131.8

426.8

353.4

174.0

...

117.6

148.9

0.8

27.7

253.1

3.0

4,098.1

53.4

503.8

192.1

43.9

129.3

146.1

1,236.8

376.9

462.1

237.5

66.3

237.9

8.0

.

26.0

360.3

13.8

Rate per 1,000 population

4,380.5

406.2

572.6

65.0

22.9

12.1

164.5

1,332.5

643.0

388.3

286.0

93.0

110.4

.

30.5

250.0

3.1

4,243.6

49.9

618.7

145.3

36.7

125.7

157.5

1,322.9

483.8

443.7

343.9

...

49.6

165.1

‘6.6

.

29.3

250.9

14.1

3,115.7 3,999.6

186.6

318.2

105.1

28.7

8.1

146.4

1,005.6

290.8

331.5

103.6

...

133.1

173.2

1.1

25.9

255.0

2.9

55.7

426.1

223.7

48.7

131.7

136.4

,181.9

304.6

474.5

165.7

.

77.5

287.2

9.0

●

27.1

434.2

13.6

U.S. lengths of stay exceeded 2 weeks for atherosclerosis

and other diseases of the arteries, arterioles, and capillaries.

Diseases of the circulatory system accounted for approximately 30 percent of all patient care days for patients 65

years CIt’age and over (table HH). As was the case fordischwges, circulatory diseases were theleading cause of patient

care days for both sexes and in both countries. Neoplasms

was also among the leading causes of patient care days for

both sexes in both countries. For males in both countries,

diseases of the respiratory system was a leading cause of

patient care days. Infectious and parasitic diseases was a leading cause for Polish males, and diseases of the digestive

system wasaleading cause for U.S. males. Digestive diseases

was a leading category for females in both countries, along

with diseases of the respiratory system for Polish females

and injury and poisoning for U.S. females.

Only patients 65 years of age and over had a higher

rate of patient care days in the United States than in Poland.

33
This difference reflects a 28-percent higher rate for U.S.

females. Patient care dayrates formales inthe two countries

did not differ significantly,

Differences by sex in patient care day rates were reported

for a number of diagnostic categories. U.S. females had a

70-percent higher rate than Polish females had for injury and

poisoning, a 60-percent higher rate for diseases of the

genitourinary system, a 43-percent higher rate for diseases

of the digestive system, a 34-percent higher rate for neoplasms,

and an 18-percent higher rate for diseases of the circulatory

system. Differences in patient care day rates between U.S.

and Polish males were not statistically significant for any

of these diagnostic categories.

Polish males had a patient care day rate one-third higher

than that for U.S. males for diseases of the respiratory system,

but rates for females in the two countries did not differ significantly. Further, Polish males had a patient care day rate eight

times that for U.S. males for infectious and parasitic diseases,

and the rate for Polish females was three times that for U.S.

females. For diseases of the skin and subcutaneous tissue,

the patient care day rate was 88 percent higher for Polish

males, 72 percent higher for Polish females.

Both U.S. males and females had higher rates of patient

care days than their Polish counterparts had for endocrine,

nutritional, and metabolic diseases and immunity disorders;

diseases of the blood and blood-forming organs; mental disorders; diseases of the musculoskeletal system and connective

tissue; congenital anomalies; and the supplementary classification. Diseases of the nervous system and sense organs was

the only category for which there were no significant differences in rates of patient care days.

Fatality rates

Fatality rates and the percent distribution of deaths in

Polish and U.S. hospitals are compared by age and sex in

table JJ. The total fatality rate was higher in Poland than

in the United States, 34 deaths per 1,000 discharges versus

28 deaths per 1,000 discharges. In both countries, a greater

proportion of male than of female patients were discharged

dead, but fatality rates for both males and females were higher

in Poland than in the United States.

Fatality rates varied by age in a similar manner in the

two countries. Rates were higher for infants under 1 year

of age than for older children or young adults, and the rates

increased with age after 34 years. The increases were more

marked in Poland. All fatality rates were significantly higher

in Polish hospitals except those for patient 1–25 years of

age, and the differences were substantial for the older age

groups. For example, one of every four Polish patients 85

years of age and over was discharged dead, compared with

one in eight U,S. patients.

Although death rates in general were higher in Poland

than in the United States (figure 5), they do not account

totally for the higher Polish hospital fatality rates. High fatality

Table JJ. Rate andpercent distributionof inpatient discharged dead by age, according to aex Pofandandthe United Statea, 19S0

[Data are for short-stay non-Federal hospitals in the United Statea and for all general hospitals In Poland. Data exclude healthy newborn infanta and riormal deliveries]

Both sexes Male Female

United United United

Age Poland States Poland States Poland States

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under l year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

l-4years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-14 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-S4years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

75-S4years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85yearsandover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under l year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

l-4years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5-14years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15-24years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

75-S4years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85yearsandover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

34

31

6

3

3

5

13

26

52

96

165

254

100.0

5.2

0.s

0.9

1.2

2.4

4.0

10.8

15.9

29,3

24.4

5.0

28

21

‘4

●3

3

3

6

16

32

55

77

127

100.0

3.7

‘0.5

‘0.5

1.3

1.8

2.2

6.2

14.5

26.3

27.0

16.0

Rate per 1,000 diechargee

41 34

33 18

6

●

3

●

6 *6

9 6

19 9

35 20

61 35

109 64

173 94

246 155

Percent distribution

100.0 100.0

5.5 3.4

D.9 .

0.s .

1.6 *1.6

2.8 2.0

6.8 2.5

12.9 6.7

17.9 14.s

29.7 26.7

19.8 2&2

3.3 12.9

28

29

6“

3

2

3

8

17

41

64

158

257

100.0

6.7

0.7

0.9

0.8

1.9

3.1

8.2

13.5

26.6

30.3

7.1

24

25

*

.

.

*2

“5

13

31

47

66

112

100.0

4.1

.

.

,

●1.5

‘2.0

5.7

14.2

23,7

27.7

19.3

34
and low discharge rates, particularly for the elderly, suggest

that only the more severely ill were hospitalized in Poland.

The percent distribution of deaths indicates, as expected,

that most hospital deaths occur in the older age groups. In

Poland, patients 65 years of age and over accounted for 58.7

percent of all hospital deaths; in the United States, 69.3 percent. The percents of deaths were similar in the two countries

for patients 1–24 years of age but were higher in Poland

for infants under 1 year and for patients 25–74 years of age.

U.S, hospitals had higher percents of deaths for the two oldest

tige groups, especially for patients 85 years of age and over.

The higher proportion of U.S. than of Polish hospital

deaths in the oldest age groups probably is related to their

higher frequency of hospitalization in the United States, which

would increase their likelihood of dying in the hospital. As

can be seen in figure 15, more than half of the deaths of

persons 65 years and over in the United States took place

in hospitals, compared with about a third in Poland. Tine

percent of deaths in hospitals was similar in the two countries

for most of the other age groups; however, infants were much

more likely to die in hospitals in the United States.

Table KK presents fatality rates according to diagnostic

category by sex. In both countries, the highest fatality rates

were for neoplasms and diseases of the circulatory system.

Fatality rates in Polish hospitals were also significantly above

average for certain conditions originating in th~ perinatal period

and for congenital anomalies.

Fatality rates were higher in Poland for most diagnostic

categories. Especially large differences, Polish fatality rates

close to three times U.S. rates, were reported for congenital

anomalies; perinatal conditions; and symptoms, signs, and

ill-defined conditions. Polish rates were 25-65 percent higher

than U.S. rates for endocrine, nutritional, and metabolic diseases and immunity disorders; genitourinary diseases; injury

and poisoning; circulatory diseases; and digestive diseases.

One of the smallest differences in fatality rates was for neoplasms. The Polish rate was only 17 percent higher than

the U.S. rate. Also of note, the U.S. fatality rate was 95

percent higher than the Polish rate for diseases of the respiratory

system and 56 percent higher for infectious and parasitic

diseases.

Fatality rates for selected conditions within the diagnostic

categories are illustrated in figure 16. Fatality rates for two

of the major causes of death—malignant neoplasm of the

trachea, bronchus, and lung and acute myocardlal infarction—

were fairly similar in the two countries. However, there were

large differences in fatality rates for other circulatory diseases.

For example, the U.S. rate for cardiac dysrhythmias was

i 00

1

❑ Poland

❑ UniteclStates

All ages Under 1 year 1-14 years 1644 years 4S64 years 65 years and over

Fiiure 15. Percent of all deaths that occur in hoapitsla by age: Poland and the United States, 1980

35
Table KK. Rate of inpatients of all agea discharged dead by diagnostic chapter and sex Poland and the United States, 1980

[Data are for shori-stay non-Federal hospitals in the United Statea and for all general hospitals in Poland. Data exclude healthy newborn infants and normal deliveries Diagnostic chapters and

code numbers are from the Ninth Revision, International Claaaificafion of Diseaaes, 1975]

Both sexes Male Female

United United United

Diagnostic chapter and ICD-9 code Poland States Poland States Poland States

Rate per 1,000 discharges

Alicondifions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infecfiousand parasiticdiseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001–139

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Endocrine, nutritional andmetabolic diseases and immunity disorders . . . . . . . . . 240-279

Diseasesofthe bloodand blood-forming organs . . . . . . . . . . . . . . . . . 280-289

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...290-319

Diseases of thenervous system and sense organs . . . . . . . . . . . . . . . . . 32i3-389

Diseasesofthecirculatorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Diseasesoftherespiratorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460–519

Diseasesofthed[gesfivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . 520–579

Diseasesofthegenitourinarysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Complications ofpregnancy, childbirth andthepuerperium . . . . . . . . . . . . . . , 630-676

Diseases of theskin andsubcutaneoue tissue . . . . , . . . . . . . . . . . . . . 680-709

Use:ses of themusculoskeletal system and connective tissue. . . . . . . . . . . . . 710–739

Congenial anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..740–759

Certancondlflons originating intheperinatal period . . . . . . . . . . . . 760-779

Symptoms, signs andill-definecl conditione . . . . . . . . . . . . . . . . . . . . 780-799

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..800–999

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VO1-V82

34.3

19.5

120,8

34.2

18.9

3.5

11.8

118.5

15.1

18.9

11.6

0.2

2.1

2.3

55.9

85.1

26.6

17.6

27.9 47.3 33.7

30.4 23.4 33.1

103.4 159.8 132.9

20.7 36.6 “20.4

.

20.1 ●

‘5.4 4.2 ●5.8

9.1 13.4 ‘1 0.9

80.5 118.2 78.3

29.5 16.1 35.7

15.1 21.2 14.4

7.1 24.3 11.3

*

... ...

.

2.2 .

“2.5 2.3 “,

‘18.0 53.5 .

29.6 104.7 27.1

‘9. 1 21.5 .

11.4 17.9 11.8

● .

5.7 times the Polish rate, and the Polish rate for acute cerebrovascular disease wasmore than twice the U.S. rate. Other

interesting differences include a U.S. fatality rate for

pneumonia that was twice the rate in Poland and a Polish

fatality rate for chronic liver disease and cirrhosis that was

tv.ice the rate in the United States.

Fatality rates for patients under 65 years of age are shown

by diagnostic category in table LL. The number of patients

under 65 years who were discharged dead is small. As a

result, most of the estimates of fatality rates by diagnosis

for the more detailed age groups (under 1 year, 1–14, 15-44.

and 45–64 years) are unreliable. Even for all patients under

65 years of age, most estimates of fatality rates by sex are

not reliable.

Patterns of fatality rates by diagnostic category for patients

under 65 years of age are much the same as for patients

of all ages. The highest fatality rates in Poland were for

neoplasms and certain conditions originating in the perinatal

period. Polish fatality rates were also high for diseases of

the circulatory system and congenital anomalies. In the United

States, the highest fatality rate was for neoplasms. Fatality

rates for diseases of the circulatory system and certain conditions originating in the perinatal period were also higher than

for other diagnostic categories.

The fatality rate for all patients under 65 years of age

was 46 percent higher in Poland than in the United States.

Polish fatality rates were approximately three times U,S, rates

for congenital anomalies and for certain conditions originating

in the perinatal period. Fatality rates for diseases of the circulatory system and injury and poisoning were more than 70

percent higher in Poland. For neoplasms, though, fatality

rates did not differ significantly between the two countries.

28.2

14.3

90.7

31.8

18.0

2.9

10.1

121.2

13.6

16.5

6.8

0.2

2.0

2.3

58.5

64.8

31.6

17.1

23.8

“26.1

82.9

20.9

,

●

‘7.6

62.7

23.1

15.7

5.2

●

●

*

●

32.5

●

10.9

●

Table LL. Rate of inpatienta under 65 yeara of age discharged dead by

dngnostic chapten Poland and the United States, 1980

[Data are for short-stay non-Federal hospitals in the United S;ates and for all general

hosptals m Poland. Data exclude healthy newborn infants and normal deliveries. Dlagnostlc

chaplers and ctie numbers are from the Ninth Revision, International Classification of

D!aeases, 1975]

United

Diagnostic chapter and ICD-9 code Poland States

Rate per 1,000

discharges

Allcond}tions ( . . . . . . . . . . . . . . . . . . . . .

fnfechous and parasitic diseases . . . . . .001-139

Neoplasms . . . . . . . . . . . . . . . ...140-239

Endocr(ne, nutritional and metabolic diseases

and )mmunity disorders . . . . . . . . . . 240-279

Diseases of the blood and blood-forming

organs . . . . . . . . . . . . . . .

Mental d]sorders . . . . . . .

Dis~ases of the nervous system and

sense organs . . . . . . . . . . . .

Diseases of the circulatory system . .

Diseases of the respiratory system . . .

Diseases of the digestive system . . .

Diseases of the genitourinary system .

Complications of pregnancy, childbirth

and the puerper(um . . . . . . . . .

D!seases of the skin and subcutaneous

tissue . . . . . . . . . . . . . . .

. . . . 280-289

. . . . 29f2-319

. . . . 320-389

. . . . 390-459

. . . . 460-519

. . . . 520-579

. . . . 680-629

. . . . 630-876

. . . . 680-709

D!seases of the musculoskeletal system and

connecwe tissue . . . . . . . . . . . . . . 710-739

Congenial anomakes. . . . . . . . . . . . .740-759

Cerfam conditions originating in the

perinatal period . . . . . . . . . . . . . , . .760-779

Symptoms, signs and ill-defined conditions . .780-799

Injury and poisoning . . . . . . . . . . . . .800-999

Supplementary classification . . . . . . . . . VO1-V82

17.1

14.9

85.8

18.1

11.3

2.8

10.4

58.6

6.9

9.2

5.7

0.2

1.3

1.9

56.1

85.1

9.7

12,6

11.7

“9.9

73.1

.

●

●

●6.9

34.0

8.0

10.1

‘1.9

*

,

●

18.3

29.6

●

7,4

*

36
Malignant neoplasm 257

of trachea, bronchus,

and lung

Acute myocardial

222

infarction

Cardiac

dysrhythmias

149

Acute 324

cerebrovascular

disease

Pneumonia

59

❑ Poland

❑ United States

Chronic liver disease

179

and cirrhosis

! I I I I I I I

10 20 40 60 80 100 200 400

Deaths per 1,000 discharges(logscale)

Ftgurs 16, Fatah~ratea forselected condtions: Pokndand the UnRed Sbtea, l98O

Table MM shows fatality rates for patients 65 years of

age and over by sex and according to diagnostic category.

As was the case for younger patients, fatality rates forneoplasms and diseases of the circulato~ system were high in

both countries, The Polish fatality rate for symptoms, signs,

and ill-defined conditions was also significantly above average,

as was the rate for infectious and parasitic diseases in the

United States.

The total fatality rate for patients 65 years of age and

over was 71 percent higher in Poland than in the United

States, Polish rates were at least twice U.S rates for three

diagnostic categories:- diseases of the digestive system, diseases

of the genitourinary system, and injury and poisoning. In

addition, the Polish rate was 87 percent higher for endocrine,

nutritional, and metabolic diseases and immunity disorders,

68 percent higher for circulatory diseases, and 45 percent

higher for neoplasms. In contrast, the U.S. fatality rate for

infectious and parasitic diseases was nearly twice the Polish

rate, and the U.S. rate was 25 percent higher for diseases

of the respiratory system.

The fatality rate for males 65 years of age and over

was 57 percent higher and that for females was 83 percent

higher in Poland. Patterns of fatality rates by diagnostic category were generally similar for males and females, but there

were some differences. For example, Polish males had fatality

rates 2.6 times those for U.S. males for diseases of the digestive

and genitourinary system, Fatality rates for Polish females

were 81–84 percent higher for these diagnostic categories.

On the other hand, Polish females had a fatality rate more

than twice that for U.S. females for injury and poisoning;

the rate for Polish males was 81 percent higher. Also, the

fatality rate for U.S. males with a respiratory disease diagnosis

was 42 percent higher than the rate for Polish males, but

the rates for females in the two countries d]d not differ

significantly.

37
Table MM. Rate of inpatients 65 yasrs of age and ovar discharged dead by diagnostic chapter and sex: Pofend and the United States, 1980

[Data are for short-stay non-Faderal hospitals in the United Statea end for all general hospitals in Poland. Diagnostic chaptera and code numbers are from the Ninth Revision, lntematlonal

Classificationof Diseases, 1975]

Both sexes Male Female

United United United

Diagnostic chapter and ICD-9 code Poland States Poland States Poland States

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectioueand paraeiticdiseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Endocrine, nutritional andmetabohc ~seases and immunity disorders . . . . . . . . . . 240-279

Diseases of the blood and blood-forming organe . . . . . . . . . . . . . . . . . . . . . 28f)-289

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...290-319

Diseaeesofthenervoussystem andaenseorgane . . . . . . . . . . . . . . . . . . . . 320-389

Diseases ofthecirculatoysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Diseaseeofthereepiratorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Diseasesofthedigestivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseaeesofthegenitourinaryeyetem . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Complications ofpregnancy, childbirth andthepuerperium . . . . . . . . . . . . . . . . 63C!-676

Diseases of theskin andsubcutaneous fiseue . . . . . . . . . . . . . . . . . . . . . . 680-709

Dseasee of themusculoskeletal system and connective tissue. . . . . . . . . . . . . . 710-739

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...740-759

Certain conditions originating intheperinatal period . . . . . . . . . . . . . . . . . . . 780-779

Symptoms, aignsand ill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . . 780-799

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 800-999

Supplementary classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI-V82

124.4

61.7

211.8

87.3

52.2

22.1

20.2

197.3

67.6

75.0

64.3

7.4

4.9

55.8

156.1

59.4

Rate per 1,000 discharges

72.7 131.8 63.9 117.8

120.6 66.7 155.7 53.3

146.1 220.0 165.5 202.1

46.7 109.3 *49.8 78.7

.

60.6 .47.6

‘25.4 50.0 ●

10.4

‘13.3 27.2 “15.1

117.7 203.6 124.5 191.9

84.7 69.9 99.2 64.6

34.5 87.1 33.1 65.4

29.2 63.7 ‘24.2 65.2

...

●

4.3 ““~ 9.3

●

6.5 ●3.2

“ “

71.4

●

123.7 .

180.7

28.1 65.6 ‘36.4 54.5

. ●

64.2

“96.6

125.7

45.2

.

.

●

112.4

68.9

35.5

36.0

.

.

●

.

24,4

“

38
Discussion

The general pattern of hospital use was different in Poland

than in the United States. Poland had a lower discharge rate

but a longer average length of stay than the United States

htid. Because of its longer stays, total hospital use, as measured

by the rate of patient care days, was higher in Poland.

Lower discharge rates and longer average stays than for

U,S. patients have also been reported for other European

ccwntr~es, such as England and Wales, France, Sweden, and

West Germany (NCHS, 1980c). Among the explanations that

have been suggested for this European pattern is the division

of physicians providing ambulatory versus inpatient hospital

ctire (Romer and Roemer, 1977; Bacon, Wojtyniak, and

Krzyzanowski, 1984).

In the United States, one physician is usually responsible

for treating the patient in an ambulatory care setting and

for admitting and discharging the patient to and from a hospital.

Because the patient remains in the care of the same physician

before, during, and after a hospitalization, the physician presumably is more likely to admit the patient to the hospital

and to discharge the patient sooner than would one providing

only inpatient or ambulatory care.

In Poland and other European countries, the physician

who treats the patient before and after a hospitalization is

usually not the physician who treats the patient during the

hospitalization. In this situation, the ambulatory care physician

may be reluctant to admit the patient and, instead, may provide

outpatient treatment. Poland’s longer lengths of stay thus could

have been partly due to a greater selectivity of serious cases

as well as to a tendency for the ward physician to keep

the patient until “fully” recovered. The greater number of

ambulatory care contacts per person in Poland would support

this view, as would its higher hospital fatality rates, assuming

that the more seriously ill patients are apt to die.

It is also possible that these different.x in hospital use

ptittems are related to other factors. For example, differences

in the organization and financing of the health care systems

could have had an effect. The nationalized, public system

in Poland contrasts with the decentralized, private system

in the United States. Polish physicians are largely salaried

by the national system, but U.S. physicans are primarily in

private, fee-for-service practices. Medical care in Poland is

free to patients, but in the United States patients often have

out-of-pocket costs for medical care. The emphasis on advances in medical technology is greater in the United States,

und a more highly developed screening system for some popuIuticmgroups exists in Poland.

There were notable variations in the general patterns of

hospital use in the two countries for children I– 14 years

of age and for the elderly 65 years of age and over. Children

1–14 years of age were the only major age group for which

no significant difference was found in discharge rates between

the two countries. However, this age group had the largest

differences in average lengths of stay and rates of patient

care days.

Discharge rates for U.S. children have been found to

be relatively low in other cross-national comparisons (NCHS,

1980c). The low rates were suggested to result from an emphasis on ambulatory care for U.S. children, particularly by

pediatricians, and from financial barriers to health care for

some children (NCHS, 1984b). Polish children have no financial barriers to care, and the proportion of physicians who

are pediatricians is higher in Poland than in the United States.

The Polish emphasis on ambulatory care is suggested by the

country’s higher rate of ambulatory visits and special programs

of preventive care for infants and children.

The longer hospital stays for Polish children may reflect

a greater seriousness of their illnesses. Death rates were higher

for children 1–14 years of age in Poland than in the United

States. The longer stays could also reflect different approaches

to the treatment of common children’s problems—U.S. children may have been treated surgically more frequently than

Polish children. For example, U.S. discharge rates were higher

and lengths of stay much shorter for chronic disease of tonsils

and adenoids, often treated in the United States with a tonsillectomy, and diseases of the ear and mastoid process, often

treated by U.S. physicians with a mynngotomy. Unfortunately,

surgical information is not collected in the Polish survey.

Patients 65 years of age and over were the only age

group in the United States that had higher total hospital use,

that is, a higher rate of patient care days. This primarily

reflects a U.S. discharge rate that was more than twice the

Polish rate for this age group. The difference in discharge

rates was even more pronounced for the oldest patients; the

U.S. rate for patients 85 years of age and over was four

times the Polish rate. Average lengths of stay for the elderly

were higher in Poland, but the smallest difference in length

of stay for any age group was for patients S5 years of age

and over. The fatality rate for patients 65 years of age and

over was also higher in Poland, suggesting that the Polish

patients were more seriously ill. However, only about a third

of the Polish population in this age group who died did so

in hospitals, compared with more than half in the United

States.

One reason suggested for these differences is a greater

emphasis on institutional care for the elderly in the United

States (Bacon, Wojtyniak, and Krzyzanowski, 1984). The

39
Medicare program is focused on acute care in hospitals; the

Medicaid program, on chronic care in nursing homes. The

number of nursing home beds per 1,000 persons 65 years

of age and over is also much higher in the United States.

Family members are usually more available to care for the

elderly in Poland; children and elderly parents are more likely

to live in the same area (Shanas, 1973), and the elderly

are less likely to live alone than are those in the United

States. The availability of home health care services, such

as visiting nurse programs, also helps the elderly in Poland

avoid institutions.

Hospital use rates for some specific conditions also departed from the general patterns. Among the conditions for

which U.S. discharge rates were particularly high compared

with Polish rates were mental disorders and certain conditions

originating in the perinatal period. Both of these differences

resulted, at least in part, from variations in the data systems

of the two countries. There were more U.S. than Polish discharges for mental disorders because patients treated in psychiatric units of short-stay hospitals were included in the U.S.

data b’lt not in the Polish survey. Newborn infants were sampled without regard to their health status in the U.S. survey,

but they had to be reported only if sick in the Polish survey.

This probably led to some underreporting of perinatal conditions inPoland.

U.S. discharge rates for diabetes mellitus were 2.6 times

Polish rates for the age groups 15-44 years, 45-64 years,

and 65 years and over, and the death rate for diabetes mellitus

was 23 percent higher in the United States. This could mean

that more patients have diabetes in the U.S. population.

Further, diabetics may have easier access to outpatient services

in Poland, where there are special clinics for the treatment

of diabetes.

Several problems with the musculoskeletal system were

much more frequent causes of hospitalization in the United

States. U.S. discharge rates for rheumatism were 5–13 times

Polish rates for patients aged 15 years and over. For patients

65 years of age and over, disorders of bone and cartilage

caused a discharge rate in the United States that was 21

times that in Poland, U.S, discharge rates for dislocations,

sprains, and strains were about five times those in Poland

for patients 15 years of age and over, and for patients 65

years of age and over, fracture of the neck of the femur

gave U.S. females a discharge rate six times that for Polish

females. U.S. males had a rate three times that for Polish

males.

These differences are probably explained by several factors. There may be a greater prevalence of musculoskeletal

problems, such as osteoporosis, in the U.S. population. U.S.

patients may also be hospitalized for less severe cases of

these disorders. Outpatient treatment is emphasized in Poland

for such conditions as rheumatism and dislocations, sprains,

and strains. Surgical treatment, such as joint replacement,

is probably more common in the United States for musculoskeletal problems.

Discharge rates for certain circulatory diseases were also

particularly high in the United States for patients 65 years

of age and over. In part, the higher rates were probably

due to differences in disease classification. Higher U.S. rates

for ischemic heart disease maybe the result of the classification

of coronary atherosclerosis as chronic ischemic heart disease

in the United States but as the more generalized atherosclerosis

in Poland. However, the U.S. discharge rate for patients 65

years of age and over for acute cerebrovascular disease was

three times the Polish rate—and for cardiac dysrhythmias,

nearly seven times the Polish rate. The death rate for this

age group for cerebrovascular disease was 16 percent higher

in the United States. These differences in discharge rates

may also have been the result of greater development of

the technology to diagnose and treat these conditions in the

United States.

Although discharge rates were higher in the United States

for most conditions, some rates were higher in Poland. Polish

discharge rates for infectious and parasitic diseases were higher

for all age groups under 65 years. One of the main diagnoses

in this category in Poland was tuberculosis. Tuberculosis

sanitariums were covered by the Polish survey, but near]y

all hospitals specializing in the treatment ofituberculosis and

other respiratory diseases were excluded from the U.S. survey

because they had stays of more than 30 days. However, the

Polish death rate for tuberculosis was more than nine times

the U.S. rate, suggesting that the disease was a more serious

health problem for the Polish population.

Another major diagnosis in the infectious and parasitic

diseases category for Polish patients was viral hepatitis, for

which hospitalization was mandatory in Poland. In addition,

Polish infants under 1 year of age had a discharge rate for

intestinal infectious diseases that was more than seven times

that for U.S. infants. The infant mortality rate in Poland

for intestinal infectious diseases was six times the U.S. rate,

It should also be noted that the hospital fatality rate for

infectious and parasitic diseases was higher in the United

States. This may indicate that Polish patients were hospitalized

for less severe cases of infectious and parasitic diseases than

were U.S. patients.

For infants under 1 year of age, the discharge rate was

much highef in Poland for respiratory diseases, especially

for pneumonia and for bronchitis and emphysema. Polish

children 1–14 years of age also had higher discharge rates

for these conditions as well as for acute respiratory infections,

Death rates for both age groups were higher in Poland for

pneumonia, and Polish infants under 1 year died more frequently of bronchitis, emphysema, and asthma.

Polish rates of patient care days also were substantially

higher for respiratory diseases, Age groups under 65 years

in Poland had patient care day rates ranging from 2 to 7.5

times U.S. rates for the respiratory disease category as a

whole and from 5.6 to 37 times U.S. rates for bronchitis

and emphysema, Gr&dter hospital use for these respiratory

diseases, especially in conjunction with greater hospital use

and death rates for tuberculosis, suggests that the Polish population is at greater risk for lung disorders. However, it should

be noted that the hospital fatality rate for respiratory diseases

was higher in the United States, possibly indicating that U.S.

patients hospitalized with respiratory diseases were more seriously ill than were Polish patients. Differing approaches to

the treatment of respiratory diseases may also help explain

differences in hospital use between the two countries.

40
Discharge rates were higher in Poland for patients 1–14

and 15J14 years of age for appendicitis, and Polish death

rates fortippendicitis also were higher. Polish patients 1544

years ofagehad higher discharge and death rates for gastric

and duodenal ulcers. Males 45-64 years of age were hospitalized twice as often in Poland as in the United States

for the treatment of fractures. This age group had a higher

death rate in Poland for accidents and adverse effects, although

their death rate for motor vehicle accidents was higher in

the United States. Polish patients 65 years of age and over

had higher discharge and death rates for atherosclerosis, which,

M was discussed earlier, probably reflects differences in the

coding and classification of coronary atherosclerosis.

The finding of differences between Poland and the United

States in the general pattern of hospital use and in hospital

use for specific conditions raises a number of questions for

health researchers and policymakers. For example, in the

United States the costs and benefits of the high frequency

of hospitalization, particularly for the elderly, need to be

examined further. Ambulatory care may be able to replace

inpatient treatment for the less serious cases of conditions,

such as diabetes mellitus and dislocations, sprains, and strains.

Home health care programs may be able to substitute for

some institutional care of the elderly.

In Poland, further exploration is needed of the costs and

benefits of long hospitalizations, especially of children. New

approaches to the treatment of such conditions as respiratory

diseases may prove useful. Programs may be needed to deal

with environmental hazards and to promote healthy lifestyles.

41
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43
List of detailed tables

1. Midyear population estimates by sex and age: Poland 6.

andthe United States, 1980 . . . . . . . . . . . . . . . 45

2. Death rates by sex and cause: Poland and the United

States, 1980 . . . . . . . . . . . . . . . . . . . . ...45 7.

3. Death rates by age and cause: Poland and United States,

1980 . . . . . . . . . . . . . . . . . . . . . . . ...46

4. Rates of discharge and days of care for inpatients dis- 8.

charged from hospitals by sex and diagnosis: Poland

andthe United States, 1980 . . . . . , . . . . . . . . . 47

5. Rates of discharge and days of care for patients under 1 9.

year of age, by sex and diagnosis: Poland and the

United States, 1980 . . . . . . . . . . . . . . . . ...50

Rates of discharge and days of care for patients 1-14

years of age, by sex and diagnosis: Poland and the

United States, 1980 . . . . . . . . . . . . . . . . ...53

Rates of discharge and days of care for patients 15J14

years of age, by sex and diagnosis: Poland and the

United States, 1980 . . . . . . . . . . . . . . . . ...56

Rates of discharge and days of care for patients 45-64

years of age, by sex and diagnosis: Poland and the

United States, 1980 . . . . . . . . . . . . . . . . ...59

Rates of discharge and days of care for patients 65

years of age and over, by sex and diagnosis: Poland

andthe United States, 1980 . . . . . . . . . . . . . . . 63
Table 1. Midyear population eatimatea by aex and age Poland and the United Statea, 1980

Poland United States

Aae Both sexes Male Female Both sexes Male Female

Number in thousands

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...35.578 17,335 18,243

Under lyear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 689 353 336

l-14years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,950 4,066 3,865

l-4yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,564 1,311 1,253

5-14years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,388 2,755 2,632

1544years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...16.167 8,190 7,997

15-24years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,112 3,134 2,978

25-34y8ars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,119 3,095 3,024

35-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,958 1,961 1,995

45-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,155 3,336 3,817

45-54years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,276 2,063 2,213

56-84years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,879 1,275 1,604

65yearsandover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,598 1,389 2,209

65-74yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,376 976 1,398

75-84years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,052 365 887

85yearsandover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 46 124

Tabfe2. Death rateaby sexandcause: Poland andthe United States, 1980

225,552

3,546

47,722

12,900

34,822

104,126

41,605

36,920

25,601

44,446

22,696

21,752

25,708

15,648

7,787

2,274

108,695 116,857

1,815 1,733

24,393 23,330

6,597 6,303

17,795 17,027

51,203 52,923

20,645 20,960

18,105 16,815

12,453 13,146

21,121 23,328

10,948 11,749

10,173 11,579

10,363 15,345

6,787 8,861

2,886 4,901

691 1,563

Both sexes Male Female

Unitad United United

Cause of death and AD-9 code’ Poland States Poland States Poland States

Allcausesz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectiousand parasiticdiseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Intestinal infectiousdiseasea. . . . . . . .’ . . . . . . . . . . . . . . . . . . . . . . . 001-009

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...010-018

Meningococcallnfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...036

Tetanus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...037

Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...036

Mal{gnantneoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-208

Malignant neoplasm ofstomach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...151

Malignantneoplasmofcolon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...153

Malignant neoplasm ofrectum, rectosigmoid junctionandanus . . . . . . . . . . . . . . . 154

Malignantneoplasm oftrachea, bronchus and lung. . . . . . . . . . . . . . . . . . . . . . 162

Malignantneoplasmoffemalebreast . . . . . . . . . . . . . . . . . . . . . . . . . . . ...174

Malignantneoplasmofcervixuteri.. . . . . . . . . . . . . . . . . . . . . . . . . . . ...180

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-208

Dlabetesmellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250

Nutritional marasmus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...261

Anemias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..28C-285

Meningitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...320-322

Diseasesofthecirculatorysystem.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Acuterheumatlcfever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...390-392

Chronlcrheumaticheartcfisease.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 393-398

Hypertensivedisease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...401405

Lschemlcheartdlsease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...410414

Acute myocardial infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...410

Cerebrovasculardisease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...43&436

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...440

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 480+86

Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...487

Bronchitis, emphysemaand asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . 490-493

Ulcerofstomachandduodenum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 531–533

Appendicllla . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..54G543

Chronic liverdiseaseandclrrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...571

Nephrills, nephrotlcsyndromeand nephrosis . . . . . . . . . . . . . . . . . . . . . 580-589

Hyperplasiaofprostate, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...600

Directobstetr[cdeaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 64C-646.651-876

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..74G759

984.3

15.9

1.2

8.3

0.1

0.1

3.5

167.8

25.4

4.6

8.2

33.6

9.7

5.6

5.3

12.5

0.0

0.9

1.4

474.4

0.4

9.1

20.4

91.6

65.8

65.4

155.0

21.8

0.5

28.4

5.8

1.0

12.3

9.1

1.7

0.2

11.6

Rate per 100,000 population

878.3

7.6

0.2

0.9

0.2

0.0

4.2

183.9

6.3

19.5

4.0

45.8

15.7

2.2

7.3

15.4

0.1

1.4

0.6

436.5

0.0

3.4

14.4

249.7

132.2

75.1

13.0

22.9

1.2

9.0

2.7

0.3

13.5

7.4

0.3

0.1

6.2

1,091.5

22.4

1.4

13.1

0.2

0.1

4.1

191.4

33.1

4.3

8.3

56.5

...

...

6.0

9.1

0.1

0.8

1.8

485.3

0.3

7.8

15.4

125.7

96.9

56.4

134.3

23.6

0.5

41.7

8.3

1.0

16.3

10.3

3.4

...

13.2

976.9

6.2

0.2

1.2

0.2

0.0

4.3

205.3

7.7

19.2

4.4

68.6

...

...

8.4

13.0

0.1

1.3

0.7

459.9

0.1

2.4

12.7

282.4

162.2

63.6

10.5

24.2

0.9

12.5

3.1

0.3

16.0

7.8

0.7

...

6.8

662.5

9.7

1.0

3.7

0.1

0.1

2.9

145.4

18.0

4.9

8.1

9.9

18.9

10.9

4.6

15.8

0.0

1.0

1.0

464.0

0.4

10.3

25.2

59.7

36.2

72.0

174.7

20.1

0.5

15.7

3.4

0.9

8.4

8.1

...

0.4

10.4

765.3

7.1

0.2

0.6

0.2

0.0

4.1

163.6

5.0

19.8

3.6

24.3

30.6

4.2

6.3

17.6

0.1

1.6

0.5

418.2

0.0

4.4

16.0

218.9

104.0

66.1

15.3

21.7

1.5

5.7

2.3

0.3

9.3

7.0

...

0.2

5.5

See foolnotesat end of table,

45
Table2. Death retesby sexandceuse: Poland andthe United Statea, 1980-Con.

Both sexes Male Female

United United United

Cause of death and ICD-9 code’ Poland States Poland States Poland States

Certain conditions originating intheperinatal period . . . . . . . . . . . . . . . . . . . 760-779

Birth trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...767

Signs, symptoms andill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . . 780-799

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., .,,.800-999

Accidantsand advarseeffacts. . . . . . . . . . . . . . . . . . . . . . . . . . . ..E800-E949

Motorvehicletrafficaccidents. . . . . . . . . . . . . . . . . . . . . . . . . . ..E810-E819

Accidentalfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..EIY3GE13E13

Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..E95GE959

Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . ..EE989E989

Rate per 100,000 population

17.8 10.1 22.1 11.9 13.8

3.8 0.5 5.1 0.6 2.7

77.4 12.7 71.9 15.0 82.7

75.9 70.9 119.0 105.8 35.0

51.9 46.7 79.3 87.4 25,9

7.7 22.9 12.2 34.5 3.4

4.5 5.9 5.1 6.4 3<9

10.7 11.9 16.2 18.6 3.6

0.9 10.6 1.2 17.1 0.6

8.4

0.4

10.6

37.9

27.1

12.0

5.4

5.5

4.5

lManua/oftha /ntarnat/ona/ Statiat/ca/ C/ass/teat/on of Diseases, lnjudes and Cauaasof Doath(baaed ontherecommandationa oftha Ninth Revlslon Conference, 1975).

21ncludesoausea not ahown In table.

Table3. Death rates byageand cause Pdandand the United Stete& 1980

Under 1year 2 1-14 years 15-44 years 45-S4 years 65 years and ovar

United United United United United

Cause of death and ICD-9 cwde’ Poland States Poland States Poland States Poland States Poland States

Rate per 100,000 population

Allcauses3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...2.129.9

Infectious andparasltlc diseases. . . . . , . . . . . . . . . 001-139

Intestinal infectious diseases. . . . . . . . . . . . . . . . . 001-009

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . .. 010+18

Meningococcal infection . . . . . . . . . . . . . . . . . . . . ..036

Tetanus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..o37

Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . ...038

Malignantneoplasms ..,.... . . . . . . . . . . . . . .. I4c-2O8

Malignant neoplasmofstomach . . . . . . . . . . . . . . . , . .151

Malignantneoplasmofcolon . . . . . . . . . . . . . . . . . . ..I53

Malignant naoplasm of rectum, rectosigmoid junction

and anus . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154

Malignant neoplasm oftrachea, bronchue and lung. . . . . . . .162

Malignant neoplasm of female breast . . . . . . . . . . . . . . .174

Malignant naoplasm ofcervix uteri. . . . . . . . . . . . . . . . .180

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . ...204-208

Diabetas mellitus . . . . . . . . . . . . . . . . . . . . . . . . . ..25o

Nutritional marasmus . . . . . . . . . . . . . . . . . . . . . . . ..26I

Anemias . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a&285

Meningitis . . . . . . . . . . . . . . . . . . . . . . . . . ...320-322

Diseases of thecirculatory syatem . . . . . . . . . . . . . . . 390-45g

Acuterheumaticfever . . . . . . . . . . . . . . . . . . . . 390-392

Chronicrheumatic haartdisease. . . . . . . . . . . . . . . 393-398

Hypertensivedisease . . . . . . . . . . . . . . . . . . . .401-405

Ischemicheartdisease . . . . . . . . . . . . . . . . . . ..41c-414

Acute myocardial infarction . . . . . . . . . . . . . . . . . . .4IO

Cerebrovasculardisease. . . . . . . . . . . . . . . . . . . 430-438

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . ..44o

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . ...460-486

Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...487

Bronchitis, emphysemaand asthma . . . . . . . . . . . . . . 490-493

Ulcerofstomach and duodenum . . . . . . . . . . . . . . . . 531-533

Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . ...540-543

Chronic liverdiseaseandcirrhosis . . . . . . . . . . . . . . . . . .571

Nephritis, nephritic syndrome andnephrosis . . . . . . . . . 580-589

Hyperplaeia of prostate . .,,....., . .,...,.,,....600

Qirectobstetric deaths . . . . . . . . . . . . . . . 64C-646,651-676

Congenital anomalies . . . . . . . . . . . . . . . . . . . . .. 74*759

Certain conditions originating inthaperinatal period . . . . . 76C-779

Birfhtrauma . . . . . . . . . . . . . . . . . . . . . . . . . ...767

Signs, symptoms andill-defined conditions . . . . . . . . . . 780-799

206.4

56.8

3.2

133.1

6.8

1.4

0.1

0.4

3E

36.6

1.0

8.1

183.2

3.3

4.5

0.1

0.3

0.6

2.6

...

507.7

915.8

197.4

45.7

1,260.3

19.3

3.5

0.1

2.1

6.7

3.1

0.1

0.9

0.1

0.2

0.7

12.3

28.8

0.1

0.1

0.8

0.6

4.3

0.1

27.7

0.3

1.5

0.3

0.3

0.9

6.2

...

255.2

629.7

29.3

168.5

50.3

2.2

0.3

0.0

0.2

1.0

7.5

0.0

0.0

0.0

0.0

0.0

2.9

0.0

0.1

0.5

1.5

0.0

0.1

0.0

0.1

0.4

2.6

0.1

0.1

0.0

0.2

0.2

0.5

5.0

1.4

39.5

1.1

0.1

0.0

0.3

0.2

4.3

0.0

0.0

0.0

0.0

0.0

1.8

0.1

0.0

0.3

0.6

1.8

0.0

0.1

0.0

0.1

0.1

0.3

0.9

0.0

0.2

0.0

0.1

0.0

0.1

3.3

0.2

0.0

0.9

176.5

3.2

0.0

2.2

0.0

0.0

0.4

24.8

2.2

0.5

0.6

2.8

2.2

2.0

1.9

1.4

0.2

0.6

35.2

0.2

3.9

1.3

13.4

12.0

5.2

1.3

2.4

0.0

0.9

1.1

0.3

2.3

2.9

0.4

1.0

10.6

149.9

1.5

0.0

0.2

0.1

0.0

0.4

19.2

0.4

1.1

0.2

2.5

2.6

0.8

2.1

1.5

0.0

0.4

0.1

19.5

0.0

0.5

0.9

8.4

5.6

3.4

0.1

1.7

0.1

0.5

0.2

0.1

4.7

0.7

0.2

1.3

0.0

3.1

1,051.0

20.6

0.1

15.0

0.0

0.2

1,3

305.1

38.6

6.6

13.0

75.2

23,2

12,8

7.6

16.1

0.1

1.2

1.2

415.6

0.6

21.8

24.6

154.0

130.3

64.2

48.6

12.6

0.2

25.1

8.6

1.2

25.4

14.3

0.5

0.0

0.8

43.1

955.8

6.6

0.2

1.4

0.1

0.0

4.0

304.9

6.6

24.4

5.3

95.1

33.6

4.5

6.5

17.9

0.1

0.9

0.5

395.3

0.1

5.6

14.9

249.2

165.8

44.7

2.9

12.7

0.3

10.2

2.8

0.4

36.2

6.2

0.1

0.0

2.0

0.0

0.0

12.4

6,328,5 5,252.1

56.7 41.7

0.2 0.9

42.2 4.7

0.1 0.2

0.8 0.1

2.5 26.8

923.0 1,011.3

164.2 39.5

29.9 126.3

51.6 25.4

169.9 230.5

39.8 69.3

21.0 8.0

22.2 36.0

85.9 98.7

0.2 0.9

5.2 8.9

2.0 1.3

3,695.6 3,111.1

1,4 0.2

28.3 18.1

147.3 98.2

541.2 1,745.2

337.9

492.7

1,430.2

138.7

3.5

225.3

35.0

5.1

59.9

47.6

15.5

...

1.3

620.5

860.4

573.1

109.9

168.5

9.7

59.8

18.1

1.8

37.3

50.6

2.8

...

3.3

0.0

52.6

See footnotas at end of table.

46
Table3. Death rateaby ageandoaustx Poland andthe United States, 1980-Con.

Under I year 2 1–14 years 15-44 years 4H4 years 65 years and over

United United United United United

Cause of death and ICC-9 code’ Poland States Poland States Poland States Poland States Poland States

Rate per 100,000 population

Injury andpolsoning . . . . . . . . . . . . . . . . . . . ...800-999 56.8 40.0 20.4 20.1 75.7 83.6 97.0 67.6 161.5

Accidents and adverse effects . . . . . . . . . . . . . E60C-E949

122.4

46.0 32.3 16.2 17.9 48.4 50.3 61.7 40.6 128.0 97.2

Motor vehicle traffic accidents . . . . . . . . . . . E61 C-E819 0.3 6.4 2.4 7.5 6.4 32.9 9.6 17.6 13.7 22.0

Accidental falls . . . . . . . . . . . . . . . . . . . .. E880-E888 0.1 1.2 0.4 0.4 1.9 1.5 4.2 4.8 26.6 36.6

Suicide . . . . . . . . . . . . . . . . . . . . . . . . .. E95GE959 - - 0.6 0.3 12.6 14.3 17.2 15.9 13.9 17.8

Homicide . . . . . . . . . . . . . . . . . . . . . . . .. E96GE969 1.6 5.6 0.1 1.5 1.1 16.7 1.1 9.0 1.3 5.5

'Manual of/he lnternationa/ Statist)ca/ Cfass/fication of Diseases, injuries arrd Causes of Death (based on the rermmmendafions of the Ninth Revision Conference, 1975).

‘Rates per 100,000 live bltihs.

%cludesca uses not shown In table.

Table4, Rates of@acharge anddays of~refor inpatients discharged from hosptils bysexand diagnosis: Pdandand the Untied States, 1980

[Data are for short-stay non-Federal hospitals In the United States and for all general hospitals in Poland. Data exclude healthy newtmm infants and normal deliveries, Diagnostic categories and

code numbers are from the Ninth Revision, International Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Allconditlons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectious andparasilic diseases, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Intestinal infectious dieeeses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-009

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..010-018

Viral hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..o7o

Neoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Mallgnantneoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-208

Mallgnantneoplasm ofatomach. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...151

Malignant neoplasm ofother digestive organs 8ndpetitoneum . . . . . . . . . 150,152-159

Mallgnantneoplasm oftrachea, bronchus and lung . . . . . . . . . . . . . . . . . . . . 162

Malignantneoplasm ofbreast . . . . . . . . . . . . . . . . . . . . . . . . . . ...174-175

Malignantneoplasm ofcewixuteri . . . . . . . . . . . . . . . . . . . . . . . . . . ...180

Mallgnent neoplaam ofother female genital organs . . . . . . . . . . . . . .179, 181-lf34

Malignant neoplasm of prostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..165

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-208

Benign neoplasms, carcinoma insitu, andneoplasma ofuncetiain behavior. . . . . 210-239

Benign neoplasm ofuterus . . . . . . . . . . . . . . . . . . . . . . . . . . . ...218-219

Endocrine, nutritional andmetabotic dseases andimmunity deorders . . . . . . . . . 240-279

Diabates mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250

Diseasesofbloodandblood-forming organs . . . . . . . . . . . . . . . . . . . . . 280-289

Mentafdlsorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...290-319

Diseases oflhenervous aystemand sense organs . . . . . . . . . . . . . . . . . . . . 320-3e9

Disorders of theautonomic nervous system. . . . . . . . . . . . . . . . . . . . . . . . . . 337

Other disorders of thecentral nervous system . . . . . . . . . . . . . . . 320-336, 34W349

Disorders of theperipheral nervous system . . . . . . . . . . . . . . . . . . . . . . 35&359

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...366

Other disorders of theeyeandadnexa . . . . . . . . . . . . . . . 360-365,367-379

Dweases of theearand mastoid process . . . . . . . . . . . . . . 380-3e9

Diseases of thecirculatory system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Rheumati chearfdiseas e..... . . . . . . . . . . . . . . . . . . . . . . . . . ...390-398

Essantiaf hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..4ol

Hypertensive hearfand renaf disease . . . . . . . . . . . . . . . . . . . . . . . . . . 402+04

Acute myocardial infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...410

Olheracute andsubacute forms ofischemic heart disease . . . . . . . . . . . . . . 411

Angina pectorie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...413

Other chronic ischemic heart disease . . . . . . . . . . . . . . . . . . . . . . . . . . 412,414

Diseases of pulmonary circulation. . . . . . . . . . . . . . . . . . . . . . . . . . . . 415-417

Diseases of the pericardium and endocardium, cardiomyopathy

and conduction disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...420-426

Cardiac dysrhyfhmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...427

Heart failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...428

lll-deflned descriptions andcomptications ofheatidsease . . . . . . . . . . . . . . . 429

Acute cerebrovascular disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . .430-436

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..44o

Other cfiseasesofarteries, arterioles and capillaries . . . . . . . 441448

Dlseaaes ofveins andlymphatics, andother dseases of thecirculato~ system' . 451-459

102.2

5.3

1.3

1.2

1.4

6.1

4.5

0.4

0.6

0.7

0.4

0.3

0.3

0.1

0.3

1.6

0.6

1.8

1.0

0.6

1.1

4.8

0.0

1.3

0.8

0.3

1.3

1.0

13.4

0.9

1.2

0.6

1.1

0.5

0.4

1.4

0.6

0.6

0.4

0.8

0.2

1.1

1.9

0.3

0.9

Discharge rate par 1,000 population

164.7

2.9

0.6

0.1

0.1

11.0

8.1

0.2

1.3

1.2

0.9

0.2

0.6

0.6

0.3

2.9

o.e

5.1

2.9

1.5

7.5

7.e

.

1.8

1.0

1.9

1.3

I .e

22.6

0.3

1.4

0.7

1.9

0.7

0.9

4.4

0.4

0.6

1.7

1.9

0.6

2.8

0.5

0.9

2.2

97.4

6.2

1.4

1.8

1.4

5.4

4.7

0.5

0.6

1.1

0.0

...

...

0.2

0.3

0.7

..

1.3

0.9

0.6

1.0

5.3

0.0

1.6

1.0

0.3

1.3

1.1

14.7

0.7

1.0

0.5

1.6

0.7

0.5

1.7

1.0

0.6

0.5

0.9

0.2

1.1

2.0

0.4

0.9

144.0

2.9

0.6

0.2

0.1

9.5

e.o

0.2

1.3

1.7

*

...

...

1.2

0.3

1.4

...

3.6

2.3

1.3

8.1

7.3

.

1.8

0.8

1.6

1.2

1.9

23.6

0.2

1.1

0.6

2.5

0.7

1.1

5.4

0.3

0.9

1.7

1.7

0.7

2.8

0.5

1.1

2.1

106.7

4.5

1.1

0.7

1.4

6.7

4.2

0.3

0.6

0.2

0.8

0.7

0.6

. .

0.2

2.5

1.2

2.3

1.1

0.7

1.1

4.4

0.0

1.1

0.7

0.4

1.3

0.8

12.2

1.0

1.4

0.7

0.6

0.4

0.3

1.1

0.3

0.6

0.4

0.8

0.3

1.1

1.7

0.2

1.0

184.1

2.9

0.6

“0.1

0.1

12.5

8.2

0.1

1.2

0.7

1.8

0.4

1.1

...

0.2

4.3

1.5

6.4

3.4

1.6

6.9

8.3

.

1.8

1.2

2.2

1.4

1.7

21.9

0.4

1.6

0.8

1.4

0.7

0.8

3.4

0.4

0.8

1.8

2.1

0.6

2.9

0.4

0.7

2.4

47
Table4. Rates ofdachsrge anddaya ofarefor inpatients discharged from hospitala bysexand tiagn~is: Ptindand the Untied SMes, 1980-Con,

[Data are for shoti-stay non-Federal hospitals in the United States and for all general hospitals in Poland. Data exclude healthy newborn infants and normal deliveries. Diagnostic categories and

tie numbers are from the Ninth Revision, International Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Dkcharge rate per 1,000 population

Oiseases of therespirator pystem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Acute respiratory infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...460-466

Chronic disease oftonsils and adenoids . . . . . . . . . . . . . . . . . . . . . . . . ...474

Other diseases ofupper respiratory tract . . . . . . . . . . . . . . . . . . . 470-473,475-478

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..48C-486

h’Ifh.IeflZa. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...487

Bronchitisand emphysema.. . . . . . . . . . . . . . . . . . . . . . . . . . . ...490-492

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Oiseasesofthedigestivesystem. . . . . . . . . . . . . . . . . . . . . . . . . . . ..520_57g

Diseaseeoforalcavity, salivaryglsnds and jaw . . . . . . . . . . . . . . . . . . . 520-529

Gastricand duodenalulcer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..531–532

Other diseases ofesophagus, stomach and duodenum . . . . . . . . . . . . . .530, 538-537

Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...540-543

Herniaofabdominalcavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...550-553

Noninfectiveenteritisandcolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55.5-556

Otherdiseasesofintestinesand peritoneum . . . . . . . . . . . . . . . . . . . . . . 560-569

Chronichverdiseaseandcirrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . ...577

Disordersofgall bladderand biliarytract . . . . . . . . . . . . . . . . . . . . . . . . 574-576

Other diseases ofdigestive system . . . . . . . . . . . . . . . . . . 570, 572-573, 577-57g

Diseases of thegenitourinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Oiseasee of urinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..580_5gg

Diseases ofmale genital organs... . . . . . . . . . . . . . . . . . . . . . . . . . . 600-608

Disorders of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..810-EII

Inflammatory disease of female pelvic organs. . . . . . . . . . . . . . . . . . . . . 814-618

Dsorders ofmenstruation andother abnormal bleedng from female genital tract . . . . . . 626

Complications ofpregnancy, childbirth andthepuerperium . . . . . . . . . . . . . . . . 630+76

Induced abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...635-638

Other pregnancy with abortive outcome . . . . . . . . . . . . . . . . . . . . 630-634,837+39

Complications oflabor, delivery andthepuerperium . . . . . . . . . . . . . . . . . . 652-876

Oiseases of the skin and subcutaneous tissue . . . . . . . . . . . . . . . . . . . . . . 680_709

Diseases of the musculoskeletal syatem and connective tissue . . . . . . . . . . . . . . 710-739

Osteoarfhrosis and allied disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . ..7I5

Other arthropathies and related disorders . . . . . . . . . . . . . . . . . . 710-714, 710_719

Intervertebral disc disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...722

Other dorsopathies . . . ...’.. . . . . . . . . . . . . . . . . . . . . ...720-.721.723-724

Rheumaffsm, excluding the back . . . . . . . . . . . . . . . . . . . . . . . . . . . . 725-729

Disorders of bone and cartilage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 730-733

Congenital anomalies.,.....,,.. . . . . . . . . . . . . . . . . . . . . . . . ,. 740-759

Certain conditions originating intheperinatal period . . . . . . . . . . . . . . . . . . . 760-779

Symptoms, signs and ill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . . 780-799

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-999

Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-629

Dk.locations, sprains and strains.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 830-646

intracranial injuy, excluding those with skull fracture . . . . . . . . . . . . . . . . . . 650-654

Openwound andinjuty to blood vessels . . . . . . . . . . . . . . . . . . . . . . . . 87C-904

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...94&949

Poisoning andtoxic effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96C-989

Complications ofsurgical andmedical care notelsewhere classified. . . . . . . . . 996-999

Supplementary classification of factors influencing health statue and

contact with health services.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VO1-V82

13.6

2.7

1.0

1.4

4.4

0.1

2.8

0.7

13.4

0.3

2.0

1.5

2.8

1.6

0.7

1.0

0.4

2.7

0.7

9.9

4.1

0.8

0.1

0.9

1.5

10.5

1.7

2.3

2.1

2.8

3.5

0.6

0.9

0.5

0.7

0.3

0.3

1.0

0.5

1.6

11.6

4.7 “

0.6

0.8

1.4

0.7

0.9

0.1

0.8

A[l conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...1.677.6

Infectious and parasitic diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001–139

Intestinal infectious diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-009

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..010 -!318

Viral hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...070

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .,.,.140-239

Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..140-2f18

Malignant neoplasm ofetomach. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...151

Malignant neoplasm ofother digestive organs andpefitoneum . . . . . . . . .150, 152–159

Malignant neoplasm oftrachea, bronchus and lung . . . . . . . . . . . . . . . . . . . . 162

Malignant neoplasm of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174-175

Malignant neoplasm ofcewix uteri . . . . . . . . . . . . . . . . . . . . . . . . . . ...180

Malignant neoplasm ofother female genital organs . . . . . . . . . . . . . . . 179,181-184

Malignant neoplasm of prostate.. . . . . . . . . . . . . . . . . . . . . . . . . . . ...185

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-206

181.9

18.6

92.3

43.7

136.9

110.6

7.9

15.4

21.7

9.1

8.2

7.1

1.7

5.5

15.3

2.3

2.0

1.3

3.5

0.4

1.4

1.8

20.7

1.2

1.2

2.7

1.2

3.7

2.6

3.3

0.5

2.7

1.4

16.0

5.5

2.2

1.0

1.4

2.0

13.0

0.7

1.6

7.0

2.7

10.0

0.8

1.6

1.7

1.9

1.9

1.3

1.9

4.1

2.9

15.9

5.2

2.9

1.3

1.5

0.4

0.9

1.1

3.6

16.4

3.2

1.0

1.8

5.3

0.1

3.5

0.7

14.1

0.3

2.9

1.7

2.5

2.5

0.7

1.0

0.5

1.3

0.6

5.5

3.8

1.7

0.0

...

...

...

...

...

...

2.9

3.5

0.4

0.7

0.6

0.8

0.4

0.5

1.1

0.6

1.7

16.9

6.8

0.9

1.2

2.2

0.9

1.0

0.1

0.5

18.1

2.3

1.8

1.4

3.8

0.4

1.6

1.7

20.0

1.1

1.3

2.6

1.3

5.3

2.3

2.5

0.6

1.5

1.5

10.1

5.4

4.5

0.2

...

...

.

...

...

...

2.7

8.9

0.5

1.5

1.9

1.6

1.6

1.1

1.9

4.5

2.8

16.6

5.3

3.6

1.6

2.3

0.6

0.9

1.1

1.7

10.9

2.3

0.9

1.1

3.5

0.1

2.0

0.6

12.7

0.2

1.1

1.4

2.6

0.8

0.7

1.0

* 0.3

4.1

0.7

14.1

4.3

...

0.1

1.6

3.0

20.5

3.3

4.5

4.0

2.2

3.5

0.8

1.0

0.4

0.6

0.2

0.2

0.9

0.5

1.6

6.9

2.8

0.3

0.5

0.5

0.5

0.9

0.1

1.0

Rate of days of care per 1,000 population

1,226.9

20.1

2.7

1.9

0.9

115.4

97.6

2.5

20.4

15.2

10.3

1.9

5.3

6.1

3.2

1,758.8

231.7

21.0

133.9

44.3

132.7

119.5

9.8

14.6

37.6

0.2

...

...

3.6

6.4

1,099.9 1,600.5

19.0 134.6

2.4 16.3

2.7 52.8

0.9 43.1

104.7 140.8

96.6 102.1

3.1 6.1

19.5 16.2

21.5 6.5

●

17.5

... 15.9

... 13.8

12.7 ..

3.6 4.6

14.5

2.3

2.3

1.2

3.2

0.5

1.2

2.0

21.3

1.4

1.0

2.9

1.0

2.1

3.1

4.1

0.4

3.8

1.4

21.4

5.6

...

1.7

2.6

3.8

25.0

1.4

3.1

13.6

2.7

11.0

1.1

1.7

1.5

2.0

2.2

1.4

1.9

3.7

3.1

13.5

5.0

2.3

1.0

0.7

0.2

0.9

1.2

5.4

1,345.4

21.2

3.0

“1.1

1.0

125.4

98.5

2.0

21.2

9.3

19.9

3.7

10.2

...

2.7

46
Tabks4. Rataaof dlachame anddaya ofarefor inpatienta discharged from hoapHala byaexand dagnoaia: Poland andthe United Stitea, 198f)-Con.

[Dala are for short-stay nonfederal hoepltala In the United Statee and for all ganaral hospitals in Poland. Data exolude healthy newborn Infanta and normal daliverfes. Diagnostic categories and

code numbers are from the Ninth Revleion, International Classification of Diseaaea, 1975]

Both sexes Male Famale

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Rate of daye of care per 1,000 population

Benign neoplasms, carcinoma lnsltu, andneoplasms ofuncedain behavior. . . . . . 210-239

Benign neoplasm of uterus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213-219

Endocrine, nutritional andmetabolic diseases andimmunity daorders . . . . . . . . 24C-279

Diabetea mellltus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250

Diaeaaeeofbloodand blood-forming organs . . . . . . . . . . . . . . . . . . . 28C-2s9

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...290-319

Diseases ofthenervoussystem andsenseorgans . . . . . . . . . . . . . . . . . . . . 320-389

Dleordersoftheautonomic nervous system . . . . . . . . . . . . . . . . . . . . . . . ...337

Other disorders of thecentral nervous ayatem . . . . . . . . . . . . . . . . 320-336,340+49

Disorders of the peripheral nervoue eystem . . . . . . . . . . . . . . . . . . . 35=59

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...366

Other disordere of the eye and adnexa . . . . . . . . . . . . . . . . . . . . 360-365,367-379

Diseaeee of theearand maetold process. . . . . . . . . . . . . . . . . . . . . . 3S0-3S9

Diseases of theclrculatory system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Rheumatic heart dleeaee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 391X398

Essential hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...401

Hypertensive heart andrenaldieeaee. . . . . . . . . . . . . . . . . . . . . . . . . . 402-404

Acute myocardial infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...410

Other acute and eubacute forms of iechemic heari disease . . . . . . . . . . . . . . . . . 411

Angina pectorla . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...413

Other chronic ischemlc heart disease . . . . . . . . . . . . . . . . . . . . . . . . . . 412,414

Dieeaees ofpulmonary circulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41=17

Diaeaees of the pericardium and endocardium, cardiomyopathy

and conduction disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..42~26

Cardiac dyarhythmlaa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...427

Heart failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...426

Ill-defined descriptions and compllcatione of heart diseaee . . . . . . . . . . . . . . . . . 429

Acute cerebrovascular dlseaee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 430-436

Atheroacleroeis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...440

Other dieeaeea of arterlea, arteriole and capillaries . . . . . . . . . . . . . . . . . 441A4e

Diseases of velne and Iymphatics, and other dieeasee of the circulatory syetem . . 451-459

Dlaeaaes of theresplratory system . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Acute respiratory infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...460-466

Chronic disease oftonsils andadenolde . . . . . . . . . . . . . . . . . . . . . . . . ...474

Other dleeases of upper reepkatory tract . . . . . . . . . . . . . . . . 470-473, 475-478

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..46W86

Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..4S7

Bronchltls andemphysema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .490-492

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Dleeaaes of thedlgestlveaystem . . . . . . . . . . . . . . . . . . . . . . . . . . 52C-579

Diseases of oral cavity, salivary glande and jaw . . . . . . . . . . . . . . . . . . 520-529

Gaatrlc and duodenal ulcer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..531–532

Other diseases of esophagus, stomach and duodenum . . . . . . . . . . . . . .530, 533-537

Appendicltie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .540-543

Hernlaof abdominal cavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...550-553

Nonlnfectlve enteritis andcolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 555-558

Other diaeasee oflntestines andparitoneum . . . . . . . . . . . . . . . . . . . 56C-569

Chronic llverdisease andcirrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . ...571

Disorders of gall bladder and biliary tract . . . . . . . . . . . . . . . . . . . . . . . . 574-576

Other diaeaaea of digestive eyetem . . . . . . . . . . . . . . . 570.572-573, 577-579

Dlseasee of thegenitourinary eyetem . . . . . . . . . . . . . . . . . . . . . 580-629

Dieeaaes ofurlnary system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..580-599

Dleaasee ofmalegen[tal organa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600-606

Dlsordere of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .610-611

Inflammatory diaease of female pelvic organe. . . . . . . . . . . . . . . . . 614-616

Dlsordara ofmenstruation andother abnormal bleedng from female genital tract . . . . . 626

Complications ofpregnancy, childMflh andthepuerperium . . . . . . . . . . . . . . . . 630-676

Induced abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .635-636

Other pregnancy with abortive outcome . . . . . . . . . . . . . . . . . 630-634, 637-639

Complication of labor, delivery and the puerperium . . . . . . . . . . . . . . 652-676

Diseases of the skin and subcutaneous tiesue . . . . . . . . . . . . . . . . . . . 660-709

Diseasea of the muaculoskeletal system and connective tissue . . . . . . . . . . . . . 710-739

Osteoarthrosis and allied disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . ...715

Other arthropathies and related disorders . . . . . . . . . . . . . . . . . . . 710-714, 716-719

Intervertebral disc disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...722

Other dorsopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...720-721. 723-724

Rheumatism, excluding the back . . . . . . . . . . . . . . . . . . . . . . . . . . . . 725-729

Disorders of boneandcartllage . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . 730-733

Congenital anomalies . . . . . . . . . . . . . . . . . . ..~~ . . . . . . . . . . . . . . 740-759

26.3

9.7

34.5

19.9

10.1

12.9

93.9

0.2

30.9

16.0

6.1

23.9

14.8

251.7

17.3

17.4

9.5

24.0

8.1

5.4

22.5

13.8

15.6

5.8

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4.3

23.3

39.6

6.0

17.1

240.4

26.6

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19.5

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0.7

68.0

16.5

191.4

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35.9

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102.4

52.6

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6.9

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66.6

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143.6

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16.8

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13.9

11.7

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25.2

17.0

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34.1

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7.3

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274.8

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71.4

44.4

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50.8

80.6

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22.8

6.7

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40.4

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20.0

4.4,

5.5

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5.5

229.0

1.5

7.0

5.3

30.7

5.3

5.6

47.3

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8.2

12.4

17.5

5.5

34.1

7.4

14.1

16.2

102.1

10.2

3.3

4.5

31.3

1.8

11.6

9.2

129.4

2.9

11.4

15.4

7.4

26.2

12.1

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6.7

15.2

13.8

64.3

33.2

30.6

0.6

...

. .

...

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...

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20.3

67.9

6.0

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17.9

15.2

6.7

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11.6

38.7

16.9

43.3

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87.3

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27.8

14.0

9.0

23.7

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229.7

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20.8

11.2

13.5

6.2

4.1

18.8

5.6

16.0

5.5

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4.7

23.2

35.2

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18.8

1S3.7

23.0

8.5

14.9

64.2

0.6

47.6

14.3

166.3

2,6

21.4

15.2

28.2

11.1

7.6

11.9

6.2

68.6

13.2

131.7

60.4

...

1.4

19.2

13.4

146.2

6.2

21.5

39.3

46.8

93.3

20.5

31.6

11.0

13.5

3.6

5.7

23.6

26.9

10.6

62.6

36.6

12.8

84.7

44.9

●

16.9

6.3

S.1

5.7

5.9

227.4

3.9

11.7

8.6

17.9

5.6

5.4

34.8

5.0

7.6

14.0

21.7

6.5

3S.6

5.7

9.6

20.9

90.7

11.4

4.4

4.6

26.7

3.0

9.1

12.3

156.9

3.8

9.5

17.8

5.8

14.9

18.4

34.0

5.4

34.5

12.9

112.1

37.1

...

5.9

13.6

12.8

95.2

2.1

7.5

56.6

22.4

96.9

13.4

16.6

15.8

18.1

11.1

16.5

11.7

49
Table 4. Rates of discharge and daya of care for inpatients discharged from hcspitals by sex and diagnosis: Potsnd and the United States, 1980-Con.

[Data are for shorl-stay non-Federal hospitals in the Unitad States and for all general hospitals in Poland. Data exclude healthy newborn infants and normal deliveries. Diagnostic calagories and

code numbers are from the Ninth Revision, International Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Rate of days of care per 1,000 population

Certain conditions originating in the perinaial period . . . . . . . . . . . . . . . . . . . 760-779

Symptoms, signs and ill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . . 780-799

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-999

Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-629

Dislocations, sprainsandstrains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 830-848

Intracranial injury, exclucting thoaewith skull fracture . . . . . . . . . . . . . . . . . . 850-854

Openwound andinju~to blood vessels . . . . . . . . . . . . . . . . . . . . . . . . 870-904

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...940-949

Poisoning andtoxiceffects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..96G969

Complications ofsurgical andmedcal care notelsewhere classified. . . . . . . . . 996-999

Supplementary classification of factors influencing health status and

contactwith healthservicea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VO1–V82

7.4

15.6

158.8

83.6

7.7

10.0

16.2

12.2

4.7

1.1

6.9

31.9 7.5 32.2 7.2

13.2 15.9 12.1 15.2

122.6 224.1 128.1 96.7

55.8 113.8 48.4 54.9

17.3 12.2 19.8 3.6

7.4 14.6 9.9 5.3

7.6 26.2 11.8 6.7

5.7 16.4 7.4 8.2

3.7 4.9 3.7 4.5

9.5 1.1 9.5 1.2

12.2 5.5 7.1 8.2

31.7

14.3

117.6

62.8

15.1

5.0

3.8

4.1

3.6

9.s

17.0

Tsble5. Rste.$of discharge anddaya ofcerefor patients underl yearofage, byaexand tiagnoais: Poland andthe Untied Sbtes, 1980

[Data are for short-stay non-Federal hospitals in the United States and for all general hospitals in Poland. Data exclude healthy newbarn infants (codes V30-V39). Diagnostic categories and code

numbers are from the Ninth Revision, International Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Discharge rate per 1,000 live births

.Allcondifions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectiousand parasiticdiseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Intestinal infectiousdiseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-009

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...010-018

Viral hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...070

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Malignantneoplasms . . ...’. . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-208

Malignantneoplasm ofstomach. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...151

Malignant neoplasm ofother dgestive organs andpefitoneum . . . . . . . . .150, 152–159

Malignant neoplasm oftrachea, bronchus and lung . . . . . . . . . . . . . . . . . . . . 162

Malignantneoplasm ofbreast . . . . . . . . . . . . . . . . . . . . . . . . . . ...174-175

Malignantneoplasmofcervixuteri . . . . . . . . . . . . . . . . . . . . . . . . . . . ..1S0

Malignant neoplasm ofother female genital organs . . . . . . . . . . . . . . .179, 1S1-184

Malignantneoplasm ofprostate. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...185

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-206

Benign neoplasms, carcinoma inaitu, andneoplaems ofunceRain behavior. . . . . . 210-239

Benign neoplasm ofuterus . . . . . . . . . . . . . . . . . . . . . . . . . . . ...218-219

Endocrine, nutritional andmetabolic diseasee and immunity disorders . . . . . . . . . . 24C-279

Diabetesmellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250

Diseasesofblood andblood-forming organs . . . . . . . . . . . . . . . . . . . 280-289

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..29G319

Diseasesofthe nervoussystemand sense organs . . . . . . . . . . . . . . . . . . . . 320-369

Disordersoftheautonomic nervoussystem . . . . . . . . . . . . . . . . . . . . . . . . . 337

Other disorders ofthecentralnewous system . . . . . . . . . . . . . . . 320-33S,340-349

Disordersoftheperipheral nervoussyetem . . . . . . . . . . . . . . . . . . . . 350-359

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...366

Otherdisordersoftheeyeandadnexa . . . . . . . . . . . . . . . . . . . . 360-365,367-379

Diseasesoftheearandmastoid process. . . . . . . . . . . . . . . . . . . . . 3S0-369

Diseases ofthecirculatorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39&459

Rheumaticheartdisease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...390-398

Essential hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..4ol

Hypertensive hearfand renaldisease . . . . . . . . . . . . . . . . . . . . . . . . . . 402-404

Acute myocardial infarction.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...410

Ofheracute andsubacute forms ofiechemic hearf disease . . . . . . . . . . . . . . . . 411

Angina pectoris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...413

Other chronic ischemic heart disease . . . . . . . . . . . . . . . . . . . . . . . . . . 412,414

Diseases ofpulmonary circulation. . . . . . . . . . . . . . . . . . . . . . . . . . . . 415-417

Diseases of the pericardium and endocardium, cardiomyopathy

and conduction disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...420-426

Cardiac dysrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...427

Hearffailure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...428

298.3

49.2

42.3

+

0.5

1.2

0,3

●

0.9

.

2.2

●

3.5

.

17.2

4.4

0.2

●

1.1

11.5

0.9

,

0.5

.

.

506.8

19.7

5.9

.

5.1

“1.6

●

.

*

.

.

.

.

3.5

4.2

●

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●

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.

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.

.

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.

.

.

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.

328.8

53.9

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0.7

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2.4

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.

18.7

5.0

●

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12.4

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,

0.5

.

536.5

19.4

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5.4

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*

...

...

.

.

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...

‘4.5

.

.

.

23.0

5.s

●

●

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12.7

6.8

.

●

.

●

●

.

●

●

266.0

44.2

38.4

.

0.4

1.4

.

...

●

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2.0

.

3.3

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15.7

3.8

.

●

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.

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19.9

5.7

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,

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50
Tabfe5. Rateaof discharge anddays ofmrefor patients under lyearof age, bysexand dmgnosis Pokndand the Untied States, 1960-Con.

[Data are for short-slay non-Federal hospitals in the United States and for all general hospitals in Poland. Data exclude healthy newborn infants (codes V30-V39). Diagnostic categories and code

numbers am from the Ninth Revision, International Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Discharge rate per 1,000 live births

lfl-defined descriptions andcomplicafions ofhearf disease . . . . . . . . . . 429

Acute cerebrovascular disease . . . . . . . . . . . . . . . . . . . . . . . . . . ...430436

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..44o

Other diseases of arteries, arterioles and capillaries . . . . . . . . . . . . . . . 441448

Diseases of velne and lymphatic, and other dieeases of the circulatory system . . 451459

Diseasesofthe reepiratorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Acuterespiratoryinfections.... . . . . . . . . . . . . . . . . . . . . . . . . ...460466

Chronicdlseaseoftoneilsandadenoids . . . . . . . . . . . . . . . . . . . . . . . . ...474

Other diseases of upper respiratory tract . . . . . . . . . . . . . . 470-473, 475-478

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...480466

Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...487

Bronchitisand emphysema, . . . . . . . . . . . . . . . . . . . . . . . . . . . ...490-492

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Dlseasesofthedigestivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseasesoforalcavity, ealivaryglande and jaw . , . . . . . . . . . . . . 520-529

Gastricand duodenalulcer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..531–532

Other diseases of esophague, stomach and duodenum . . . . . . . . . . . . .530, 533-537

Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...540-543

Hernlaofabdorninalcavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...550-553

Nonlnfectlveenterifisandcofitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 555-558

Otherdlseaseeoflnteafineaandperitoneum . . . . . . . . . . . 560-569

Chronic llverdlseaeeandcirrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . ...571

13isordersofgall bladderand biliarytract . . . . . . . . . . . . . . . . . . . . . . 574-576

Other diseases of digestive system . . . . . . . . . . . . . . . . . . 570,572-573,577-579

Dieeaees of thegenitourinary aystem . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Diseaees ofurinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..58f)-599

!Xeasesof malegenitalor gans . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600-606

Disorderso fbreaet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...610-611

Inflammatory disease of female pelvic organs, . . . . . . . . . . . . . . . . . . 614-616

Msorders ofmenstruation andother abnormal bleeding from female genital tract 626

Complications ofpregnancy, childbirth andthepuerperium . . . . . . . . . . 630-676

Induced abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...935-636

Other pregnancy with abortive outcome . . . . . . . . . . . . . . . . 630-634,637-639

Complications oflabor, delivery andthepuerperium . . . . . . . . . . . . . . . . 652-676

Diseases of theskin andsubcutaneous fissue . . . . . . . . . . . . . . . . . . . 66C-709

Diseasee of themueculoskeletal syetemand connective tissue. . . . . . . . . . 710-739

Osteoarthrosie andallied cfieorders . . . . . . . . . . . . . . . . . . . . . . . . . . . ...715

Other arthropathlee and related disorders . . . . . . . . . . . . . . . . . 710-714,716-719

Intervertebral ctisc disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...722

Other dorsopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...720-721. 723–724

Rheumatism, excluding the back . . . . . . . . . . . . . . . . . . . . . . . . . . . . 725-729

Disorders of bone and cartilage . . . . . . . . . . . . . . . . . . . . . . . . . . . 730-733

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...740-759

Certain conditions originating intheperinatal period . . . . . . . . . . . . . . . 760-779

Symptoms, signs andill-defined concfitions . . . . . . . . . . . . . . . 780-799

Injury andpolsoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...60&999

!+acturee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...900-629

Dislocallons, sprains and strains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 830-648

intracranial lnjuy, excluding those with skull fracture . . . . . . . . 650-654

Openwound andin]ury to blood veseele . . . . . . . . . . . . . . . . . . . . . . . . 870-904

Elurne . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...940-949

Poisoning and toxic effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..g6&ggg

Complications ofsurgical andmedcal care notelsewhere classified. . . . . 99e-999

Supplementary classification of factora Influencing health etatus and

contact withhealth aervicea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI–V82

.

.

,

.

136.2

29.5

0.2

1.1

82.2

0.3

21.3

o.e

23.7

0.6

●

4.6

0.2

3.4

7.3

6.3

●

0.2

1.0

4.6

4.4

0.4

,

*

...

...

...

6.1

0.5

.

.

●

0.4

13.3

27.2

3.4

5.6

1.0

.

0.4

0.2

2.1

0.7

.

3.1

Allconditlons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...4.766.1

Infectious andparasitic diseaeee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139 877.6

Intestinal infectious diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-009 714.6

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..01&O18 ‘

Vlralhepatitls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..o7o 20.4

.

.

.

.

.

59.6

26.6

.

.

19.9

.

4.5

3.3

43.6

.

.

4.2

.

10.1

23.6

“2.0

.

.

“1.6

5.7

‘2.6

“2.4

,

.

.

...

..

...

5.1

3.5

.

‘1.4

.

.

●

.

41.5

254.9

13.5

10.1

“2.7

.

.

,

.

.

.

8.0

.

.

●

166.9

32.6

.

1.1

94.9

0.3

25.6

1.0

27.8

0.5

.

5.0

.

6.0

7.8

6.6

.

.

1.1

3.6

2.9

0.7

●

...

...

..

...

...

6.1

0.5

.

0.4

13.3

27.0

3.3

6.5

1.0

.

0.5

*

2.5

0.7

.

2.8

.

.

.

.

.

71.4

31.4

●

,

24.3

.

“5.1

‘4.4

50.9

.

●

5.4

.

15.7

24.5

.

.

.

.

6.6

*

“4.6

.

...

...

...

...

...

...

●4.7

.

.

.

,

.

.

42.1

265.0

13.6

10.3

.

.

,

●

.

.

.

6.3

.

.

114.3

25.9

.

1.1

68.9

.

16.7

0.5

19.4

0.7

.

4.1

●

0.6

6.7

5.9

.

●

0.9

6.1

5.9

...

●

.

...

...

...

...

6.1

0.6

.

.

●

0.4

13.2

27.4

3.5

4.6

0.9

,

0.3

,

1.7

0.7

.

3.4

Rate of days of care per 1,000 live births

3,284.8 5,265.2 3,260.1 4,236.9

100.9 954.2 99.2 797.1

27.5 773.1 26.2 652.8

.

.

24.2 16.4

●

✎

✎

✎

47.2

21.7

,

●

15.3

●

“3.9

,

36.0

.

.

*4.3

22.7

●

.

.

“4.4

‘3.2

...

“

.

●

...

...

...

...

“5.4

‘4.6

,

●

.

●

●

.

40.7

244.2

13.4

9.9

“3.4

.

.

●

.

.

.

7.7

3,310.7

102.6

26.9

.

51
Table5. Rateaof discharge anddaya ofcerefor petientaunderl yearof age, byaexand dmgnosi% Poland andthe United Statas, 1980-Con.

[Data are for short-stay non-Federal hospitals in the United States andfor all generalhospitalsIn Poland. Date exclude healthy nawbom infants (scalesV30-V39). Diagnostic categories and code

numbers are fmmthe Ninth Revialon, international Classificationof Dlseaaes, 1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Rate of days of care per 1,000 live birthe

Neoplaems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Malignantneoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-208

Malignant neoplaem ofstomach. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...151

Malignant neoplasm ofother dgestive organs andpedtoneum . . . . . . . . . 150,152-159

Malignant neoplasm oftrachea, bronchua and lung . . . . . . . . . . . . . . . . . . . . 162

Malignant neoplasmofbreast . . . . . . . . . . . . . . . . . . . . . . . . . . ...174-175

Malignant neoplaemofcervixuteri . . . . . . . . . . . . . . . . . . . . . . . . . . ...180

Malignant neoplasm ofother female genital organs . . . . . . . . . . . . . . . 179,181-184

Malignant neoplasm of prostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..185

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-206

Benign neoplasms, carcinoma insitu, andneoplaeme ofuncefiain behavior. . . . . . 210-239

Benign neoplasm ofuterus . . . . . . . . . . . . . . . . . . . . . . . . . . . ...216-219

Endocrine, nutritional andmetabolic @seaseaandimmunity disorders . . . . . . . . . . 24C-279

Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250

Diseasesofbloodand blood-forming organe . . . . . . . . . . . . . . . . . . . . . . . 280-289

Mentaldisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...290-319

Diseasesofthenervoussystemand senaeorgans . . . . . . . . . . . . . . . . . . . . 32C-389

Disorderaoftheautonomicnervous eyatem. . . . . . . . . . . . . . . . . . . . . . . . . . 337

Other clisordereof thecentral nervous system . . . . . . . . . . . . . . . . 320-338,340-349

Disordera of theperipheral nervous eystem . . . . . . . . . . . . . . . . . . . . . . . 350-359

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...368

Other disordera of theeyeandadnexa . . . . . . . . . . . . . . . . . . . . 380-365,387-379

Diseases of theearand mastoid process . . . . . . . . . . . . . . . . . . . . . . . . . 380-369

Oiseases of thecirculatory system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390459

Rheumatic heart disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...390-398

Essential hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...401

Hypertensive heart andrenaldiseaae . . . . . . . . . . . . . . . . . . . . . . . . . . 402-404

Acute myocardial infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...410

CXheracute andsubacute forms ofiachemic hearf dieease . . . . . . . . . . . . . . . . . 411

Angina pectoris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...413

Other chronic ischemic heart diaease . . . . . . . . . . . . . . . . . . . . . . . . . . 412,414

Oieeases ofpulmonary circulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415-417

Diseases of the pericardium and endocardium, cardiomyopathy

and conduction disorders ..:. . . . . . . . . . . . . . . . . . . . . . . . . . ...420426

Cardiac dysrhythmias ..,....,. . . . . . . . . . . . . . . . . . . . . . . . . . ...427

Hearffailure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...428

hi-defined descriptions andcomplicatione ofheatidseaae . . . . . . . . . . . . . . . . . . 429

Acute cerebrovaecular disease . . . . . . . . . . . . . . . . . . . . . . . . . . ...430436

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . ..44o

Ofherdiseases ofarleries, arterioles andcapillariee . . . . . . . . . . . . . . . . . . 441-448

~seases ofveins andlymphatics, andother dseaaes of thecirculato~ system . . . 451459

Dieeases of therespiratory system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46C!-519

Acute respiratory infectione . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...460466

Chronic dieease oftonsils andadenoide . . . . . . . . . . . . . . . . . . . . . . . . ...474

Other diseases ofupper respiratory tract . . . . . . . . . . . , . . . . . . . 470473,475478

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...480486

Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . ...487

Bronchitis and emphysema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..490-492

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Diseases of thedigeetiveaystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diaeases oforalcavity, salivary glands and jaw . . . . . . . . . . . . . . , , . . . . 520-529

Gaafric andduodenai ulcer... . . . . . . . . . . . . . . . . . . . . . . . . . . ..531–532

Other diseases ofesophagus, stomach and duodenum . . . . . . . . . . . . . .530, 533-537

Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . ...540-543

Hernia ofabdominal cavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..55c-553

Noninfective enteritis andcolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 556-558

Other diseases ofintestines andperltoneum . . . . . . . . . . . . . . . . . . . . . . 560-569

Chronic liver disease and cirrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..57 I

Disorders ofgallbladder and biliarytract . . . . . . . . . . . . . . . . . . . . . . . . 574-576

Other diseases ofdigeetive system . . . . . . . . . . . . . . . . . . . 570,572-573,577-579

Diseases of thegenitourinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Diseases ofurinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..580-599

Diseases ofmale genital organs... . . . . . . . . . . . . . . . . . . . . . . . . . . 600-608

Disorders of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..610-611

Inflammatory disease of female pelvic organs. . . . . . . . . . . . . . . . . . . . . . 614-616

D[sordere ofmenstruation andother abnormal bleedng from female genital tract . . . . . . 826

24.5

7.5

●

17.1

●

53.7

,

37.8

*

274.3

104.9

9.0

●

11.2

146.7

21.7

*

12.2

*

●

●

●

.*

●

2,186.3

322.6

1.6

9.2

1,493.9

1.7

329.5

10.7

312.0

4.5

.

44.1

1.5

31.1

109.8

84.9

●

2.6

30.1

113.5

110.1

2.0

●

*

31.7

‘14.1

.

●

●

●

.

●

*

17.6

36.9

●

“12.9

*

106.8

.

52.9

●

●

10.9

36.2

59.6

*

●

.

●

*

*

●

‘11.0

*

●

●

●

*

*

288.4

114.7

●

.

108.3

*

21.8

17.4

219.9

●

●

20.4

.

32.3

126.0

“13.4

●

●

“16.1

24.2

‘16.0

“5.s

●

●

●

23.8

11.6

...

...

●

12.3

...

63.2

.

44.5

●

293.0

118.0

.

11.5

156.9

19.4

.

10.6

●

*

.

.

2,569.0

362.6

*

10.7

1,749.1

1.9

405.9

13.7

361.0

4.5

●

47.e

●

53<5

116,5

92.4

●

.

32.1

81.0

77.1

3.6

●

...

...

28.6

.

.

●

...

.,,

.

●

‘1 7.9

...

‘37.9

.

.

*

124.0

61.7

.

●

“11.1

44.4

51.8

●

.

●

●

.

.

.

●

●

●

●

.

●

352.7

136.0

●

●

136.7

●

‘26.0

“24.0

237.9

●

.

27.3

,

49.6

120.1

●

,

.

.

25.2

●

“11.3

●

...

...

25.3

●

...

.

22.1

●

43.6

●

30.7 a,

254.6

93.1

“

●

10.9

140.1

24.2

●

13.8

●

,

.

1,762.0

280.4

.

7.5

1,224.4

*

246.6

7.6

260.2

4.5

.

40.3

●

7.4

100.6

77.0

●

*

26.0

147.9

144.9

...

.

●

“34.6

●

.

●

.

●

...

●

“17.4

‘40,0

●

●

●

92.9

.

*43.5

●

●

‘1 0.8

31.7

67.6

●

●

.

●

●

.

●

●

●

●

●

●

220.7

92.3

●

●

78.4

●

●I 7.4

.

200.9

●

.

‘14,0

132.3

●

●

●

●23.1

*19.0

...

●

●

.

52
Table5. Rates ofdischarge anddaya ofcsrefor patients underl yesrofage, byaexand diagnose% Poland andthe United State& 1980-Con.

[Data are for short-slay non-Federal hospitals in the United States and for all genersl hospitals in Poland. Data exclude healthy newborn infants (codes V30-V39). Diagnostic categories and code

numbers are from the Mnth Revision, international Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Complications ofpregnancy, childbirth andthepuerperium . . . . . . . . 630-676

Induced abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...83&836

Other pregnancy with abortive outcome . . . . . . . . . . . . . . 630-634, 637-839

Complications of labor, delivery and the puerperium . . . . . . . . . . . . . . . 652-876

Diseases of the akin and subcutaneous tissue . . . . . . . . . . . . . . . . . . . . . 660-709

Disease; of the musculoskeletal eystem and connective tissue . . . . . . . . . 710-739

Oeteoarfhrosls and allied disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . ...715

Olher arthropathies and related disorders . . . . . . . . . . . . . . . . . 710-714, 718-719

Intervertebral discdisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...722

Other dorsopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...720-721. 723-724

Rheumatism, excluding the back . . . . . . . . . . . . . . . . . . . . . . . . . . . . 725-729

Disorders of bone and cartilage.. . . . . . . . . . . . . . . . . . . . . . . . . . ..73G733

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 740-759

Certain conditions originating intheperinatal period . . . . . . . 760-779

Symptoms, slgnsand ill-defined conditions . . . . . . . . . . . . . . 76C-799

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..80G999

Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-629

D[.slocations, sprains and strains . . . . . . . . . . . . . . . . . . . . . . . . . . . . 630-648

intracranial injury, excluding those with skull fracture . . , . . . . . . . . . . . 650-854

Openwound andinjury to blood vessels . . . . . . . . . . . . . 870-904

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...940-949

Poisoning andtoxlc effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..96G989

Complications ofsurgical andmedcal care notelsewhere classified. . . . . . . . . 996-999

Supplementary claseitication of factora influencing health status and

contact withhealth sewices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI-V82

...

...

...

...

66.9

13.0

.

●

.

12.3

277.6

378.4

33.5

64.7

12.6

.

5.1

1.9

2s.s

6.1

.

26.0

Rate of days of care per 1,000 live births

.. .. ... ...

. . .. .. ...

... ... ... ...

.

23.7 68.3““” “20.6““” 65.4““”

18.4 16.1 .

9.7

● ●

● ● . ,

. .

. . .

. .

.

15.7 .

6.7

235.2 275.2 235.0 280.1

1,974.6 367.7 1,873.2 389.7

53.0 31.7 54.5 35.5

61.2 71.2 49.5 57.7

‘1 9.9 12.4 ,

12.8

● . . .

.

5.4 .4.6

. . ● .

.

35.2 .

22.1

.

5.5 .

6.7

. . ● .

27.4 20.1 30.8 32.2

..

...

...

. .

“27.0

’21.8

.

●

.

●

.

.

235.4

2,081.5

51.3

73.5

’31.7

*

.

.

.

.

.

23.8

Table6. Rates oftiacharge anddays ofcarefor patients l-14yeara ofage, bysexand tiagnoai% Poland andthe Untied Statea, 1960

[Data are for shorbstay non-Federal hospitals in the United Statss and for all ganeral hospitals in Poland. Data exclude normal deliveries (code 650). Diagnostic categories and code numbers are

from the Ninlh Revision, International CIsssifkation of Diseases, 1975]

Both sexes Male Famale

United United United

Diagrrosia and ICD-9 code Poland States Poland States Poland Statas

Allconditlons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectious andparasitlc diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Intestinal infectious diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-009

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..01G016

Vir.?dhepatltis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..o7o

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...14&239

Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...1413-208

Malignantneoplasm ofstomach. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...151

Malignant neoplasm ofother digestive organs andpefitoneum . . . . . . . 150,152-159

Malignant neoplasm oftrachea, bronchus and lung . . . . . . . . . . 162

Malignant neoplasm ofbreast . . . . . . . . . . . . . . . . . . . . . . . . . . ...174-175

Malignant neoplasm ofcervixuteri . . . . . . . . . . . . . . . . . . . . . . . . . . ...180

Malignant neoplasm ofother female genital organs . . . . . . . . . 179,181-164

Malignant neoplasm ofprostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...185

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-206

Benign neoplasms, carcinoma insitu, andneoplasms ofunceRain behavior. . . . 210-239

Benlgnneoplasm ofuterus . . . . . . . . . . . . . . . . . . . . . . . . . . . ...218-219

Endocrine, nutritional andmetabofic diseases andimmuniW disorders . . . . . . 24C-279

Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250

Dlseasesofbloodand blood-forming organs . . . . . . . . . 2ao-2a9

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..29C-319

Diseases ofthenervous system and sense organs . . . . . . . . . 32(!-S69

Dlsordersofthe autonomicnervous system . . . . . . . . . . . . . . . . . . . . . . . ...337

0th6rdLsorders of thecentral nervous system . . . . . . . . . . . 320-336,340-349

Disorders of theperipheral nervoua system . . . . . . . 35CI-359

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...366

Other disorders of theeyeandadnexa . . . . . . 360-365,367-379

Diseases of theearand mastoid process . . . . . . . 380-369

60.5

5.5

1.2

0.1

1.s

1.1

0.8

0.0

.

0.3

0.3

0.5

0.1

o.e

0.4

3.6

,

1.5

0.1

0.1

1.0

0.9

Discharge rate per 1,000 population

59.6

2.6

0.7

.

●

1.3

0.7

.

.

.

.

0.6

1.0

0.4

1.4

0.9

6.0

*

1,0

“0.2

.

1.0

3.8

67.4

5.9

1.3

0.1

1.9

1.2

0.9

●

. .

0.4

0.3

...

0.5

0.2

0.8

0.4

3.9

*

1.6

0.1

0.1

1.0

1.0

65.4

2.9

0.8

.

.

1.2

0.7

●

...

...

.

0.5

..

1.0

‘0.3

1.5

0.8

6.9

.

1.2

.

.

1.1

4.4

53.2

5.0

1.0

0.2

1.8

1.0

0.6

●

.

...

0.3

0.3

0.5

0.1

0.5

0.4

3.2

*

1,3

0.1

0.1

1.0

0.7

53.4

2.3

0.5

.

.

1.4

0.7

●

.

●

...

.

0.6

1.1

0.5

1.2

1.0

5.1

0.8

.

.

1.0

3.2

53
Tabte6. Rataaof dscha~e anddays of=refor ptients l-14yeam of age, bysexand diagnose%Poland andthe United Stetes, 1960-Con.

[Data are for ahorf-stay non-Federal hospitala in the United States and for all general hospitals in Poland. Data exclude normal deliveries (code 650). Diagnostic categories and cade numbers are

from the Ninth Revision, International Classification of Diseaaea,1975]

Both sexes Male Female

United United united

Diagnosis and ICD-9 code Poland States Poland States Poland Stales

Oiseases of the circulatory system. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Rheumatic heart disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...39&398

Essential hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..4o1

Hypertensive hearfand renal disease. . . . . . . . . . . . . . . . . . . . . . . . . . 402-404

Acute myocardial infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..4Io

Other acute and subacute forms of ischemic heart disease . . . . . . . . . . . . . . . . . 41 I

Angina pectoris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..4I3

Other chronic ischemic heart disease . . . . . . . . . . . . . . . . . . . . . . . . . . 412,414

Diseases ofpu[monary circulation. . . . . . . . . . . . . . . . . . . . . . . . . . . . 415-417

Diseases of the pericardium and endocarcfium, cardiomyopathy

and conduction disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...420426

Cardiac dysrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...427

Heart failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...428

ill-defined descriptions andcomphcations ofheafl disease . . . . . . . . . . . . . . . 429

Acute cerebrovascular disease . . . . . . . . . . . . . . . . . . . . . . . . . . ...430436

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...440

Other diseaseaof arteries, arterioles and capillaries . . . . . . . . . . . . . . . . . 441-448

Dseases ofveins andlymphatics, andother dseases of thecirculatoy system . . . 451-459

Diseases of the respiratory system.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Acute respiratory infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46&466

Chronic disease oftonsils and adenoids . . . . . . . . . . . . . . . . . . . . . . . . ...474

Other diseases ofupper respiratory tract . . . . . . . . . . . . . . . . . . . 470-473,475478

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...480-486

kIfhJenZa. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...487

Bronchitisandemphysema . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...49&492

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Diseasesofthedigestivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseasesoforal cavity, salivaryglandsandjaw . . . . . . . . . . . . . . . . . . . . 520-529

Gastricandduodenal ulcer... . . . . . . . . . . . . . . . . . . . . . . . . . . ..531–532

Other diseases ofesophagus, stomach and duodenum . . . . . . . . . . . . . .530, 533-537

Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...540-543

Herniaofabdominalcavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...550-553

Noninfectiveenterifisandcolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 555-558

Otherdiseasesofintesfinesandperitoneum . . . . . . . . . . . . . . . . . . . . . . 560-569

Chronicliverdiseaseand cirrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . ...571

Disordersofgall bladderand biliarytract . . . . . . . . . . . . . , . . . . . . . . . . 574-576

Ofherdiseases ofdigestive system . . . . . . . . . . . . . . . . . . . 570,572–573,577-579

Diseases of thegenitourinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . 58Cf+29

Diseases ofurinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...580-599

Diseases ofmale genital organs... . . . . . . . . . . . . . . . . . . . . . . . . . . 600-606

Disorders of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...610-511

lnflammato~ disease of female pelvic organs . . . . . . . . . . . . . . . . . . 614-616

Dsorders ofmenstruation andother abnormal bleedng from female genital tract . . . . . 626

Complications ofpregnancy, childMflh andthepuerperium . . . . . . . . . . . . . . . . 630-676

Induced aborfion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..63&036

Other pregnancy with aborfiveoutcome . . . . . . . . . . . . . . . . . . . . 63M34,637+39

Complications oflabor, delivery andthepuerperium . . . . . . . . . . . . . . . . . . 652-676

Diseases of theskin and subcutaneous tissue . . . . . . . . . . . . . . . . . . . . . . 680_70g

Useases of themusculoskeletal system and connective tissue. . . . . . . . . . . . . . 710-73g

Osteoafthrosis and allied disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . ...715

Ofherarthropathies and related disorders . . . . . . . . . . . , . . . . . . 710-714, 716-71g

Intervertebral cfisc disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...722

Other dorsopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...720-721. 723-724

Rheumatism, excluding the back . . . . . . . . . . . . . . . . . . . . . . . . . . . . 725-729

Disorders of bone and cartilage.. . . . . . . . . . . . . . . . . . . . . . . . . ...730-733

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...740-759

Certain conditions originating inthepednatal period . . . . . . . . . . . . . . . . . . . 760-779

Symptoms, signs andill-definad conditions . . . . . . . . . . . . . . . . . . . . . . . . 780-7gg

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..80c-ggg

Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,800-829

Dislocations, sprains and strains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 830-S48

intracranial inju~, excluding those with akull fracture . . . . . . . . . . . . . . . . . . 850-654

Openwound andinjury to blood vessels . . . . . . . . . . . . . . . . . . . . . . . . 670-904

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..g4&g4g

Poisoning and toxic effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...960-989

CompMcations ofsurgical andmedcal care notelsewhere classified. . . . . . . . . . 996-999

Supplementary classification of factors influencing health status and

contact withhealth services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Vol-V62

0.8

0.4

0.0

●

0.1

0.0

●

0.0

0.0

0.0

0.1

f 9.4

7.0

2.9

1.1

5.1

0.2

2.6

0.5

8.0

0.2

0.1

1.1

3.2

1.7

0.6

0.6

0.0

0.1

0.1

3.3

2.7

0.6

.

0.0

0.0

0.0

*

●

.

1.8

1.3

0.0

0.4

0.1

0.1

0.5

2.4

2.3

9.0

2.7

0.2

0.7

1.0

1.5

0.9

0.0

0.4

Oischarge rate per 1,000 population

0.4

●

●

.

*

*

.

●

●

●

●

●

●

*

.

●

17.2

3.6

6.3

0.4

3.3

0.3

0.6

2.4

7.7

0.7

●

0.5

1.6

1.6

2.4

0.6

●

●

‘0.1

3.3

2.2

0.6

.

.

.

0.4

.

●

0.2

1.3

1.4

●

0.4

*

.

0.5

0.4

2.5

.

1.9

9.4

3.1

0.4

1.5

0.9

0.4

0.8

0.3

0.7

0.6

0.4

.

●

0.1

0.0

.

.

0.0

0.1

22.0

6.0

3.1

1.2

5.6

0.2

3.1

0.5

9.1

0.3

0.1

1.1

3.3

2.7

0.7

0.8

0.0

0.0

0.1

2.6

1.5

1.1

...

...

...

...

...

...

2.0

1.4

0.0

0.4

0.1

0.1

0.6

2.6

2.4

11.4

3.5

0.2

0.9

1.5

1.7

0.9

0.0

0.4

0.5

.

.

●

.

“

.

●

.

.

.

.

.

.

18.4

3.9

6.7

0.6

3.8

‘0.3

0.7

2.9

8.7

0.8

*

0.4

1.7

2.5

2.5

0.6

●

.

3.4

1.7

1.6

.

. .

...

...

...

...

...

1.5

1.4

.

‘0.3

*

.

*0.4

0.5

3.0

.

1.9

11.4

3.8

‘0.4

1.9

1.2

0.6

0.9

“0.4

0.6

0.8

0.5

.

.

0.1

0.0

●

●

,

0.0

0.1

16.7

5.9

2.6

1.0

4.6

0.1

2.0

0.4

6.9

0.2

0.1

1.1

3.1

0.7

0.6

0.8

0.0

0.1

0.1

4.1

3.9

...

.

0.0

0.1

0.0

●

●

*

1.6

1.3

0.0

0.3

0.0

0.1

0.4

2.3

2.3

6.4

1.7

0.2

0.5

0.6

1.2

0.9

0.0

0.3

‘0.3

.

.

.

●

●

●

●

●

●

.

.

.

16.0

3.3

6.8

“0.3

2.8

‘0.3

0.5

1.8

6.6

0.7

*

0.6

1.4

0.8

2.3

0.6

.

*

*

3.3

2.7

...

*

.

.

0.8

.

●

0.3

1.1

1.5

0.6

.

0.5

“0.3

2.1

.

1.9

7.2

2.3

0.4

1.0

0.6

‘0.3

0.6

‘0.3

0.5

54
Tabhs6. Rateaof dacha~e anddaya ofwrefor patients l-14years ofage, bysexand dagnosi= Poland andthe United SWtes, 1980-Con.

[Data are for shorbstay non-Federal hospitals in the United Slates and for all general hospitals in Poland. Data exclude normal deliveries (sOde 650). Diagnostic categories and cede numbers are

from the Nlnlh Revision, International Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Rate of days of care per 1,000 population

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectiousand parasiticdiaeases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ool-139

Intesllnal lnfecliouadiseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-009

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........131~18

Viralhepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...070

Neoplaems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Malignantneoplaems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..14~208

Mallgnantneoplasm ofstomach. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...151

Malignant neoplasm ofother digestive organs andpefitoneum . . . . . . . .150, 152–159

Malignant neoplasm oftrachea, bronchua and lung . . . . . . . . . . . . . . . 162

Malignant neoplasm ofbreast . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 174-175

Malignantneoplaem ofcervixuteri . . . . . . . . . . . . . . . . . . . . . . . . . . ...180

Malignant neoplaam ofother female genital organs . . . . . . . . . . . .179, 181–184

Malignantneoplasm ofprostate. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...185

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-208

Ben[gnneoplasms, carcinoma insitu, andneoplasms ofunceflain behavior. . . . . . 210-239

Benignneoplasm ofuterua . . . . . . . . . . . . . . . . . . . . . . . . . . . ...216-219

Endocrine, nutfltional andmetabohc ~seases andimmunity daorders . . . . . . . . . . 240-279

Diabeteamellitus . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250

Diseasesofblood andblood-forming organs . . . . . . . . . . . . . . . . . . . . - . - 280-289

Mentaldisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..-.....290-319

Diseasesofthe nervoussystemand sense organs . . . . . . . . . . . . . . . . . . . 320-389

Disordersoftheautonomlc nervous ayatem . . . . . . . . . . . . . . . . . . . . . ...-.337

Other disorders of thecentral nervous ayatem . . . . . . . . . . . . . . . . 320-338,34~49

Dlaordersofthe peripheral nervouasyatem . . . . . . . . . . . . . . . . . . . . . - . 35~59

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...366

Otherdisordersoftheeyeandadnexa . . . . . . . . . . . . . . . . . . . . 380-365.367+7g

Diseaseaoftheearand mastoid process . . . . . . . . . . . . . . . . . . . . . . . - 380-389

Diseasesofthecirculatorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39@$59

Rheumatichearfdiseaae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...390-398

Easentlal hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...401

Hyperfenaiveheartand renaldiseaee . . . . . . . . . . . . . . . . . . . . . . . . . . 402-404

Acute myocardial infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...410

Other acute andsubacute forms ofischemic heart diseese . . . . . . . . . . . . . 411

Angina pectoris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...413

Olherchronic ischemic heart dlaease . . . . . . . . . . . . . . . . . . . . . . 412.414

Dlseasea ofpulmonary circulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415-417

Diseases of the pericardium and endocardium, cardiomyopathy

andconductlon disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...420-426

Cardiac dyarhythmlaa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 427

Heart failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...428

lll-deflned descriptions andcompfications ofheafldsease . . . . . . . . . . . . . . 429

Acute cerebrovascular disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . .430-436

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........~o

Other diseases ofarteries, arterioles and capillaries . . . . . . . . . . . . . 441448

Diseases ofvelns andlymphatics, andother dseases of thecirculato~ system . . 451-459

Diaeaeee of theresplratory system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Acute respiratory infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..460_466

Chronic disease oftonaila and adenoida . . . . . . . . . . . . . . . . . . . . . . . . ...474

Other diseases ofupper reaplratory tract . . . . . . . . . . . . . . . . . 470-473.476-478

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..46~86

Influenz a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...487

Bronchitis andemphysema . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...490-492

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Diseases of thedigestlvesyatam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseases oforalcavlty, sallvary glands and jaw . . . . . . . . . . . . . . . . . . 520-529

Gastric andduodenal ulcer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .531–532

Other diseases ofesophagus, stomach and duodenum . . . . . . . . . . . . . .530, 533-537

Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..54~5*

Hernia ofabdomlnal cavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..550_553

Noninfective enteritis and colitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 555-558

CXherdiseaaea ofinteafines and peritoneum . . . . . . . . . . . . . . . . . . . . 560-689

Chronic liver disease andcirrhoais . . . . . . . . . . . . . . . . . . . . . . . . . . . ...571

Disorders ufgallbladder and biliary tract . . . . . . . . . . . . . . . . . . 574-576

Other diseases ofdfgestive system . . . . . . . . . . . . . . . . . . 570,572–573,577-579

904.4

105.5

11.8

17.3

43.7

20.8

16.5

0.3

.

7.6

4.1

9.5

2.2

8.7

8.5

76.2

.

38.6

3.9

1.1

19.5

12.9

18.4

11.5

0.3

●

3.2

0.5

.

0.3

0.5

0.6

0.8

292.2

62.0

24.4

22.8

78.2

1.2

77.9

17.0

76.1

2.6

1.9

6.9

32.0

14.8

4.8

6.7

0.5

1.2

2.6

240.3

10.1

2.5

.

.

7.8

5.1

.

●

●

“

2.7

6.3

2.5

5.3

12.8

17.9

●

6.6

‘0.7

●

2.3

8.1

3.3

.

.

.

.

.

●

.

.

.

.

.

.

.

.

.

54.8

11.8

10.9

1.4

15.3

0.9

2.1

8.9

27.0

1.5.

.

2.1

S.2

3.3

6.2

2.4

,

.

‘0.8

985.5

106.1

13.3

12.2

44.6

23.5

19.s

.

..

...

9.1

3.7

10.1

2.6

9.8

9.0

eo.4

.

41.3

3.0

1.2

19.8

15.1

18.1

10.8

.

*

3.5

0.4

.

.

0.5

1.0

345.0

70.7

26.2

27.5

87.5

1.6

96.3

22.7

86.3

2.7

1.8

8.8

33.6

23.1

5.2

8.9

0.7

0.6

2.8

263.0

11.4

3.1

.

.

9.0

5.7

.

...

...

,

3.3

...

5.6

‘1.9

6.3

10.3

20.4

.

6.6

●

●

2.6

10.0

3.8

●

.

●

.

.

,

.

●

.

.

,

.

.

61.6

13.3

9.6

1.8

17.4

‘0.8

2.6

11.1

29.1

1.4

,

1.7

9.4

4.9

8.3

2.6

.

.

819.6

102.8

10.2

22.8

42.8

17.5

13.1

“

“

...

6.0

4.4

6.8

1.8

7.6

7.9

71.7

●

35.8

4.8

1.1

19.2

10.6

16.8

12.3

.

.

3.0

0.5

.

*

.

0.6

0.5

237.0

53.0

22.6

17.9

68.5

0.9

56.5

11.0

65.4

2.4

2.0

9.0

30.3

6.2

4.5

6.5

0.4

1.7

2.4

216.6

8.7

1.9

.

●

6.5

4.5

.

●

,

...

●

2.0

7.0

3.1

4.3

15.4

15.3

6.5

*

,

2.0

6.2

‘2.7

.

.

●

.

.

●

.

●

.

,

,

,

47.7

10.3

12.0

‘0.9

13.2

‘1.0

1.6

6.5

24.7

1.6

.

2.4

6.9

1.7

6.1

2.3

.

.

,

55
Tabfe 6. Ratea of diaohetge and daya of care for patients 1-14 years of age, by aex and diagnoai$xPoland and the United States, 1980-Con.

[Data are for short-stay non-Federal hospitals in the United Statea and for all general hoapifala in Poland. Data exclude normal deliveries (code 650). Diagnostic categories and code numbers are

from the Ninth Revision, International Classification of Diseaaea,1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Rate of days of care per 1,000 population

Diaeasee of thegenitourinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-829

Diseases ofurina~syatem . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...580-599

Diseasea ofmale genital organs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600-608

Disorders of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..61HII

Inflammatory diseaae of female pelvic organs . . . . . . . . . . . . . . . . . . . . . . 614-616

Disorders of menstruation and other abnormal bleeding from female genital tract . . . . . . 626

Complications of pregnancy, childbirth and the puerperium . . . . . . . . . . . . . . . . 630-676

Induced abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..63H36

Ofher pregnancy with eborfive outcome . . . . . . . . . . . . . . . . . . . . 630-634, 637-839

Complication of labor, delivery and the puerperium . . . . . . . . . . . . . . , . . . 652-676

Diseases of the skin and subcutaneous tissue . . . . . . . . . . . . . . . . . . . . . . 660-709

Diseases of the musculoskeletal system and connective tissue . . . . . . . . . . . . . . 71 C-739

Osteoarthrosis and allied disorders.. . . . . . . . . . . . . . . . . . . . . . . . . . ...715

Other arthropathies and related disorders . . . . . . . . . . . . . . . . . . . 710-714,716-719

Intervertebral disc disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...722

Other dorsopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..72C-721. 723-724

Rheumatism, excluding the back . . . . . . . . . . . . . . . . . . . . . . . . . . . . 725-729

Disorders of boneand cartilage . . . . . . . . . . . . . . . . . . . . . . . . . . . . .730-733

Congenital anomsties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...740-759

Certain conditions originating in the parinatal period . . . . . . . . . . . . . . . . . . . 760-779

Symptoms, signs and ill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . . 780-799

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-999

Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-829

Dislocations, sprains and straina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 830-848

Intracranial injury, excluding those with skull fracture . . . . . . . . . . . . . . . . . . 650-654

Openwound andinjuryto blood vessels . . . . . . . . . . . . . . . . . . . . . . . . 87C-904

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..94G949

Poisoning andtoxic effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...980-989

Compticationa ofeurgical andmetical care notelaewhere classified. . . . . . . . . . 998-999

Supplementary classification of factors influencing health status and

contact with health services.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI–V82

51.4

46.0

4.6

.

0.2

0.3

0.1

●

●

.

22.1

37.0

0.5

9.1

1.9

1.7

12.8

56.1

19.5

95.6

30.8

1.7

6.2

11.3

24.5

4.2

0.6

6.7

11.8

8.9

1.7

●

.

.

3.0

●

.

“0.7

5.7

9.6

●

2.8

.

●

1.5

4.0

12.4

●

6.1

44.1

17.5

1.7

5.4

3.0

5.2

3.1

1.9

2.0

36.2

27.3

8.9

...

...

...

...

...

...

23.0

38.5

0.7

6.6

2.8

2.1

16,1

46.0

20.9

121.2

40.4

1.8

8.5

16.3

28.9

4.1

0.5

7.3

11.6

8.1

3.4

.

...

...

...

...

...

...

6.9

9.8

.

‘2.3

*

.

‘1.4

5.0

13.3

.

6.1

55.0

23.7

‘1.6

7.3

4.2

6.0

3.3

●2.3

2.5

67.2

65.5

...

.

0.4

0.8

0.2

*

“

.

21.1

35.5

●

9.7

,.

0.9

1.2

9.3

64.7

18.1

69.1

20.8

1.8

3.8

6.0

20.0

4.4

0.8

6.1

12.1

9.8

...

.

●

●

6.2

●

.

“1.5

4.5

9.8

3.3

.

1.5

“3.0

11.3

.

6.1

32.6

11.0

1.7

3.4

1.7

“4.4

2.8

“7.4

1.4

Tabte7. Rates oftischa~e anddaya ofmmfor patients lWyears ofqe, bysexand dagmi~Poland andthe Unitd Stites, 1980

[Data are for short-stay nonfederal hospitals in the United Slates and for all general hospitals in Poland. Data exclude normal deliveries (code 650). Diagnostic categories and code numbers are

from the Ninth Revision, International Classification of Diseaaea, 1975]

Bo~h sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Allconditione . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectious andparasific diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Intestinal infectious diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-009

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...010-018

Viral hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..o7o

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...14&239

Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...14&208

Malignant neoplasm of stomach . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...151

Malignant neoplaamof other digestive organs and peritoneum . . . . . . . . 150, 152-159

Malignant neoplasm oftrachea, bronchus and lung . . . . . . . . . . . . . . . . . . . . 162

Malignant neoplasm of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 174-175

Malignant naoplasm ofcervixuteri . . . . . . . . . . . . . . . . . . . . . . . . . . ...180

Malignant neoplaam ofother female genital organs . . . . . . . . . . . . . . .179, 161–184

Malignant neoplasm of prostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...185

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-206

Benign neoplasms, carcinoma inaitu, andneoplasms ofuncetiain behavior. . . . . . 21C-239

Benign neoplasm of uterus ...,. . . . . . . . . . . . . . . . . . . . . . . ...218-219

Endocrine, nutritional andmetabotic diseases and immunity disorders . . . . . . . . . . 240-279

Uabetes mellitue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..25o

Diseases of blood and blood-forming organs . . . . . . . . . . . . . . . . . . . . . 260-289

90.1

3.7

0.3

1.0

1.4

3.1

1.6

0.1

0.1

0.1

0.2

0.2

0.1

0.1

1.5

0.5

1.2

0.5

0.4

Discharge rate per 1,000 population

134.0 67.8 91.5 112.9

2.4 4.0 2.3 3.3

0.4 0.3 0.4 0.3

0.1 1.3 ‘0.1 0.7

0.2 1.3 “0.2 1.5

4.5 1.9 2.1 4.4

1.7 1.5 i .4 1.6

.

0.1 .

0.0

0.1 0.2 “0.1 0.1

01 0.1 ‘0.1 0.0

0.3 - 0.4

0.2 ... ... 0.4

‘0.1 ... ... 0.2

. ●

...

●0.1 0.1 .

0.1

2.8 0.4 0.7 2.6

1.0 ... ... 1.1

2.9 0.6 2.0 1.7

1.3 0.5 1.2 0.4

0.9 0.3 0.8 0.4

175.1

2.5

0.5

●

‘0.2

6.9

2.1

.

‘0.1

●

0.5

0.3

“0.2

...

“0.1

4.6

1.9

3.7

1.4

1.0

56
Table7. Rateaof discharge anddaya ofmrefqr p?tienta lWyears ofage, bysexand ti8gnosi= Poland andthe Untied SWtes, 198f&Con.

[Data are for short-stay non.Faderal hospitals in the United States and for all general hospitals in Poland. Data exclude normal deliveries (code 650). Dlagnoatk categories and code numbers are

from Ihe Nlnlh Revision, International Classificationof biseaaea, 1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Discharge rate per 1,000 population

Mental dleordera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...290-319

Diseases of the nervous system and sense organs . . . . . . . . . . . . . . . . 320-389

Disorders of theautonomic newoussystem . . . . . . . . . . . . . . . . . . . . . . . . . . 337

Other disorders of the central nervous system . . . . . . . . . . . . 320-336, 340-349

Disorders of the peripheral nervous system . . . . . . . . . . . . . . . . . . 350-359

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...366

Other disorders of the eye and adnexa . . . . . . . . . . . . . . . . 360-365.367-379

Diseases of the ear and mastoid process . . . . . . . . . . . . . . . . . . . 380-389

Diseases of theclrculatory system.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 39~59

Rheumatic heart disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .390-398

Essential hyperfenslon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...401

Hypertensive heart and renal disease.. . . . . . . . . . . . . . . . . . . . . . . . . 402-404

Acute myocardial infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...410

Other acute and subacute forma of ischemic heart disease . . . . . . . . . . . . . . . . . 411

Angina pectoris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...413

Other chronic ischemlc heart disease . . . . . . . . . . . . . . . . . . . . . . . - . 412,414

Diseases ofpulmonary circulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415-417

Dlaeases of the pericardium and endocardium, cardiomyopathy

andconductlon dleorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...420-426

Cardiac dysrhyfhmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...427

Heart failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..42e

Ill-defined descriptions and complications of heart disease . . . . . . . . . . . . . 429

Acute cerebrovascular disease . . . . . . . . . . . . . . . . . . . . . . . . . . . ..430-436

Atheroscleroala . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .....~o

Other diseases of arteries, arterioles and capillaries . . . . . . . . . . . . . . . 441-448

D[seasea of valns and Iymphatics, and other diseases of the circulatory system . 451-459

Diseases of theresplratory system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Acute respiratory infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..46@t66

Chronic disease oftonslls and adenoida . . . . . . . . . . . . . . . . . . . . . . . . ...474

Other diseases of upper respiratory tract . . . . . . . . . . . . . . . . 470-473, 475-476

pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..4e~86

influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...487

Bronchitis andemphyaema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..490-492

Asthma . . . . . . . . . ..’...... . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Diseases of the digestive system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diaeases oforalcavlty, salivary glands and jaw . . . . . . . . . . . . . . . 52C-529

Gastric andduodenal ulcer . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...531-532

Other diaeaaes ofeaophagus, stomach and duodenum .“. . . . . . . . . . . 530,533-537

Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .540_543

Hernlaof abdominal cavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .550_553

Noninfective enteritis andcolltis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 555--55e

Other diseases oflntestines and peritoneum . . . . . . . . . . . . . . . . . . 560-589

Chronic liver diaeaae andcirrhosia . . . . . . . . . . . . . . . . . . . . . . . . . . . ...571

Disorders ofgallbladder and biliarytract . . . . . . . . . . . . . . . . . . . 574-576

Other diseases ofdlgesfiveaystem . . . . . . . . . . . . . . . 570t572–573, 577–579

Diseases of thegenitourinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Diseases ofurinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . ..58 ~599

Diseaees ofmalegenltal organs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60~06

Disordere of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..610-611

inflammatory disease of female pelvic organs. . . . . . . . . . . . . . . . . . . . 614-616

Dlsordere ofmenatruatlon andother abnormal bleeding from female genital tract . . . 626

Complications ofpregnancy, chlldbltih andthepuerpefium . . . . . . . . . . . . . 630-676

Induced abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..635-636

Other pregnancy with aborfiveoutcome . . . . . . . . . . . . . . 630-634i637+3g

Complications oflabor, delivery andthepuerperium . . . . . . . . . . 652-676

Dlsaases of theskln and subcutaneous tissue . . . . . . . . . . . . . . . . . 660-709

Diseases of themusculoskeletal system and connective tissue. . . . . . . . . . . . 710-739

Osteoatthrosis and allied disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . ...715

Other arthropathles and related disorders . . . . . . . . . . 710-714,716-719

Intervarfebral disc disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...722

Other dorsopathles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..72~721. 723-724

Rheumatism, excluding the back . . . . . . . . . . . . . . . . . . . . . . . . . . 725-729

Disorders of bone and cartilage . . . . . . . . . . . . . . . . . . . . . . . . . . . . 730-733

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..74’3_759

Certain conditions originating inthepednatal period . . . . . . . . . . . . . . 760-779

Symptoms, signs andill-defined concMions . . . . . . . . . . . . . . . . . 760-7g9

1.4

3.7

0.0

1.1

0.9

0.1

0.9

0.8

4.2

0.7

0.6

0.1

0.2

0.2

0.1

0.3

0.1

0.3

0.3

0.1

0.1

0.2

0.1

0.2

0.7

5.6

0.9

0.6

1.6

1.0

0.1

0.7

0.4

11.6

0.3

2.1

1.4

3.2

0.7

0.5

0.7

0.2

2.1

0.5

11.5

4.0

0.3

0.1

1.8

2.1

23.0

3.7

5.0

4.5

2.5

2.6

0.2

0.6

0.6

0.5

0.3

0.3

0.3

1.3

9.2

3.7

.

1.4

0.6

0.1

0.6

0.8

5.2

0.2

0.6

0.1

0.2

‘0.1

0.2

0.5

0.1

0.4

0.4

“0.1

‘0.1

0.2

.

0.1

1.7

7.3

1.0

1.4

1.6

1.1

0.2

0.3

1.0

15.0

1,6

0.7

2.3

1.5

2.0

1.9

1.9

0.3

2.0

0.8

17.4

4.1

0.9

1.1

2.6

3.3

27.8

1.6

3.5

15.1

2.3

8.6

0.1

1.6

1.9

1.6

1.7

0.9

0.9

.

2.7

1.3

4.2

0.0

1.3

1.1

0.1

1.0

0.9

5.0

0,7

0.7

0.1

0.4

0.2

0.2

0.4

0.1

0.3

0.3

0.1

0.1

0.3

0.2

0.2

0.7

6.3

0.9

0.5

2.0

1.3

0.1

0.7

0.3

tl.6

0.3

3.1

1.6

2.8

1.1

0.5

0.7

0.3

0.8

0.5

4.4

3.8

0.6

.

...

.

...

.

...

3.0

3.0

0.1

0.6

0.7

0.6

0.4

0.4

0.3

1.2

10.0

3.4

●

1.2

0.6

0.2

0.6

0.7

5.6

‘0.1

0.5

‘0.1

0.4

“0.1

0.3

0.8

*

0.5

0.4

.

●

0.2

.

‘0.1

1.6

6.3

0.7

0.9

1.7

1.1

‘0.2

0.3

0.6

13.8

1.3

0.8

2.2

1.6

3.1

1.6

1.4

0.3

0.7

1.0

5.5

3.5

1.8

“0.2

...

...

...

...

...

2.6

9.3

“0.2

1.9

2.3

1.6

1.5

1.2

0.s

.

2.2

1.5

3.2

0.0

1.0

0.7

0.0

0.6

0.6

3.4

0.8

0.5

0.1

0.1

0.1

0.1

0.2

0.0

0.2

0.2

0.1

0.1

0.2

0.1

0.1

0.7

4.9

0.9

0.8

1.2

0.7

0.1

0.6

0.4

11.5

0.3

1.1

1.2

3.5

0.3

0.4

0.7

0.1

3.4

0.4

18.8

4.2

. .

0.2

3.6

4.2

46.5

7.6

10.2

9.1

1.9

2.3

0.2

0.7

0.4

0.3

0.3

0.2

0.3

1.3

6.3

4.0

.

1.5

0.9

.

0.6

0.9

4.8

0.2

0.7

“0.1

●

●

‘0.1

“0.2

‘0.2

0.4

0.4

*

*

0.2

.

‘0.1

1.9

6.2

1.2

1.9

1.6

1.0

0.2

0.4

1.3

16.2

1.9

0.5

2.4

1.3

1.0

2.3

2.4

0.2

3.3

0.7

28.9

4.7

...

2.1

5.1

6.6

54.7

3.1

6.9

29.e

2.0

8.3

‘0.1

1.4

1.5

1.6

2.0

0.6

1.1

.

3.1

57

I
Tabfe7. &teaoftiacha~e anddays ofmrefor ~tienWl- yeamofage, bysexand tiagnoaic Poland andthe Untied Stites, 196f)-Con.

[Dafa are for short-stay non-Federal hospitals in the United States and for all general hospitals in Poland. Deta exclude normal deliveries (code 650). Diagnostic categories and code numbers are

from the Ninth Revision, International Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Injutyan dpoisonin g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-999

Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..800-S29

Dislocations, sprainsand sprains.. . . . . . . . . . . . . . . . . . . . . . . . . 830-848

intracranial injury, excluding those with skull fracture . . . . . . . . . . . . . . . . . . 850-S54

Openwound andinjurytoblood vessels . . . . . . . . . . . . . . . . . . . . . . . . 870-904

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...940-949

Poisoning andtoxiceffects. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...980-989

Complications ofsurgical andmedical care not elsewhere classified. . . . . . . . . . 996-999

Supplementary classification of factors influencing health status and

contactwith health services . . . . . . . . . . . . . . . . . . . . . . . . . . . . VOI-V82

Allconditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectiousand parasificdiseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Intestinal infectiousdiseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-009

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Olfl-tM8

Viral hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..o7o

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Malignantneoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..14G208

Malignantneoplasm ofstomach. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...151

Malignant neoplasm ofother digestive organs andpedtoneum . . . . . . . . . 150,152-159

Malignant neoplaem oftrachea, bronchus and lung . . . . . . . . . . . . . . . . :. . . 162

Malignantneoplasmofbreast... . . . . . . . . . . . . . . . . . . . . . . . ...174-175

Malignantneoplasm ofcervixuteri . . . . . . . . . . . . . . . . . . . . . . . . . . ...160

Malignant neoplasm ofother female genital organs . . . . . . . . . . . . . . . 179,181-184

Malignantneoplaam ofprostate. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...165

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-208

Benign neoplasms, carcinoma insitu, andneoplaems ofuncetiain behavior. . . . . . 210-239

Benign neoplasm ofuterus . . . . . . . . . . . . . . . . . . . . . . . . . . . ...218-219

Endocrine, nutritional andmetabohc diseases andimmunity dsorders . . . . . . . . . . 240-279

Oiabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..25o

Oiseasesofbloodand blood-forming organs . . . . . . . . . . . . . . . . . . . . . . . 260-269

Mentaldisorders ...,..... . . . . . . . . . . . . . . . . . . . . . . . . . . . ..29G319

Diseases ofthenervous system’and sense organs . . . . . . . . . . . . . . . . . . . . 320-389

Disordersoftheautonomic nervoussystem . . . . . . . . . . . . . . . . . . . . . . . . . . 337

Other disorders ofthe central nervous system . . . . . . . . . . . . . . . . 320--336, 34N49

Disordersoftheperipheral nervoue eystem . . . . . . . . . . . . . . . . . . . . . . . 350-359

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...366

Ofherdisordersoftheeyeandadnexa . . . . . . . . . . . . . . . . . . . . 360-365,367-379

Diseaeesoftheearandmastoid process . . . . . . . . . . . . . . . . . . . . . . . . 380-389

Diseasesofthecirculatoryaystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3g0-45g

Rheumaficheartcfisease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...390-398

Essential hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..4ol

Hypertensiveheartand renaldisease . . . . . . . . . . . . . . . . . . . . . . . . . . 402404

Acutemyocardial infarction. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . ...410

Other acute andsubacute forms ofischemic heart disease . . . . . . . . . . . . . . . . . 411

Angina pectoris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...413

0th8rchronic ischemic hearfdisease . . . . . . . . . . . . . . . . . . . . . . . . . . 412,414

Diseases ofpulmonary circulation.. . . . . . . . . . . . . . . . . . . . . . . . . . . 415-417

Diseases of the pericardium and endocardium, cardiomyopathy

and conduction disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...420-426

Cardiac dysrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...427

Heart failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...428

ill-defined descriptions andcomplications ofheatidsease . . . . . . . . . . . . . . . . . . 429

Acute cerebrovascular ctisease. . . . . . . . . . . . . . . . . . . . . . , . . . ...430436

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...440

Other cfiseases ofarteries, arterioles and capillaries . . . . . . . . . . . . . . . . . . 441-448

Diseasea ofveins andlymphatics, andother diseaees of thecirculato~ syetem . . . 451459

Diseases of therespiratory eystem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46C-519

Acute respiratory infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...46&466

Chronic disease oftonsils and adenoids . . . . . . . . . . . . . . . . . . . . . . . . ...474

Other diseases ofupper respiratory tract . . . . , . . . . . . . . . . . . , . 470+73,47+178

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...480486

Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...467

Bronchitis and emphysema . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...490492

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

12.9

4.7

0.6

0.9

1.7

0.5

1.2

0.1

1.2

1,159.6

145.4

2.8

62.1

42.5

56.4

34.5

0.9

2.7

2.5

3.5

4.4

2.4

2.4

21.8

7.8

19.9

7.6

5.2

15.0

67.6

0.3

23.7

16.2

1.1

14.2

12.2

69.0

13.5

7.2

1.9

5.1

2.1

1.5

3.9

1.2

5.2

2.9

1.1

1.2

4.3

2.5

4.1

10.2

90.5

6.5

6.3

18.5

18.8

0.5

14.6

9.4

Oischarge rate per 1,000 population

17.1 20.0 23.0 5.8

4.2 7.8 6.3 1.6

4.1 1.3 5.5 0.3

1.5 1.4 1.9 0.5

2.1 2.9 3.4 0.5

0.4 0.6 0.6 0.3

1.1 1.2 1.1 1.3

0.9 0.1 0.6 0.1

5.9 0.5 1.7 1.8

Rate of days of care per 1,000 population

739.6

14.9

1.7

2.0

1.2

31.8

16.6

.

1.3

1.6

2.1

1.4

“0.5

●

“1.5

15.0

6.8

20.9

10.3

5.1

101.3

21.6

.

13.1

3.5

0.4

2.2

2.6

36.9

1.6

3.3

0.8

2.7

‘0.6

0.8

3.5

1.4

3.1

2.0

‘0.6

●0.5

2.9

*

1.1

10.8

31.9

4.0

3.2

5.4

6.8

0.9

1.6

5.2

1,086.6

175.6

2.7

109.4

41.9

38.8

32.1

1.0

3.7

4.0

...

...

2.8

6.7

...

13.5

6.7

3.5

13.0

76.3

0.2

24.7

19.6

1.4

16.4

14.0

82.2

12.2

8.5

2.3

9.0

3.2

2.0

5.7

1.3

5.7

3.6

1.2

1.1

5.4

4.0

5.8

10.1

104.8

8.6

4.9

21.8

26.1

0.4

14.4

9.0

581.0

14.1

1.4

‘2.4

●I .2

18.2

14.4

.

‘1.2

‘1.7

...

...

●

.

3.8

...

14.7

9.7

3.8

106.5

19.9

.

12.5

2.5

0.6

2.1

2.2

41.1

‘1.2

2.9

‘0.7

4.7

“0.9

1.2

5.8

*

3.5

2.0

●

●

3.9

.

“0.9

9.4

28.1

2.8

2.1

5.1

7.5

‘0.8

1.3

3.1

1,234.4

114.4

2.8

54.2

43.1

74.3

37.0

0.7

1.8

0.8

6.9

9.0

4.6

...

1.9

37.3

15.8

26.4

6.5

6.9

17.0

58.7

0.3

22.7

12.7

0.8

12.0

10.2

55.4

14.9

6.0

1.5

1.2

1.1

1.0

2.2

1.1

4.7

2.2

0.9

1.3

3.1

0.9

2.3

10.4

75.9

8.3

7.7

15.1

11.3

0.6

14.9

9.8

11.4

2.3

2.6

1.1

0.8

‘0.2

1.2

1.1

9.9

693.4

15.8

2.0

●

‘1.3

45.0

19.1

.

“1.4

.

4.1

2.7

‘1.1

...

●1.1

25.9

13.4

26.9

11.0

6.3

96.2

23.6

●

13.6

4.4

.

2.4

3.0

32.8

1.9

3.7

‘0.8

.

.

‘0.6

●1.4

‘1.8

2.7

2.0

.

●

1.9

●

●1.2

12.1

35.5

5.2

4.3

5.7

8.2

1.0

2.0

7.1

56
Table7. Rateaof discharge anddays of-refor patienta lWyeamof age, bysexand diagnosis Poland andthe Un3ed SWtes, 1980-Con.

[Data are for short-stay non-Federal hospitals In the United States and for all general hospitals in Poland. Data exclude normal deliveries (code 650). Diagnostic categories and cede numbers are

from the Ninth Revision, International Classification of Oiseases, 1975]

Both sexes Male Female

United United United

Diagnosis and \CD-9 code Poland Statea Poland States Poland States

Rate of days of care per 1,000 population

Dis.easesof the digestive system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseases of oral cavity, salivary glands and jaw . . . . . . . . . . . . . . . . . 520-529

Gastric and duodenal ulcer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .531-532

Other diseases of esophagus, stomach and duodenum . . . . . . . . . . . .530, 533-537

Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...540-543

Hernia ofabdomlnal cavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...550-553

Noninfective enteritis and colitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 555-558

Other diseases ofintestines and peritoneum . . . . . . . . . . . . . . . . . . . . . 560-569

Chronic liver disease and cirrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..57 I

Disorders of gall bladder and biliary tract . . . . . . . . . . . . . . . . . . 574-576

Olher diseases of digestive system . . . . . . . . . . . . . . . . . 570, 572–573, 577-579

Diseases of thegenitourinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . 5e0-629

Diseases ofurirtaIy system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .560-599

Diseases ofmalegenital organs..,.. . . . . . . . . . . . . . . . . . . . . . . . . 600-808

Dlsordera of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .610-811

lnflammato~ disease of female pelvic organs . . . . . . . . . . . . . . . . . . . . . . 614-816

Disorders of menstruation and other abnormal bleeding from female genital tract . . . . 626

Complications of pregnancy, childbirth and the puerperium . . . . . . . . . . . . . . . . 630-676

Induced abortion . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...635-636

Other pregnancy with abortive outcome . . . . . . . . . . . . . . . . . . 630-634, 637-639

Complications of labor, delivery and the puerperium . . . . . . . . . . . . . 652-676

Diseases of the skin and subcutaneous tissue . . . . . . . . . . . . . . . . . . 680-709

Diseases of the musculoskeletal syetem and connective tissue . . . . . . . . . . . . . 71C-739

Osteoarthrosis and allied disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . ...715

Other arthropathies and related disorders . . . . . . . . . . . . . . . . . . 710-714, 716-719

Intewertebral cfiscdisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...722

Other dorsopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...720-721. 723-724

Rheumatism, excluding the back . . . . . . . . . . . . . . . . . . . . . . . . . . . . 725-729

Disorders of bone and cartilage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73c-733

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 740-759

Certain conditions originating in the perinatal period . . . . . . . . . . . . . . . . . . . 760-779

Symptoms, signs and Ill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . . 78C-799

In)sryand poisoning, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-999

Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-829

Dislocations, sprains and strains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 830-648

Intracranial injury, excluding those with skull fracture . . . . . . . . . . . . . . . . . . e50-654

Openwound andinjuty to blood vessels . . . . . . . . . . . . . . . . . . . . . . . 870-904

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...940-949

Poisoning andtoxlc effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..960-989

Complications of surgical and medical care not elsewhere classified. . . . . . . . . . 993-999

Supplementary classification of factors influencing health status and

contact withhealth sewices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI-V82

148.2

3.5

34.4

13.9

31.6

9.3

5.0

6.5

3.5

30.4

e.3

93.0

37.6

3.5

1.0

18.9

9.7

164.0

6.9

24.0

44.1

38.9

60.4

4.2

15.1

13.0

10.7

4.3

8.1

8.1

10.1

160.0

76.9

10.4

11.5

19.9

8.9

5.4

1.3

8.1

e2.o

3.8

4.5

11.2

7.3

9.3

9.7

12.0

2.5

15.2

6.5

78.0

19.9

3.3

3.5

13.1

11.0

105.1

2.3

8.4

63.1

13.0

56.0

0.7

9.2

17.5

12.4

7.2

6.7

6.3

.

10.5

105.1

34.7

23.0

e.6

10.9

4.4

3.9

5.1

17.2

150.8

3.6

49.9

15.3

29.5

14.0

5.0

8.9

4.9

11.0

8.7

39.1

31.9

7.0

.

...

..

..

.

.

..

47.8

63.6

2.6

11.7

14.9

14.1

5.0

11.9

6.3

10.1

256.5

127.1

17.1

17.6

33.8

13.5

5.4

1.1

4.7

71.2

3.0

5.0

10.3

8.2

12.6

7.6

8.1

2.7

5.5

7.9

23.1

15.8

6.8

“0.4

...

.

...

..

...

...

15.3

59.6

‘0.8

9.1

20.7

11.6

5.6

8.8

5.6

.

9.5

143.5

50.1

28.6

11.4

17.9

7.0

4.0

4.3

6.5

145.6

3.3

18.5

12.4

33.8

4.4

4.9

8.0

2.1

50.2

7.9

148.1

43.4

...

1.8

3e.2

19.7

331.9

13.9

48.6

e9.3

29.9

57.1

5.6

18.6

11.1

7.2

3.6

4.1

9.9

10.1

61.1

25.6

3.5

5.3

5.8

4.2

5.5

1.5

11.7

92.4

4.5

4.0

12.1

6.5

6.1

11.6

15.8

2.2

24.5

5.1

131.1

23.8

.

6.4

25.7

21.6

206.7

4.6

16.6

124.2

10.7

56.5

“0.6

9.3

14.4

13.0

8.8

4.6

7.0

.

11.4

68.0

19.9

17.7

5.9

4.2

“1.8

3.9

5.9

27.5

Table8. Rates of discharge and daya of care for patients 4S-84 yeara of age, by sex and diagnosis Poland and the United States, 1980

[Data are for short-slay non-Federal hospitals in the United States and for all general hospitals in Poland. Data exclude normal deliveries (code 650). Diagnostic categmies and wde numbers are

from the Ninth Revision, International Classificationof Diseases, 1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Allcondltions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectious and parasitic diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001–139

Intestinal infectious diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-009

Tuberculosm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..010-018

Viral hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..o7o

Neoplasm. . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 140-239

Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..14W208

Malignant neoplasm of stomach . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...151

Malignant neoplasm ofother dgestive organs and peritoneum . . . . . . . 150,152-159

Malignant neoplasm of trachea, bronchus and lung . . . . . . . . ‘. . . . 162

Malignant neoplasm of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 174-175

126.1

4.8

0.2

2.2

1.3

13.5

10.0

0.7

1.2

1.e

1.2

Discharge rate per 1,000 population

194.8 138.8 195.4 114.9

2.0 6.5 2.0 3.3

0.4 0.3 “0.3 0.2

‘0.2 3.7 ‘0.3 0.8

.

1.4 .1.3

20.2 12.3 16.7 14.6

15.5 10.9 14.4 9.3

“0.2 1.1 “0.3 0.4

2.3 1.4 2.6 1.1

2.7 3.4 3.7 0.4

2.2 . .2.3

194.2

2.0

0.5

●

.

23.3

16.6

●

2.1

1.e

4.2

59
Table 8. Rates of diacharga and daya of care for patients 45-64 yeare of age, by aax and diagnosk Poland and the Unitad States, 198f)-Con.

[Data are for short-stay non-Federal hospitals in the United States andfOr all 9eneral kaPitala in Poland.Dataexclude normal dellveriea (code 650). Diagnostic categories and code numbers are

from the Ninth Revision, International C[aasiticat!!n of Dlaeases, 1975]

Both sexes Male Female

Unit: United United

Diagnosis and ICC-9 code Poland States Poland States Poland States

Malignant neoplasm ofcervix uteri . . . . . . . . . . . . . . . . . . . . . . . . . . ...180

Malignant naoplasm of other femala genital organs . . . . . . . . . . . . . .179, 181-184

Malignant neoplaam of prostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...185

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-208

Benign neoplasms, carcinoma in situ, and neoplasms of uncertain behavior. . . . . . 210-239

Benign neoplasmofuterus . . . . . . . . . . . . . . . . . . . . . . . . . . . ...216-219

Endocrine, nutritional and metabolic diseases and immunity disorders . . . . . . . . . . 240-279

Diabetea mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250

Diseasesofbloodand blood-forming organs . . . . . . . . . . . . . . . . . . . . . . . 280-289

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...290-319

Diseases of the nervous system and sense organs . . . . . . . . . . . . . . . . . . . . 32C-389

Disorders of theautonomic nervous systam. . . . . . . . . . . . . . . . . . . . . . . . . . 337

Other disorders of thecentral narvous system . . . . . . . . . . . . . . . . 320-336,340-349

Oiaordera ofthaperipheral newoussyatem . . . . . . . . . . . . . . . . . . . . . . . 350-359

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...386

Ofherctisorders of theeyeandadnexa . . . . . . . . . . . . . . . . . . . . 36C-365,367-379

Oiseases of theearand maatoid process . . . . . . . . . . . . . . . . . . . . . . . . 380-389

Oiseases of thecirculatory system... . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Rheumatic heart disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...390-398

Essential hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...401

Hypertensive heart and renal disease.. . . . . . . . . . . . . . . . . . . . . . . . . 402+04

Acute myocarctialinfarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...410

Other acute andsubacute forma ofischemic heart disease . . . . . . . . . . . . . . . . . 411

Angina pectoris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...413

Other chronic ischemic heart diaease . . . . . . . . . . . . . . . . . . . . . . . . . . 412,414

Diseases ofpulmonary circulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415-417

Diseases of the pericardium and endocardium, cardiomyopathy

and conduction disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...420-426

Cardiac dysrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...427

Heart failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...428

ill-defined descriptiona andcomplications ofheati disease . . . . . . . . . . . . . . . . . . 429

Acute cerebrovascular disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43W36

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...440

Other diseases ofarterias, arteriolea and capillaries . . . . . . . . . . . . . . . . . . 441-448

Useases ofveins andlymphatics, andother dseases of thecirculato~ system . . . 451459

Diseasea of therespiratory system . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Acute respiratory infecfiona . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..460-466

Chronic diaease oftonsils and adenoids . . . . . . . . . . . . . . . . . . . . . . . . ...474

Other diseasea ofupper respiratory tract . . . . . . . . . . . . . . . . . . . 47C-473,47+178

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...480-486

Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...467

Bronchitis andemphyaema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .490-492

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Oiaeaaeaof thedigestive system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Oiseases oforalcavity, salivary glands and jaw . . . . . . . . . . . . . . . . . . . . 520-529

Gastric and duodenal ulcer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .531-532

Ofherdiaeasea ofesophagua, stomach and duodenum . . . . . . . . . . . . . .530, 533-537

Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..540-543

Hernia ofabdominal cavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..550-553

Noninfective enteritis andcolitia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 555-558

Other diseases ofinteatinee and peritoneum . . . . . . . . . . . . . . . . . . . . . . 560-569

Chronic iiverdiaeaae and cirrhosis. . . . . . . . . . . . . . . . . . . . . . . . . . . ...571

Oiaorders ofgallbladder and biliarytract . . . . . . . . . . . . . . . . . . . . . . . . 574-578

Other cfiseasesofdigestivesyatem . . . . . . . . . . . . . . . . . . . 570,572-573,577-579

Diseases of thegenitourinary syatem . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Diseases ofurinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .580-599

Oiseases ofmalegenital organs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600-608

Disorders of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...810-611

Inflammatory diseaae of female pelvic organe. . . . . . . . . . . . . . . . . . . . . . 614-616

Dsordera ofmenstruation andother abnormal bleeting from female genital tract . . . . . . 626

Complications ofpregnancy, childbirth andthepuerperium . . . . . . . . . . . . . . . . 630-676

Induced abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 63$836

Other pregnancy with aborfiveoutcome . . . . . . . . . . . . . . . . . . . . 630-634,637+39

Complications oflabor, delivery andthepuerparium . . . . . . . . . . . . . . . . . . 652-676

Ok.easesofthes. kinands ubcutaneoust issue . . . . . . . . . . . . . . . . . . . . . . 68C-709

0.9

0.9

0.1

0.3

3.5

1.9

3.4

2.1

0.6

1.4

6.3

●

1.4

1.6

0.4

1.9

0.9

27.2

1.7

3.3

1.5

2.7

1.5

1.2

3.5

1.2

1.2

0.9

1.0

0.3

2.0

2.2

0.6

1.9

11.0

0.7

0.1

1.7

2.5

0.0

3.8

1.2

19.3

0.2

3.7

1.9

1.5

2.5

0.7

1.1

0.9

5.5

1.2

13.8

5.5

0.9

0.1

0.5

2.7

0.3

0.0

0.1

0.0

2.8

Oischarge rate per 1,000 population

0.4

1.3

0.6

0.3

4.6

1.5

8.3

5.5

1.3

10.1

9.2

●

2.0

1.9

2.2

1.7

1.4

38.5

0.5

3.0

1.2

3.8

1.5

2.4

9.2

0.6

1.3

2.7

1.5

0.8

3.3

0.6

1.5

3.8

15.0

1.5

‘0.1

1.5

3.2

0.5

2.2

2.3

29.4

1.1

2.1

4.2

0.6

6.1

2.1

4.9

1.4

4.6

2.4

20.7

7.5

3.1

1.6

0.6

2.1

“0.1

.

.

●

3.4

...

...

0.2

0.4

1.4

...

2.7

2.1

0.4

1.2

7.0

●

1.8

1.9

0.4

1.9

1.0

34.3

1.4

2.8

1.4

4.6

2.2

1.7

5.0

2.1

1.3

1.0

1.2

0.4

2.5

3.4

0.9

1.9

14.8

0.6

0.1

2.3

3.6

0.1

5.3

1.3

21.2

0.3

5.8

2.2

1.6

3.9

0.7

1.2

1.4

2.9

1.2

7.7

5.8

1.9

.

...

...

...

...

. .

...

3.2

...

...

1.2

“0.3

2.4

...

6.3

4.6

1.0

11.7

8.2

●

1.9

1.3

2.3

1.5

1.1

48.3

‘0.3

2.7

1.3

6.1

1.6

2.8

14.0

0.6

1.4

3.0

1.7

1.0

3.9

0.9

2.0

4.0

16.3

1.3

●

1.7

3.2

‘0.4

2.7

1.9

30.4

1.1

2.4

4.0

0.6

9.1

1.4

4.1

1.6

3.3

2.8

15.6

8.7

6.6

“0.2

...

...

...

...

...

...

3.1

1.6

1.6

...

0.3

5.3

3.5

3.9

2.1

0.7

1.5

5.7

.

1.2

1.4

0.4

1.9

0.8

20.9

2.1

3.7

1.7

1.0

1.0

0.8

2.1

0.4

1.1

0.8

0.8

0.3

1.5

1.1

0.3

2.0

7.6

0.7

0.1

1.2

1.5

0.0

2.5

1.1

17.7

0.2

1.9

1.6

1.5

1.2

0.7

1.0

0.5

7.8

1.3

19.2

5.3

...

0.2

0.9

5.0

0.5

0.1

0.2

0.1

2.5

0.8

2.6

...

.

6.7

2.6

10.1

6.3

1.5

6.7

10.1

.

2.1

2.4

2.1

1.9

1.6

29.6

0.8

3.1

1.1

1.8

1.3

2.1

4.9

0.5

1.2

2.4

1.3

0.6

2.7

“0.4

1.0

3.7

13.9

1.6

.

1.3

3.1

0.7

1.8

2.6

28.5

1.1

1.8

4.4

0.5

3.4

2.7

5.5

1.1

5.9

2.0

25.3

6.5

2.9

1.2

4.1

‘0.3

●

.

●

3.7

80
Tablet3. Rateaof dscharge anddsya ofmrefor patien~4W yeaffiof sge, byaexand dagnosis Poland andthe UnR4S~te~ 1980-Con.

[Data are for short-stay non-Federal hospitals in the Unitad States and for all general hospitals in Poland. Data exclude normal de~weries (code 650). Diagnostic cstegwies and code numbers are

from the Ninth Revision, International Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnosis and ICD-9 code Poland States Poland States Poland States

Diseases of themusculoskeletal syatemand connective tissue. . . . . . . . . . . . . 71 C-739

Osteoarfhrosls and allied disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . ...715

Other arfhropathles and related disorders . . . . . . . . . . . . . . . . . 71 C-714, 716-719

Intervertebral dlscdisordera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...722

Other dorsopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...720-721. 723-724

Rheumatism, excluding the back . . . . . . . . . . . . . . . . . . . . . . . . . . . . 725-729

Disorders of boneand carfllage ..,. . . . . . . . . . . . . . . . . . . . . . . . ..730-733

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...740-759

Certain conditions originating intheperinatal period . . . . . . . . . . . . . . . . . . 760-779

Symptoms, signs and ill-defined conditions . . . . . . . . . . . . . . . . . . . . . 780-799

Injury andpolsoning ..,...... . . . . . . . . . . . . . . . . . . . . . . . . ...80&999

Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-829

Dislocations, sprains and strains.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 830-648

lnlracranlal [nju~, excluding those with akull fracture . . . . . . . . . . . . . . . , 650-854

Openwound andinjuy to blood veasels . . . . . . . . . . . . . . . . . . . . . . . . r370-904

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...940-949

Poisoning and toxic effects, . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...960-989

Complications ofsurgical andmedical care notelsewhare classified. . . . . . . 996-999

Supplementary classification of factors influencing health status and

conlact withhealth sewices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI–V82

7.4

1.5

1.7

1.2

2.0

0.6

0.3

0.2

1.3

12.4

6.0

0.7

0.9

1.2

0.4

0.7

0.1

0.4

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...2.440.9

Infectious and parasitic diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001–139

Intestinal infectious diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-009

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. O1O-O1S

Viral hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..o7O

Neoplasm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-208

Malignant neoplasm ofstomach. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...151

Malignant neoplaam ofother digestive organs and peritoneum . . . . . .150, 152-159

Malignant neoplasmoftrachea, bronchusandlung . . . . . . . . . . . 162

Mallgnantneoplaam ofbreaat. . . . . . . . . . . . . . . . . . . . . . . . . . ...174-175

Malignantneoplaam ofcewixuteri . . . . . . . . . . . . . . . . . . . . . . . . . . ...180

Malignant neoplasm ofotherfemale genital organs . . . . . . . . .179, 161–164

Malignantneoplasm ofprostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...185

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-206

Benlgnneoplasms, carcinoma insitu, andneoplasms ofuncetialn behavior. . . . 210-239

Benign neoplasm of uterus . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 216-219

Endocrine, nutritional andmetabohc diseases andimmunity dsorders . . . . . . 24C!-279

Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250

Diseases of blood and blood-forming organs . . . . . . . . . . . . . . . . . . 280-2S9

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...290-319

Diseases of thenarvous system andsenseorgans . . . . . . . . . . . . . 320-389

Clsorders of theautonomic nervoua system . . . . . . . . . . . . . . . . . . . . . . . ...337

Other disorders of thecentral newous system . . . . . . . . . . . . 320-336,340-349

Disorders of theperipheral nervous system . . . . . . . . . . . . . . . . 350-359

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...368

Olherdisorders of theeyeandadnexa . . . . . . . . . . . . . . . 360-365,367-379

Diseases of theearand mastoid proceas. . . . . . . . . . . . . . . . . . . . 380-389

Diseases of the circulatory system.,. . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Rheumatic heart disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...39&398

Essential hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..4o1

Hypertensive heart and renal disease. . . . . . . . . . . . . . . . . . . . . . . . . 402-404

Acute myocardial infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...410

Other acute andsubacute forms ofischemic heart disease . . . . . . . . . . 411

Angina pectoris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...413

Other chronic ischemic heart disease . . . . . . . . . . . . . . . . . . . . . . . . . . 412,414

Diseases of pulmonary circulation.,.. . . . . . . . . . . . . . . . . . . . . . . . . 415-417

Diseases of the pericardium and endocardlum, cardiomyopathy

and conduction disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...420426

Cardiac dysrhyfhmlas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...427

Hearf failur e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...426

ill-defined descriptions andcomplications ofheati disease . . . . . . . . . . . . . . . 429

Acute cerebrovascular disease.. . . . . . . . . . . . . . . . . . . . . . . . . ...430436

237.2

2.9

158.4

48.5

318.4

259.1

15.0

32.9

62.9

26.3

21.8

19.9

1.9

6.9

59.3

29.9

65.7

41.2

11.9

15.9

125.5

,

33.4

30.3

11.0

36.0

14.6

503.7

33.5

46.3

24.3

62.3

23.6

16.8

55.0

26.8

22.2

10.s

17.6

5.6

45.0

Discharge rate per 1,000 population

16.4 7.4 14.4 7.5

1.3 1.1 1.0 1.9

2.2 1.2 1.5 2.2

3.3 1.4 3.7 1.0

3.6 2.2 3.6 1.7

3.4 0.8 3.0 0.4

1.3 0.5 1.1 0.1

0.9 0.2 0.7 0.2

. ●

3.3 1.4 3.3 1.2

14.1 18.1 15.7 7.5

4.3 8.5 4.0 3.8

3.3 1.0 3.6 0.4

0.7 1.3 0.9 0.5

1.0 2.0 1.7 0.6

0.3 0.5 “0.5 0.2

0.6 0.9 “0.4 0.5

1.5 0.1 1.6 0.1

1.9 0.5 1.7 0.3

Rate of days of care per 1,000 population

1,597.4

17.1

2.0

“2.4

.

208.6

179.6

“3.0

35.6

34.0

22.4

4.4

11.4

5.9

2.6

29.2

11.0

77.4

55.1

10.6

114.4

53.1

●

22.2

10.0

7.1

7.8

5.6

346.5

6.1

19.3

11.5

45.9

12.0

13.6

73.9

7.0

12.9

16.6

15.2

6.1

40.0

2,864.6

370.3

3.2

281.3

50.6

324.5

295.4

21.3

33.6

117.4

.

...

..

4.0

8.0

29.1

...

51.8

40.0

S.3

13.9

136.3

.

39.7

34.3

11.2

36.7

16.3

647.0

25.5

36.7

23.3

105.0

32.6

21.6

79.e

47.7

23.5

12.0

21.4

6.3

54.0

1,590.3

17.2

‘1.1

“4.5

.

179.2

167.2

‘3.8

37.7

44.1

.

...

...

12.3

“2.6

12.0

...

58.2

45.9

9.2

127.1

46.0

●

21.9

7.6

7.1

6.6

4.4

422.9

“3.3

18.3

12.3

73.6

14.1

14.2

109.6

7.1

15.2

17.4

16.7

7.7

42.3

2,052.6

120.9

2.6

50.8

46.6

313.2

227.5

9.5

32.3

15.3

48.9

40.8

37.3

...

5.9

85.7

56.1

77.9

42.3

15.0

17.6

114.2

.

28.0

26.9

10.8

35.4

13.1

376.5

40.4

53.0

25.2

24.9

15.8

12.6

33.4

8.5

21.1

9.7

14.3

5.0

37.0

18.1

1.6

2.9

2.9

3.6

3.8

1.6

1.0

,

3.2

12.7

4.6

2.9

0.6

“0.4

.

0.7

1.3

2.1

i ,603.8

17.0

2.8

.

.

235.6

190.8

.

33.7

24.7

42.6

8.4

21.7

...

.

44.8

21.0

94.7

63.5

12.3

102.9

57.6

.

22.5

12.2

7.0

6.6

7.1

277.3

8.6

22.0

10.8

20.9

10.1

13.0

41.5

6.9

10.8

15.9

13.8

4.7

37.9

61
Table8. Rates oftischarge anddays of~refor patients 4Myeamof age, bysexand tiagnosi% Poland andthe Untiti Stites, 1980-Con.

[Data are for ahofl-s:ay non-Federal hospitals in the Unitad States and for all general hospitals in Poland. Data axclude normal deliveries (rode 650). Oiagnoafk categories and sode numbers are

from the Ninth Revision, International Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnosis and lCb9 code Poland States Poland States Poland Stales

Rate of days of care per 1,000 population

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...440

Ofherdiseases ofaderies, arterioles and capillaries . . . . . . . . . . . . . . . . . 441-448

Dseases ofveins andlymphatics, andother dseases of thecirculatov system . . . 451-459

Diseasesofthe reapiratorysystem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Acuterespiratoryinfections.... . . . . . . . . . . . . . . . . . . . . . . . . ...460-466

Chronicdiseaseoftonai[sandadenoids . . . . . . . . . . . . . . . . . . . . . . . . ...474

Other diseases ofupper respiratory tract . . . . . . . . . . . . . . . . . . . 470-473,475-478

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...460-486

Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...487

Bronchitisand emphysema . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...490-492

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Diseasesofthedigestivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseases oforalcavity, salivary glands and jaw . . . . . . . . . . . . . . . . . . 520-529

Gastricand duodenalulcer . . . . . . . . . . . . .. I...... . . . . . . . ...531-532

Other diseases ofesophagus, stomach and duodenum . . . . . . . . . . . . . . 530,533-537

Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...540-543

Herniaofabdominalcavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...550-553

Noninfecfiveenteritisand colitis. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . 555-558

Otherdiseasesofintestinesand peritoneum . . . . . . . . . . . . . . . . . . . . . . 560-569

Chronicliverdiseaseand cirrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . ...571

Oisordersofgall bladderand biliarytract . . . . . . . . . . . . . . . . . . . . . . . 574-576

Other diseases of digestive system . . . . . . . . . . . . . . . . . . . 570,572–573,577–579

Diseases of thegenitourinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-829

Diseases ofurinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...560-599

Diseases ofmale genital organs... . . . . . . . . . . . . . . . . . . . . . . . . . . 600-808

Disorders of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..610-611

Inflammatory disease of female pelvic organs. . . . . . . . . . . . . . . . . . . . . . 614-616

Usorders ofmenstruation andother abnormal bleedng from female genital tract . . . . . . 626

Complications ofpregnancy, childbirth andthepuerperium . . . . . . . . . . . . . . . . 630-876

Induced abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...635-836

Other pregnancy with abortive outcome . . . . . . . . . . . . . . . . . . . 630-834,637-839

Complications oflabor, delivery andthepuerperium . . . . . . . . . . . . . . . . . . 652-676

Oiseases of theskin and subcutaneous tissue . . . . . . . . . . . . . . . . . . . . . . 68C-709

Dseases of themusculoskeletal aystemand connective tissue. . . . . . . . . . . . . . 7?0-739

Osteoarthrosis and allied disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . ...715

Other arlhropathies and related disorders . . . . . . . . . . . . . . . . . . . 710-714,718-719

Intervertebral disc disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...722

Other dorsopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...720-721. 723-724

Rheumatism, excluding the back . . . . . . . . . . . . . . . . . . . . . . . . . . . . 725-729

Disorders of boneandcatiilage. . . . . . . . . . . . . . . . . . . . . . . . . . ...730-733

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..74C-759

Certain conditions originating intheperinatal period . . . . . . . . . . . . . . . . . . . 760-779

Symptoms, signs andill-defined conditions . . . . . . . . . . . . . . . . . . . . 780-799

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-999

Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-829

Dislocations, sprains and strains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 830-848

intracranial injury, excluding thoeewith skull fracture . . . . . . . . . . . . . . . . . . 850-854

Openwound andinju~to blood vessels . . . . . . . . . . . . . . . . . . . . . . . . 870-904

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . ...940-949

Poisoning and toxic effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...96&989

Complications ofsurgical andmedcal care notelsewhere classified. . . . . . . . . . 996-999

Supplementary classification of factors influencing health status and

contact with health services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI–V82

48.9

18.1

34.9

240.1

7.6

1.3

23.0

57.5

0.4

95.2

25.3

323.9

3.1

71.8

24.5

22.6

35.8

8.8

16.5

22.1

96.5

22.3

143.1

76.5

13.9

1.4

5.5

11.0

1.7

0.1

0.6

0.4

64.2

179.3

36.7

46.6

31.6

41.5

9.3

9.1

2.2

15.8

167.8

110.9

10.0

11.6

16.0

7.1

4.1

1.5

4.4

6.8

20.4

31.7

113.2

9.1

‘0.2

5.4

29.0

2.8

17.0

15.9

222.8

4.1

18.0

26.6

4.1

36.2

13.2

38.4

16.9

41.8

23.4

117.1

47.+

19.7

6.5

3.8

7.2

‘0.5

.

.

.

31.8

135.1

15.2

20.6

33.2

30.0

16.3

14.6

7.5

.

15.5

115.4

44.5

22.1

5.2

5.4

6.1

2.6

14.1

9.3

78.6

26.6

34.1

340.4

7.8

1.1

30.7

86.3

0.5

137.9

27.2

346.5

3.8

107.9

26.5

23.3

52.7

9.7

16.9

32.8

51.1

19.9

103.3

73.3

29.8

●

...

...

...

...

...

...

72.8

168.1

25.5

29.5

37.5

48.6

11.7

14.2

2.5

16.5

275.4

158.8

15.6

17.8

25.7

10.0

5.3

1.7

5.0

8.6

25.2

31.3

118.5

7.6

●

5.7

29.8

“2.0

20.8

13.3

222.5

4.0

21.1

25.3

4.8

49.6

9.3

31.9

18.4

29.5

26.3

91.2

46.9

41.5

“0.9

...

...

...

...

...

...

33.4

111.6

11.5

10.1

34.5

26.7

12.2

12.7

7.1

●

13.2

121.4

36.5

24.0

7.8

8.5

“8.2

“1.8

16.6

8.2

22.8

10.7

35.5

152.4

7.9

1.4

16.2

32.3

0.4

57.9

23.7

304.1

2.4

40.3

21.0

22.0

21.0

8.0

16.2

12.7

136.2

24.4

176.0

79.4

...

2.5

10.3

20.6

3.2

0.2

1.1

0.7

56.8

189.1

46.5

65.3

26.5

35.4

7.1

4.7

2.0

15.2

111.1

69.0

5.0

6.2

7.6

4.6

3.0

1.2

3.9

‘5.0

16.0

31.9

106.4

10.5

.

5.2

28.2

3.6

13.4

‘t8.2

223.0

4.1

15.3

27.8

3.6

23.9

16.6

44.3

15.4

53.0

18.9

140.6

45.4

11.6

7.2

13.7

“1.0

.

.

.

30.4

156.1

18.5

30.0

32.0

31.1

19.9

16.3

7.8

.

17.6

110.0

51.6

20,4

2.8

‘2.6

.

3.5

11.8

10.2

62
Table9. Rateaof discharge anddaya of~refor patienta 65yeara ofageand over, byaexand diagnosis: Poland andthe United Stites, 1960

[DiIta are for ahorl-stay non-Ferteral hospitals in ths Unitsd Statea and from all gensral hospitals in Poland. Diagnostic categories and code numbers are from the Ninth Revision, International

Classiflcalion of Diseases, 1975]

Both sexes Male Female

United United United

Diaanosis and lCb9 code Poland States Poland States Poland States

Allconditlons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectiousand parasiticdiseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001–139

Intestinal infectiousdiseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-009

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 010+18

Viral hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...070

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...14&239

Malignantneoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-208

Malignantneoplasm ofstomach. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...151

Malignant neoplasm ofother digestive organs andpetitoneum . . . . . . 150,152-159

Malignant neoplasm oftrachea, bronchus and lung . . . . . . . . . . 182

Mallgnantneoplasmofbreast..... . . . . . . . . . . . . . . . . . . . . . . ..174-175

Malignantneoplasm ofcervixuteri . . . . . . . . . . . . . . . . . . . . . . . . . . ...180

Malignant neoplasm ofother female genital organs . . . . . . .179, 181–184

Malignant neoplasm ofprostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...185

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-208

Benlgnneoplasms, carcinoma insitu, andneoplasms ofuncedain behavior. . . . 210-239

Benign neoplasmofuterus. . . . . . . . . . . . . . . . . . . . . . . . . . . . ..218–219

Endocrine, nutritional andmetabolic tiseases and immunity disorders . . . . . 240-279

Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250

Diseasesofblood andblood-forming organs . . . . . . . . . . . . . . . . . . . . 280-289

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...29&319

Diseasesofthe nervouasystemand sense organs . . . . . . . . . . . . . . . 32C-389

Disorderaoftheautonomicnervoussystem . . . . . . . . . . . . . . . . . . . . . . . ...337

Olherdkiorders ofthecentral rtewous system . . . . . . . . . . . . . . . . 320-336,340-349

Disorders of theperipheral nervous system . . . . . . . . . . . . . . . . . . . 350-359

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...366

Other disorders of theeyeandadnexa . . . . . . . . . . . . . . . . . . . . 360-365,387-79

Diseases of theearand mastoid process . . . . . . . . . . . . . . . . . . . . . . . . 380-389

Diseases of theclrculato~ system... . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Rheumatic hearfdisease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...39&398

Essential hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...401

Hypertensive heart and renal disease. . . . . . . . . . . . . . . . . . . . . . . . 402-404

Acute myocardial infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...410

Olheracute andsubacute forms ofischemic heart disease . . . . . . . . . . . . . . . . . 411

Angina pectorls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...413

Other chronic ischemic heart di.sease . . . . . . . . . . . . . . . . . . . . . . . . . . 412,414

Diseases of pulmonary circulation.. . . . . . . . . . . . . . . . . . . . . . . 415-417

Diseases of the pericardium and endocardium, cardiomyopathy

and conduction disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...420-426

Cardiac dysrhythmias. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...427

Heart failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...428

lll-deflned descriptions andcomphcations ofheafl disease . . . . . . . 429

Acute cerebrovascular disease . . . . . . . . . . . . . . . . . . . . . . . . . . . ..430-436

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...440

Other diseases ofarteries, arterioles and capillaries . . . . . . . . . 441-448

Diseases ofvelns andlymphatics, andother diseases of thecirculato~ system . . 451-t59

Diseases of the respiratory system... . . . . . . . . . . . . . . . . . . . . . . . . 460-519

Acute respiratory infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..460-466

Chronic disease oftonsils and adenoids . . . . . . . . . . . . . . . . . . . . . . . . ...474

Other diseases ofupper respiratory tract . . . . . . . . . . 470-473,475-476

Pn8umonla . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..480-486

Influenza, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...467

Bronchitis and emphysema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 490+92

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Diseases of thedigestlvesyatem . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diseases oforalcavity, salivary glands and jaw . . . . . . 520-529

Gastric and duodenal ulcer.... . . . . . . . . . . . . . . . . . . . . . . . . ...531-532

Other diseases ofesophagus, stomach and duodenum . . . . . . .530, 533-537

Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .540-543

Hernia ofabdomlnal cavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..550-553

Nonlnfective enteritis andcolitie . . . . . . . . . . . . . . . . . . . . . . . . . 555-558

Other dlseasesof inteafines and peritoneum . . . . . . . 560-569

Chronic liver disease and cirrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . ...571

Disorderso fgallbladdera ndbiliarytract . . . . . . . . . . .. . 574-576

Other diseases ofdigestive system . . . . . . . . . . 570,572-573,577-579

163.3

5.2

0.2

2.9

1.1

16.8

15.1

2.0

3.2

2.5

0.9

0.7

0.9

0.6

0.5

1.7

0.1

4.2

3.6

1.1

0.4

7.0

1.1

0.7

2.1

2.8

0.3

57.5

0.9

2.9

2.0

4.3

1.3

0.8

5.3

3.7

4.1

1.3

6.0

1.3

5.9

13.7

1.0

1.8

18.3

0.6

0.0

0.9

6.8

0.0

7.1

1.4

19.7

0.2

2.6

1.8

1.1

3.1

0.7

1.5

1.1

6.3

1.4

Discharge rate per 1,000 population

383.7

4.7

0.8

‘0.2

.

40.3

35.6

1.0

6.7

5.3

3.3

0.4

2.2

3.9

i .3

4.6

.

16.2

9.4

4.5

9.4

23.6

.

4.2

2.0

12.3

3.4

1.7

110.8

0.5

4.2

3.5

9.3

3.1

3.3

20.1

1.6

3.1

8.8

13.6

3.9

18.3

3.1

4.5

5.7

38.5

3.6

.

1.2

11.9

1.4

5.3

3.3

49.1

0.9

3.e

6.0

0.4

8.9

5.0

11.5

1.1

7.3

4.4

200.8

7.4

0.2

4.9

1.2

23.7

21.5

3.2

3.7

5.3

.

.

.

1.5

0.8

2.2

3.1

2.7

1.0

0.3

7.5

1.4

0.7

2.0

3.0

0.4

68.7

0.7

1.8

1.4

8.5

1.6

1.2

6.3

7.5

4.9

1.4

7.1

1.2

6.4

16.1

1.5

1.8

27.1

0.7

.

1.4

8.8

.

11.7

2.1

22.8

0.2

4.1

2.2

1.2

5.2

0.7

1.8

1.7

4.4

1.3

411.8

4.7

‘0.6

.

.

51.0

46.2

1.3

6.0

10.1

,

..

.

9.8

1.6

4.6

.

12.3

7.4

4.2

9.9

22.8

.

4.9

1.9

11.3

3.4

1.3

121.9

.

2.9

2.7

12.0

3.3

4.0

23.3

1.6

3.4

9.7

14.2

4.3

20.2

3.7

6.6

5.4

49.4

3.2

.

1.3

15.0

1.4

7.2

3.0

49.9

“0.6

4.5

6.3

.

13.3

3.7

9.1

1.3

6.2

4.4

139.8

3.8

0.2

1.6

1.0

12.5

11.1

1.3

2.8

0.7

1.3

1.1

1.4

.. .

0.4

1.4

0.2

4.9

4.1

1.2

0.4

6.6

0.9

0.7

2.1

2.7

0.3

50.5

1.0

3.6

2.4

2.8

1.1

0.6

4.7

1.3

3.7

1.3

5.2

1.4

5.6

12.2

0.7

1.8

12.6

0.6

.

0.6

5.5

.

4.2

1.0

17.8

0.1

1.7

1.5

1.1

1.8

0.7

1.3

0.8

7.5

1.4

364.7

4.8

0.8

,

,

33.0

28.5

0.7

5.8

2.1

5.5

0.7

3.8

...

0.9

4.5

●

18.8

10.8

4.7

9.1

24.0

●

3.8

2.0

12.9

3.5

1.9

f 03.4

0.7

5.0

4.0

7.5

3.1

2.8

17.9

1.5

2.9

8.1

13.1

3.6

17.0

2.7

3.0

5.9

31.1

3.8

.

1.1

9.7

1.4

4.1

3.4

4e.6

1.0

3.3

5.7

‘0.3

5.9

5.9

13.1

0.9

6.0

4.5

63
Tabfe9. Rateaof discharge anddays ofmmfor patients 65years ofageand over, byaexand dagnosi% Poland andthe United SWteS 1980-Cm.

[Data are for short-stay non-Federal hospitals in the Unitad States and from all general hospitala in Poland. Diagnostic categories and coda numbers are from the Ninth Revision, International

Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diairnosis and ICD-9 code Poland States Poland States Poland States

Diseases of thegenitourinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Diseases of urinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...580-599

Diseases ofmalegenital organs... . . . . . . . . . . . . . . . . . . . . . . . . . . 600-608

Disorders of breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...610-611

lnflammato~ disesse of female pelvic organs. . . . . . . . . . . . . . . . . . . . . 614-616

Disorders of menstruation and other abnormal bleeding from female genital tract . . . . . . 626

Complications of pregnancy, childbitih and the puerpefium . . . . . . . . . . . . . . . . 630-676

Induced abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...635-836

Other pregnancy with abortive outcome . . . . . . . . . . . . . . . . . . . . 630-834, 637-639

Complications of labor, delivey and the puerperium . . . . . . . . . . . . . . . . . . 652+376

Diseasea of the akin and subcutaneous tissue . . . . . . . . . . . . . . . . . . . . . . 660-709

Diseases of the musculoskeletal system and connective tissue. . . . . . . . . . . . . . 710-739

Osteoarthrosia and allied disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . ...715

Other arthropathies and related disorders . . . . . . . . . . . . . . . . . 710-714,716-719

Intetverfebral disc disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...722

Other dorsopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...720-721. 723-724

Rheumatism, excluding the back . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72$729

Disorders of boneand cartilage . . . . . . . . . . . . . . . . . . . . . . . . . . . ..73C-733

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...740-759

Certain conditions originating in the perinatal period . . . . . . . . . . . . . . . . . . . 760-779

Symptoms, signs and ill-defined conditions . . . . . . . . . . . . . . . . . . . . . . . . 780-799

Injury and poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..80G999

Fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...600-629

Dislocations, sprains and strains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 830--846

intracranial inju~, excluding thoaewith akull fracture . . . . . . . . . . . . . . . . . . 850-854

Openwound andinjury to blood vessels . . . . . . . . . . . . . . . . . . . . . . . 870-904

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...940-949

Poisoning and toxic effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...960-989

Complications ofsurgical andmedcal care not elsewhere classified. . . . . . . . . . 996-999

Supplementary classification of factors influencing health status and

contact withhealth servicea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI-V82

f 0.0

4.5

3.7

●

0.1

0.3

...

...

...

...

3.4

5.1

1.9

1.6

0.1

1.0

0.2

0.2

0.0

1.9

12.5

7.6

0.4

0.7

0.9

0.2

0.4

0.1

0.3

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...3.604.0

Infectious andparasitic diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-139

Intestinal infectious diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 001-009

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...010-018

Vfral hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...070

Neoplasm . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-239

Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...140-208

Malignant neoplasm of stomach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151

Malignant neoplasm ofother digestive organs andpefitoneum . . . . . . . . .150, 152–159

Malignant neoplasm oftrachea, bronchus and lung . . . . . . . . . . . . . . . . . . . . 162

Malignant neoplasm of breast . . . . . . . . . . . . . . . . . . . . . . . . . . ...17&175

Malignant neoplasm ofcervix uteri. . . . . . . . . . . . . . . . . . . . . . . . . . ...180

Malignant neoplasm ofother female genital organs . . . . . . . . . . . . . . .179, 181–184

Malignant neoplasm of prostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185

Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...204-208

Benign neoplasms, carcinoma insitu, andneoplasms ofuncetiain behavior. . . . . . 21 C-239

Benign neoplasm of uterus . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 218-219

Endocrine, nutritional andmetabohc dseases and immunity disorders . . . . . . . . . . 240-279

Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250

Diseases of blood and blood-forming organs . . . . . . . . . . . . . . . . . . . . . . 280-269

Mental disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...290-319

Diseases of thenervous system andsenseorgans . . . . . . . . . . . . . . . . . . . . 320-389

Disorders of theautonomic nervous system. . . . . . . . . . . . . . . . . . . . . . . . . . 337

Other disorders of thecentral nervous system . . . . . . . . . . . . . . . . 320-336,340+49

Disorders of theperipheral nervous system . . . . . . . . . . . . . . . . . . . . . . . 35C-359

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...366

Other disorders of theeyeandadnexa . . . . . . . . . . . . . . . . . . . 360-365,367+79

Diseases of theearand mastoid process. . . . . . . . . . . . . . . . . . . . . . . . 38C-389

Diseasea of the circulatory system.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 390-459

Rheumatic heart disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...390-398

Essential hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...401

Hypertensive hearfand renal disease . . . . . . . . . . . . . . . . . . . . . . . . . 402-404

Acute myocardial infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...410

Other acute andsubacute forms ofischemic hearf disease . . . . . . . . . . . . .’. . . . 411

Angina pectoris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...413

271.4

2.3

189.9

44.1

416.4

385.?

44.6

74.3

78.3

22.0

17.6

19.3

13.3

13.1

31.2

1.0

89.6

75.7

26.4

9.7

153.4

26.9

14.6

51.0

55.8

5.1

1,131.8

16.9

46.5

36.5

90.8

23.2

13.2

Discharge rate per 1,000 population

26,9

14.0

8.4

0.8

‘0.3

,

...

...

...

...

5.2

20.4

4.4

2.7

1.6

3.9

2.7

4.4

0.8

.

3.7

27.4

14.6

2.2

1.1

1.0

0.4

0.7

2.9

2.1

15.3

5.6

9.7

“

...

..

...

...

...

...

3.3

4.2

1.3

1.1

0.2

1.1

0.2

0.2

.

2.1

14.1

7.5

0.6

1.0

1.3

0.3

0.5

0.1

0.3

38.3

17.1

20.7

.

..

...

...

..

.

...

4.3

14.7

2.7

1.9

1.3

3.6

2.3

2.4

‘0.7

●

4.4

20.9

7.7

1.8

1.3

1.3

●

‘0.7

3.5

2.3

6.6

3.8

...

●

0.2

0.5

...

...

...

...

3.4

5.7

2.3

1.9

0.1

0.9

‘0.2

0.2

0.1

1.7

11.5

7.7

0.4

0.5

0.7

0.2

0.3

0.1

0.2

Rate of daye of care per 1,000 population

4,098.1

53.4

4.7

‘3.3

.

503.8

466.1

16.3

111.3

68.1

43.2

3.4

24.0

43.4

15.3

37.7

●

192.1

120.1

43.9

129.3

146.1

*

59.3

14.2

45.6

17.6

8.8

1,238.8

6.2

35.0

38.0

120.6

26.0

21.1

4,380.5

406.2

2.3

314.5

48.2

572.6

531.5

65.6

78.7

163.6

.

...

...

34.6

16.9

41.1

...

65.0

57.1

22.9

12.1

164.5

34.4

16.2

51.9

56.3

5.7

1,332.5

14.4

27.6

25.2

132.8

27.4

19.9

4,243.6

49.9

‘3.3

.

.

618.7

587.8

24.4

121.4

128.0

.

. .

...

107.7

22.4

30.9

...

145.3

92.6

36.7

125.7

157.5

●

77.1

15.6

39.1

18.1

6.2

1,322.9

.

24.6

26.1

149.2

23.0

24.0

3,115.7

186.6

2.3

111.6

41.5

318.2

293.2

31.4

71.5

24.7

35.2

28.7

31.5

...

10.7

25.0

1.7

105.1

87.3

26.7

8.1

148.4

22.2

13.7

50.4

55.6

4.6

1,005.8

18.5

58.3

43.6

64.4

20.5

9.0

19.3

12.0

1.1

“0.4

.

...

...

...

5.7

24.3

5.5

3.2

1.7

4.2

2.9

5.8

0.8

●

3.3

31.7

19.2

2.4

1.0

0.9

“0.4

0.7

2.5

2.0

3,999.8

55.7

5.6

“

.

426.1

383.8

10.9

104.4

27.7

72.0

5.7

40.2

10.5

42.3

*

223.7

138.6

48.7

131.7

138.4

●

47.2

13.3

50.0

17.3

10.5

1,181.9

9.0

42.0

46.0

101.2

28.0

19.2

64
Table9. Retesof discharge snddeys ofmrefor pstients 65years ofage andover, bysexand diagnosis: Poland andthe United S@ter%1980-C-on.

[Data are for short-stay non-Federal hospitals in the United States and from all genaral hospitals in Poland. Diagnostic categmiea and code numbers are from the Ninth Revision, International

Classification of Diseases, 1975]

Both sexes Male Female

United United United

Diagnosis and lCb9 code Poland States Poland States Poland States

Rate of days of care per 1,000 population

Other chronic lschemlc heart disease . . . . . . . . . . . . . . . . . . . . . . . . . . 412,414

Diseases ofpulmonary circulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41~17

Diseases of the pericardium and endocardium, cardiomyopathy

andconductlon disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...420-426

Cardiac dysrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...427

Heartfailure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...428

ill-defined descriptions andcomplications ofheaddsease . . . . . . . . . . . . . . . . . 429

Acutecerebrovasculardisease... . . . . . . . . . . . . . . . . . . . . . . . ...430-436

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...440

O1herdiseases ofart8ries, arterioles and capillaries . . . . . . . . . . . . . . . . . 441-448

Diseases ofveins andlymphatics, andother dseases of thecirculato~ system . . . 451-459

Diaeaseaofthe respiratory system. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46*519

Acute resplratoryinfectlons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..46~66

Chronlcdlseaseoftonsilsandadsnoids . . . . . . . . . . . . . . . . . . . . . . . . ...474

Otherdlseasesofupperrespiratorytract . . . . . . . . . . . . . . . . . . . 470-473,475-478

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..48fJ486

Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...467

Bronchitlsandemphysema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..49~92

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...493

Diseasesofthedigestivesystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520-579

Diaeasesoforalcavity, ealivaryglands andjaw . . . . . . . . . . . . . . . . . 520-529

Gastricand duodenal ulcer . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...531-532

Other diseases ofesophagus, stomach and duodenum . . . . . . . . . . . . .530, 533-537

Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..54~543

Hernlaofabdominalcavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..55~553

Noninfectiveenteritisandcolitis.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 55%558

Other diseases ofintestines and peritoneum . . . . . . . . . . . . . . . . . . . . . . 560-569

Chroniciiverdiseaseandcirrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . ...571

Dleorderaofgall bladderand biliarytract . . . . . . . . . . . . . . . . . . . . . . . . 574-576

Ofhercfiseases ofdigestive system . . . . . . . . . . . . . . . . . . . 570,572-573,577-579

Diseases of thegenltourinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . 580-629

Diseases ofurinary system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..56&5g9

Diseasea ofmalegenital organs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600-808

Disorderaofbreast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...610-811

Inflsmmatotydiseaseoffamalepelvlc organs. . . . . . . . . . . . . . . . . . . . . . 614-616

Disordere ofmenstruation andother abnormal bleedng from female genital tract . . . . . . 626

Complications ofpregnancy, chlldMdh andthepuerperium . . . . . . . . . . . . . . . . 830-676

Induced abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..635-636

Other pregnancy with aborfiveoutcome . . . . . . . . . . . . . . . . . . . . 630-834.637-639

Compiicatlons oflabor, delivery andthepuerperium . . . . . . . . . . . . . . . . . . 652-676

Diseaaee of theskln andaubcutaneous tiesue . . . . . . . . . . . . . . . . . . . . . . 68@709

Diseases oftt)emusculoskeletal system andconnective tissue. . . . . . . . . . . . . . 710-739

Osteoatihrosl san dallieddisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . ...715

Other arthropathlee andrelated disorders . . . . . . . . . . . . . . . . . - . 710-714,716719

Intervertebral discdisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...722

Other dorsopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..72~721. 723-724

Rheumatism, excluding the back . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72*729

Disorders of bone and cartilage . . . . . . . . . . . . . . . . . . . . . . . . . . . 730-733

Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...740-759

Certain conditions originating inthepeflnatal period . . . . . . . . . . . . . . . . . . 760-779

Symptoms, signs andill-defined concfitions . . . . . . . . . . . . . . . . . 780-799

Injury andpoisonlng . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 600-999

Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...800-329

Dislocations, sprains andstralns . . . . . . . . . . . . . . . . . . . . . . . . . . 830--s4e

intracranial inju~, excluding those with skull fracture . . . . . . . . . . . 850-854

Openwound andlnjury to blood vessels . . . . . . . . . . . . . . . . . . . . . . . . 870-904

Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..94~949

Poisoning andtoxic effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .960-989

Complications ofsurgical andmedical care notelsewhere classified. . . . . . . . 998-999

Supplementary classification of factors influencing health status and

contact withhealth sewices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. VOI–V82

95.1

77.5

77.4

19.9

103.6

24.7

120.2

283.2

22.7

52.1

426.8

9.8

0.2

11.7

152.3

0.3

182.3

30.6

353.4

2.2

53.1

25.9

18.6

44.8

9.7

20.1

27.9

123.3

28.1

174.0

76.5

75.4

.

1.0

1.7

...

...

...

...

117.6

148.9

55.4

52.7

4.4

23.0

4.3

7.2

0.8

27.7

253.1

189.5

5.6

9.0

13.2

6.4

3.2

1.3

3.0

215.0

20.7

33.1

77.2

142.0

39.9

237.1

44.6

62.8

63.2

376.9

25.0

.

5.0

132.2

10.4

47.7

27.5

462.1

4.7

41.3

47.6

4.6

67.2

39.8

111.5

13.7

e6.1

45.8

237.5

127.9

77.9

3.2

‘1.5

●

...

...

...

...

66.3

237.9

56.8

33.5

16.8

43.8

17.9

81.5

8.0

●

28.0

360.3

236.7

16.4

10.4

7.6

10.6

6.6

33.8

13.8

102.9

157.4

86.6

19.8

114.7

25.0

128.3

338.8

37.5

46.6

643.0

9.3

.

17.7

193.4

●

310.5

45.9

368.3

2.2

79.4

31.5

18.4

72.4

10.3

23.2

39.4

86.5

25.0

266.0

90.6

195.3

.

...

...

...

...

...

...

93.0

110.4

35.4

32.5

3.8

23.5

5.0

8.4

.

30.5

250.0

167.6

7.e

12.3

17.6

7.1

3.0

1.8

3.1

243.3

19.7

36.3

82.8

145.1

37.9

250.0

59.3

92.0

56.3

483.8

22.2

.

4.7

166.1

8.8

62.7

24.0

443.7

“3.2

51.5

50.1

.

90.6

28.6

81.3

19.0

71.7

42.3

343.9

149.2

193.1

.

...

...

...

...

...

...

49.6

165.1

35.4

20.4

14.7

42.3

13.7

34.1

“6.6

.

29.3

250.9

129.0

13.1

14.4

7.3

.

“8.2

37.5

14.1

90.1

27.3

71.6

20.0

96.9

24.5

115.1

248.2

13.4

55.5

290.8

10.1

.

7.8

126.4

*

101.7

21.1

331.5

2.1

36.5

22.3

1e.7

27.3

9.3

18.1

20.6

146.4

30.1

103.6

67.6

...

*

1.8

2.8

...

...

...

...

133.1

173.2

68.0

65.5

4.7

22.7

3.9

6.5

1.1

25.9

255.0

203.2

4.2

8.9

10.5

5.9

3.4

0.9

2.9

195.9

21.3

31.0

73.5

140.0

41.2

228.5

34.7

43.0

67.8

304.6

26.9

.

5.2

109.2

11.4

37.6

29.9

474.5

5.7

34.4

46.0

“4.2

51.4

47.0

131.8

10.1

95.9

48.2

165.7

113.6

...

4.4

*2.6

.

...

...

...

...

77.5

287.1

71.3

42.4

21.5

44.8

20.7

79.9

9.0

.

27.1

434.2

309.5

18.6

7.7

7.7

‘11 .0

5.5

31.3

13.6

65

I
Appendixes

Contents

I. Sources of data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

H. Technical notesonmethods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

III. Definitions ofterms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78

tistofappenclixfigures

I. Medical abstract forthe NationaIHospital Discharge Survey. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

II. Front ofmedical abstract forthe Polish General Hospital Morbidity Stidy. . . . . . . . . . . . . . . . . . . . . . . . . . . 70

III. Back ofmedical abstract forthe Polish General Hospital Morbidity Study. . . . . . . . . . . . . . . . . . . . . . . . . . . 71

IV. Approximate relative standwd emorsfor number ofpatients discharged or fordiagnoses: United States, 1980. . . . . 73

V. Approximate relative standmd emorsfor number ofpatient care days: United States, 1980 . . . . . . . . . . . . . . . . . 74

VI. Approximate relative standard emorsfor number ofpatients discharged or fordiagnoses: Poland, 1980 . . . . . . . . . 75

VII. Approximate relative standard errors for number of patient care days: Poland, 1980. . . . . . . . . . . . . . . . . . . . . 76

66
Appendix I

Sources of data

Characteristic United States Poland

Datti system The National Hospital Discharge Survey (NHDS) is

conducted by the National Center for Health Statistics.

Background The survey has been in operation continuously since

1965. The original universe for the survey consisted

of the 6,965 short-stay hospitals listed in the 1963

National Master Facility Inventory (NMFI). The NMFI

is a comprehensive list of U.S. hospitals, nursing

homes, and other inpatient facilities compiled by NCHS

(NCHS, 1965). The universe was updated in 1979

and, in addition to the original universe, included 1,052

new hospitals.

Scope Hospitals in the 50 States and the District of Columbia

in which the average length of stay is less than 30

days are’ covered by the survey, with the following

exceptions: institutional hospitals, such as prison hospitals and university student health centers; Federal hospitals, such as military and Veterans’ Administration

hospitals; and hospitals with fewer than six beds. Patients in long-term care units of hospitals covered by

the survey are sometimes excluded if the units keep

records separately from the rest of the hospital. The

discharges of females hospitalized for delivery and

of newborn infants are covered by the survey. However,

in this report, females whose only diagnosis was normal

delivery and newborn infants without any diagnosis

other than single or multiple birth were excluded.

Sumple size In 1980 the NHDS sample consisted of 544 hospitals.

Of these, 72 refused to participate and 52 were out

of scope, either because the hospital had gone out

of business or because it failed to meet the definition

of a short-stay hospital. Thus, 420 hospitals participated

in the survey during 1980, and they provided approximately 224,000 abstracts of medical records.

The General Hospital Morbidity Study (GHMS) is

supervised and coordinated by the National Institute

of Hygiene.

The study was established by the Ministry of Health

and Social Welfare in the mid- 1950’s as part of the

Ministry’s information system. Originally, data were

collected on all patients, but only data on patients

discharged dead, patients with certain rare diseases,

and a 20-percent sample of other patients were processed. Beginning in January 1979, the study was

changed so that data were collected on a 10-percent

sample of patients discharged alive or dead. The list

of hospitals covered by the study is verified every

year. The central hospitals in each Province are responsible for the addition of new hospitals to the study.

All hospitals operated by the Ministry of Health and

Social Welfare and the Ministry of Transportation are

covered by the study. This includes general hospitals

and tuberculosis sanitariums. The few hospitals under

the control of the Ministry of National Defense and

the Ministry of Internal Affairs and Justice are not

covered. Patients treated in nonpsychiatric units of

neuropsychiatric hospitals, such as neurology units,

are within the scope of GHMS. The discharges of

females hospitalized for normal delivery and of healthy

newborn infants are not covered by the study (see

appendix II for further information).

In 1980 the discharges from 641 general hospitals,

30 tuberculosis sanitariums, and the nonpsychiatric

units of 40 neuropsychiatric hospitals were sampled

for the GHMS. Participation in the study is mandatory. The hospitals reported data on approximately

364,000 discharges.

A list of referencesfollowsthe text.

67
Characteristic United States Poland

Sample design

Data collection

procedures

Items collected

Medical coding

A two-stage, stratified sampling design is used in the

survey. The first stage is selection of a sample of

hospitals. The primary stratification variables are bed

size and geographic region. Hospitals are selected in

direct proportion to size. Hospitals with 1,000 beds

or more in the universe of short-stay hospitals are

selected with certainty, and the sampling probability

decreases to 1 in 40 for the smallest hospitals. The

second stage is a systematic sample of discharges from

the sampled hospitals. The discharges are selected in

inverse proportion to hospital size to compensate for

the higher probability of selection of the larger hospitals, This ensures that the overall probability of selecting a discharge is approximately the same in each

size class. The sampling frame in nearly all the hospitals

is the daily listing of discharges. A systematic sampling

technique is used, usually based on the terminal digit

of the patient’s medical record number.

An abstract form is completed for each sample discharge, using information from the patient’s medical

record, In about 55 percent of the hospitals participating

in the survey in 1980, the sample selection and abstracting were done by the medical records staff of the

hospital. In the rest of the hospitals, the work was

performed by personnel of the U.S. Bureau of the

Census, acting for NCHS. Completed abstracts, along

with sample selection control sheets, are sent to a

CensusRegionalOffice, where the forms are checked

for completeness, The abstracts are next sent to NCHS,

where all abstract information, including diagnoses and

surgical procedures, are coded. The data are then transferred to computer tapes, edited, and processed.

The abstract form (figure I) used in the NHDS includes

items for patient identification, such as hospital, survey, and medical record numbers; date of admission

and discharge; and ZIP Code of residence. Patient

characteristics recorded include sex, date of birth or

age, race, ethnicity, marital status, expected source

of payment, and the discharge status and disposition

of the case. The medical information consists of discharge diagnoses, surgical and diagnostic procedures,

and the dates of procedures. Diagnoses and procedures

are listed, with the principal diagnosis (or the one

listedfirst, if a principalone is not identified)followed

by the other diagnoses as entered on the face sheet

of the medical record.

Diagnoses and procedures listed on the NHDS

abstract are coded using the International Classification of Diseases, 9th Revision, Clinical Modification

(ICD-9-CM) (U.S. Public Health Service and Health

Care Financing Administration, 1980), which is completely compatible with ICD–9 at the level of threedigit codes.

Beginning in 1979, a systematic sample of 10 percent

of discharges was drawn in each hospital within the

scope of GHMS, The sampling frame is the hospital’s

admission book. If the terminal digit of the patient’s

hospital number is a 6, the patient is included in the

sample. Exceptions are patients in psychiatric units,

who are excluded, and females admitted for delivery,

who are excluded unless their delivery is complicated

or other conditions arise that lengthen their hospital

stay (see appendix II). Newborn infants are not listed

in the admission book unless they have a condition

that requires treatment during their hospitalization,

Data are collected on all patients in psychiatric hospitals

in a separate psychiatric study, and information on

every tenth discharge from the nonpsychiatric units

isreported to the GHMS.

A statistical form is completed for each patient included

in the GHMS sample. The nonmedical information

is filled in by the hospital administrative staff at the

time the patient is admitted. The medical data are

recorded and coded by the patient’s physician and

confirmed by the ward’s head physician or a physician

specially appointed to review all the hospital’s forms.

The medical records department inserts the discharge

date and patient’s length of stay after discharge. Each

month, hospitals send completed forms and a list of

the sequential numbers in their admission books to

the central hospital in the Province for review. The

forms are then forwarded to the National Institute of

Hygiene, where they are transferred to computer files

for editing and processing.

The statistical form completed for each patient in the

sample includes items for patient identification, such

as the patient’s number from the admission book, admission and discharge dates and length of stay, and

identification numbers for the hospital and Province

(figure II). Patient characteristics recorded include sex,

date of birth and age, type of residence (urban or

rural), place of residence, and occupational activity.

The medical information (figure III) consists of the

principal diagnosis indicated by the physician in the

discharge summary, the number of times the patient

was hospitalized during the year, and for deaths, the

underlying cause of death according to the death certificate and autopsy report.

The diagnoses and causes of death reported for patients

in the sample were assigned three-digit codes according

to the Ninth Revision, International Classification of

Diseases (ICD-9) (World Health Organization, 1977),

A list of references follows the text.
Form AoL3roved: ,. O,M. B, No. 0937-0004

CONFIDENTIAL - All !nformatlon which would perm!t !denthcat!on of an mdwduai or of an eslablmhment WIII be held confldentlal, WIII be used only

by persons engaged In and for the purposes of the survey, and WIII not be d!sclosed or released to other persons or used for any other DurQose

y.02HDS-l DEPARTMENT OF HEALTH ANO HUMAN SERVICES

U S PUeLIC HEALTH SERVICE

NATIONAL CENTER FOR HEALTH STATISTICS

MEDICAL ABSTRACT – NATIONAL HOSPITAL DISCHARGE SURVEY

1. PATlENT IDENTIFICATION Month Dav Year

l. Hospital number, .,, . . . . . . ..l 4. Date ofadmlsslon ml- ~1- ~]

2, HDSnumber, .,, ,,. .,. .,1. ,l 5. Date of discharge [7- ~-~

3. Medical record number 6. Residence ZIP code I i

I

1. PATlENT CHARACTERISTICS Units 1D Years

Month Day Year 8. Age (Complete only If dare of

m{ 2D Months

7. Date of birth ~---~

b!rthnotgwen) . . . .

3U Days

9. Sex (Mark (X) one)

I

I

I ❑ Male 2L–J Female I ~ Not slated

10. Race 1 lo White J flAmerrcan i“dla n/Alaskan Nauve 5 ~_l Other (Spectfy)

~ 2Cl Etlack 4 U Asian/Paclflc Islander ~ [~ Not stated

I

11,Ethnicity (Mark (X) one) I I D H,spemc ongm ?~Non. H6pantc ~L.j NOI staled

12. Marital status ( I ❑ Married 3 ~ Widowed 5 [.; Separa!ed

(Mark (X) one) ~ 2G Smglc ~ ;.! DlvOrced D ~ Not stated

13.Expected source(s) of payment Prmcnpal Other addmonai 14. Status/Disposition of patient

{Mark one only) sources

[Mark accordmglyl

(Mark (X) appropriate box(es))

{

1.Workmen’s Compensation •1

status Disposition

Z. Medicare :

, ~ Alive ● a. ~ Romme d,scharge/

Government 3. Medlcatd

discharged home

sources .: ❑

4. Title V D ❑

b. D Left against med!cal adwce

5. Other government payments ❑ ❑

c. ❑ Discharged, transferred to

another short-tarm hospital

(

6. Wue Cross

Private ❑ c1

sources 7. Other private or commercial

d. ❑ Discharged, transferred to

❑ ❑

long-term care mstltutlon

insurance

{

8. Self pay

Other

❑ o, ❑ O,sposmon not stated

9. Nocharge

sources ..: c!

10.Other [Spec/fy) ‘cl •1

z a D!ed

❑ NO source of payment indicated 3 ❑ Status not stated

:. FINAL DIAGNOSES

Principal:

Other/additional:

—

—

❑ See reverse s!de

), SURGICAL AND DIAGNOSTIC PROCEDURES D;;;

Month Year

Principal: m-m-m

Other/addltlonal: m-m-m

m-m-m

— m-m-m

DNONE ~ See reverse side

;ompleted by I Date

Figure L Medical abatraot for the National Hospital Discharge Survey

69
Formularz Mz/SZp-11 A. Nr ksi@ gh5wnej 11111 .— —

KARTA STATYSTYCZNAB- Przyj?ty..........dzeim.a lg---ro

SZPITALNA OG(!)LNA cm ~ ypisany ........................................................ 19............r.

dla doroslych, mlodziefiyl dzieci dzieri,’m-c

Piecz@ szpitala

D. Liczba dni leczenia 1111

[’,’,’

Wpisa6 symbol ‘

lub znak x

Wpisa6 symbol

lub znak x_

6. Miejsce stalego zamieszkania . .

I)

1. Numer szpitala

—. — 2)

1

1) a). miasto ................................................................................

2. Wojew6dztwo poloienia szpitala —.

b) gmina ................................ ... ........... ................................... . 2

c) zagranica ........................................................................... 3/

3. Nazwisko ...............................................................................

&!!_~’

‘“ ~1-K\21 imi~ ..:....................................................................................... ..... cl+

1) 4)

d) wojew6dztwo .——

4. Data urodzenia: 3) zamieszkania ... ........... ...............................................

.—— HI

dzien ,,..,.,.!...,...... m-c .................... rok 19................

5. Wick chorego: 2)- 7. Stm.rnek do pracy 2) s) —___

a) prmizej 1 m-ca (noworodek) 11

——

.— a) czynny zawociowo -.11.—

b) 1—11m-cy i 30 dni (niemowl~) 2

——I b) bierny zawodowo 21

31 c) -- .— I

powyiej 1 roku —— c) cudzoziemiec ——31 J

Wpisat odpowiedni symbol 4) Dla cudzoziemc6w wpisad symbol ,,00”

Wpisa6 znak ,,X” 5) Rolnik~w w Wieku 1(+7’0 lat nale~y traktowa~ j~ko

Wpisa6 dwie ostatnie cyfry roku urodzenia pracuj~cych (czynnych zawodowo)

TRANSLATION: A. Admission number. S. Admission date. C. Diecharge date. D, Length of stay. E. Sex, 1. Hospital number. 2, Province of hospital. 3. Patient’s name. 4. Date of

birth (day, month, year). 5. Age a) Less thsn 1 month (newborn), b) 1 month-l 1 months 30 days (infant), c) 1 year or more. 6, Patient’s place of reaidervx a) name of town, b)

name of rural area (county), c) name of country if foreigner, d) province. 7. Occupational activity a) active, b) nonactive, c) foreigner.

F~ure II. Front of medical abstract for the Polish General Hospital Morbiity Study

Characteristic United States Poland

Missing data In 1980, the age ancVorsex of the patient were missing

from the face sheet of the medical record in fewer

than 0.25 percent of cases. When these items were

missing, imputations were made by assigning the patient an age ancVor sex consistent with the age or

sex of other patients with the same diagnostic code.

In the rare instances when dates of admission or discharge could not be obtained, a length of stay was

imputed by assigning a length of stay characteristic

of other patients of the same age.

All statistical forms are checked for completeness on

the hospital, regional, and central levels. Missing information is obtained from the hospital records, and hospital records are consulted when errors are found in

the data during the editing process. Checks are also

made to assure that the sample is complete. All patients

with admission numbers ending in 6 must be accounted

for. The hospital must submit a statistical form or

notify the regional and central authorities that the patient was not within the scope of the survey (for example, the patient was on a psychiatric unit, was a maternity patient, or was not discharged during the calendar

year).

70
—.——

& C’horalxs zasndnicza ‘v:g rozpoznania kliniw.nego .,.................. ...... ,,,,................. ................ .... ........

.,, ..............................................................................................

,. .. . .................................................................

..................... .............................................................

..............................................................................................

!?. PCI mz kttmy przebywa w szpitalu w dan]’m roku kalendarzowyrn wg daty wYpisu niezaleimie od przyczyny (choroby)

.—

%pisad symbo.

lub znak x

1) __. — .——,

II i;

———1!. .-

6)

——

I

I

. —.

10. przyczyna zgrmu wyj<ciowa wg karty

zgonu . . .. .. ... ............ .............................

. . .... . ..........................

. . ...... ...... .. . . .

...................... . . ........ . ..............

,. ..... .....................................................

Pieczatka i po.drds leka.rza

wypelniajacego karte

11. Rozpoznanie sekcyjne przyczyny zgonu

. ................. ............. .........................

Wpisa6 symbo

—lub znak x.— ——

1) 7)

-— ----

!–;

I

I

ill

1) 7) 8)

—.—II

Wpisad }iukq wslmazujrm kt6r.v to jest pobyt “’)

iejscowcx!f% ........... ............... ............. dnia . ... . ... 19..—4. 8)

,Graf. Z-d F?r If MJ#78 LO@MM

ISZP-11 wYdawk AW’de~ W-WRIBema wa ~=” ~lo~a

Dla os6b wypisanyoh ze szpitala w kratki nale2y

w.st+awib ,,XX. X”

Je.41i sekcj.i nie bylo lub nie uzyskano jej wynik6w

naleiy w kratki wpisad symbol ,,000”

TRANSfATION: S. Principal diagnoais accerdlng to the discharge summary. 9. Number of times in any hospital during the year regardless of the diagnosis. 10. Underlying cause of

death according to death certificate-seal and signature of physician responsible for patient care; seal and signature of physician in charge of ward. 11. Cause of death according to

autopay raporl-signature of patholcgiat.

F~ure Ill. Back of medal abstract for the Polish General Hospital Morbid@ Study

Characteristic United States Poland

Release of data Annual reports of data from the survey are published

by NCHS in Advance Data and in Vital and Health

Statistics, Series 13, These reports update data on hospital utilization, diagnoses, and procedures, by characteristics of patients and hospitals. Special reports are

also published on selected topics, such as expected

source of payment, hospital use by children, and diagnosis-related groups (DRG’s). Unpublished data from

the survey are available on request from the NCHS

Division of Health Care Statistics, and data for 1970

and subsequent years are available on public use tapes.

Data from the GHMS are not routinely published.

Standard tables are tabulated for the Ministry of Health

and Social Welfare each year. These tables present

the numbers of and rates for patients discharged and

their average lengths of stay by diagnosis, sex, age,

and type and place of residence. Separate tabulations

of these data for each Province are also prepared.

The data are available for special

Department of Medical Statistics,

of Hygiene.

analysis from the

National Institute

71
Appendix II

Technical notes on methods

Characteristic United States Poland

Estimation Statistics produced by the National Hospital Discharge

Survey (NHDS) are derived using a complex estimating

procedure. The basic unit of estimation is the sample

inpatient discharge abstract. The estimating procedure

used to produce essentially unbiased national estimates

in NHDS has three principal components: inflation

by reciprocals of the probabilities of sample selection,

adjustment for nonresponse, and ratio adjustment to

fixed totals. These components of estimation are described in appendix I of two earlier publications

(NCHS, 1967a, 1967b).

Sampling error The standard error isthe sampling variability that occurs

by chance because only a sample, rather than an entire

universe, is surveyed. The relative standard error of

an estimate is obtained by dividing the standard error

by the estimate itself and is expressed as a percent

of the estimate. The relative standard errors applicable

to estimates of patients discharged or diagnoses are

shown in figure IV. Relative standard errors for estimates of patient care days are shown in figure V.

Measurement As in any survey, NHDS data are subject to reporting

error and processing errors due to nonresponse. The reliability of the abstracting and coding of NHDS data have

been studied by the Institute of Medicine (IOM). The

dates of admission and discharge, as well as patient’s

age, race, marital status, and disposition, were found

to be highly reliable. The reliability of data on diagnoses and procedures was found to vary by level of

coding specificity. Reliability increased when codes

were condensed from four to three digits and was

highest for codes grouped into the major diagnostic

categories. A detailed account of these and other findings from the IOM study has been published (Institute

of Medicine, 1980).

A list of references follows the text.

National estimates can be obtained from the data collected in the General Hospital Morbidity Study

(GHMS) by multiplying the numbers in the sample

by 10.

The relative standard errors for data from the GHMS

are shown for patients discharged or for diagnoses

in figure VI. Relative standard errors for estimates

of patient care days are shown in figure VII.

The lower discharge rate for infants under 1 year in

Poland than in the United States suggested that they

may have been underreported in the GHMS. Beginning

in 1984, females admitted to Polish hospitals for delivery were included in the study whether the delivery

was normal or complicated. Beginning in 1985, each

time a female with a delivery was included in the

sample (that is, had an admission number ending in

6), her newborn infant was also included, regardless

of health status. Using this procedure, the total discharge rate for sick newborn infants did not change,

but the rate of discharge for infants with perinakd

conditions was reported to be 81 percent higher in

1985 than in 1980. Further, the discharge rate reported

for complications of pregnancy, childbirth, and the

puerperium was 20 percent higher for females 1544

years in 1985 than in 1980, even though the number

of births increased by only 1 percent from 1980 to

1985.

72
50

40

30

20

10

0

50

40

30

20

10

0

A 2 3 4 56789

A

23 456789

A

2 3 4 5 6789

A

2 3 456789

A

2 3 456789

A

1 10 100 1,000 10,000 100,000

Sze of estimate in thousands

EXAMPLE As shown in fable 4, the U.S. dkCfW9e rafe for cfi*teS melfitUS iS 2.9 Par 1,000 POPUkdiOn. The number of discharges for diabetes is approximately a54,000 (2.9 times the population in thousands, 225,552). The relative standard

error of this estimate, as read from the cuwe, is afWOximateW 6.2 Per~nt. The standard error of the discharge rate is thus 0.18 (8.2 percent of 2.9).

FUure IV. Appmxhnate refatfvestandard errora for number of patients dwharged or for dmgnose= United State~ 19S0
50 )

I i I

r

Illil

fr“

6

--l

-

. -

- 50

1

40

30

20

10

0

40 ? m

-1 ,I

30 t 1ml-l

t

I 1 I I I I II

I

, , , , , , ,

t

20 t=&

I

1 r 1 1-

EII 10

0

2 3 456789

A

23 4 56789

A

2 3 4 56789

A

23 456789

A

2 3 456789

A

10 100 1,000 10,000 100,000 1,000,000

size Of estimate in thousands

EXAMPLE: As shown in table M, the rate of patient care days for U.S. patients 15-24 yeara of age is 579 per 1,000 population, The number of patient care days is approximately 24,089,000 (579 times the population 15-24 years in thousands,

41,605). The relative standard error of this estimate, as read from the cuwe, is approximately 4.9 percent. The standard error of the rate of patient care daya ia thus 2S (4.9 percent of 579).

Fgure V. Approximate relative standard errora for number of patient sare days United States, 1980
10

9

8

7

6

5

4

3

2

1

0

A 23 456789

A

23 456789

A

2 3 4 56789

A

2 3 4 56789

A

2 3 456789

A

1 10 100 7,000 10,000 100,000

size Of estimate in thousands

EXAMPLE As shown in tsble CC, the Polish discharge rste for patients 45-64 years of age with neoplasma is 13.5 per 1,000 population. The number of discharge for neoplasma is approximately 96,6oO (13.5 times the population 45-64 years

in ihouaands, 7,155). The relative standard ertor of this estimate, as read from the curve, ia approximately 0,9 percent. The standard error of the discharge rate is thus 0.12 (0,9 percent of 13.5),

Fgure Vi. Approximate relative standard errora for number of patients discharged or for diagnoses: Poland, 1980
17

16

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

0

11 I 1 [ I 1 I I t 1 1 m 1 t 1 1 1 1 I 1 1 1

m I I I 1 I 1 Ill

\ I

I

ml , I , , , t I 1 1 1 111

\ I I I I 1 I II

l\ I I I I I 111

I

I* I I I I I I Ill

I

1 m 1 1 1 I 1 1 1 u

[

I n I I [ [ Ill

I

I 1 m I I I I II

t

I

m r m 1 1 , u

i

23 456789

A

2 3 456789

A

2 3 4 56769

A

2 34

-17

- 16

- 15

- 14

- 13

- 12

- 11

- 10

- 9

.

- 8

- 7

- 6

- 5

- 4

- 3

- 2

- 1

- 0

1 10 100 1,000

Size of estimate in thousands

EXAMPLE As shown in table 9, the Polish rate of patient care days for patients 65 years of age and over with a diagnosis of cataract is 51.0 per 1,000 population. The number

of patient care days for cataract la approximately 163,500 (51.0 times the population 65 years and over in thousands, 3,598). The relative standard error of this estimate, as read

from the curve, Is approximately 1.2 percent. The stenderd error of the rate of patiant care daya ia thus 0.6 (1.2 percent of 51.0).

1

Figure W. Approximate relative standard errors for number of patient care days Poland, 1960

76
Characteristic United States Poland

Presentation Based on consideration of the complex sample design

of estimates of NHDS, estimates derived from a sample of fewer

than 30 records are not reported. Such estimates are

replaced in the tables by an asterisk (*). Estimates

based on a sample of 30-59 abstracts are reported,

but should be used with caution. These estimates are

preceded by an asterisk (*) in the tables.

Computation The population estimates used to compute hospital use

of rates rates, shown in detailed table 1, are for the civilian

population on July 1, 1980. Rates for infants under

1 year of age were calculated using the number of

live births in 1980, which was 3,612,258 for both

sexes, 1,852,616 for males, and 1,759,642 for females.

Death rates were computed using the resident population as enumerated in the census on April 1, 1980.

The population estimates are consistent with Series

P-25 of Current Population Reports, by the U.S. Bureau of the Census.

Tests Of The determination of statistical inference was based

significance on the two-tailed t-test with a critical value of 2.576

(0.0 1 level of significance). Terms relating to differences, such as “higher” and “less,” indicate that differences were statistically significant. Terms such as

“similar” and “no difference” mean that no statistically

significant difference was found between the estimates

compared. A lack of comment does not necessarily

mean that the difference was tested and found not

to be significant.

All estimates from the GHMS are presented, except

those with a relative standard error of 30 percent or

more, which are replaced in the tables with an asterisk

(*).

The population estimates used to compute rates, shown

in detailed table 1, are for the resident population

on June 30, 1980. Rates for infants under 1 year of

age were calculated using the number of live births,

which was approximately 692,000 for both sexes—

355,000 for males and 336,000 for females. These

estimates were obtained from the Polish Central Statistical OffIce.

The same procedure was followed for comparison of

Polish estimates and for comparison of Polish with

U.S. estimates as is described for comparison of U.S.

estimates.

77
Appendix Ill

Definitions of terms

Term United States Poland

Age

Average length

of stay

Complicated

delivery

Diagnosis

Age refers to the age of the patient on the birthday

prior to admission to the hospital inpatient service.

The average length of stay is the total number of

patient days accumulated at the time of discharge by

patients discharged during the year divided by the

number of patients discharged.

A delivery is complicated if there is any abnormality

or complication or any mention of fetal manipulation

or use of instrumentation. A delivery of multiple gestation is considered complicated. Patients who have a

diagnosis of normal delivery but also one or more

secondary diagnoses are considered to have a complicated delivery. Complicated deliveries are included

in this report.

A diagnosis is a disease or injury (or some factor

that influences health status and contact with health

services) listed by the attending physician on the patient’s medical record. A maximum of seven diagnoses

can be abstracted from the face sheet (summary sheet)

of the medical record for the NHDS, but only the

principal diagnosis (or the diagnosis listed first, if a

principal diagnosis is not identified) is used in this

report. The principal diagnosis is the condition established after study to have been chiefly responsible

for occasioning the admission of the patient to the

hospital for care. The diagnosis is assigned a code

of up to five digits according to the International Classification of Diseases, 9th Revision, Clinical Mod@ation (ICD-9-CM) (U.S. Public Health Service and

Health Care Financing Administration, 1980). In this

report, the number of diagnoses is equivalent to the

number of discharges.

A discharge is the formal release of a patient by a

hospital: that is, the termination of a period of inpatient

hospitalization by death or by disposition to the place

of residence, a nursing home, or another hospital.

The terms “discharge” and “patient discharged” are

used synonymously.

For patients under 1 year of age, age refers to age

at the time of admission, which is recorded as either

under 1 month (newborn) or 1 month to 11 months

30 days (infant). The ages of patients 1 year and over

are computed by subtracting the year of birth from

the year of hospitalization.

The definition isthe same as in the United States.

A complicated delivery involves complications or other

conditions that lengthen hospitalization. Complicated

deliveries are included in this report.

A diagnosis is a disease or injury (or some factor

that influences health status and contact with health

services) regarded by the patient’s physician as the

principal reason for the hospitalization. For patients

discharged dead, the underlying cause of death is considered the diagnosis. The diagnosis is assigned a threedigit code according to the Ninth Revision, International Classification of Diseases (World Health Organization, 1977). As for the United States, the number

of diagnoses is equivalent to the number of discharges

in this report.

The definition is the same as for the United States.

As in the NHDS, transfers from one ward to another

within the same hospital are not considered discharges.

A list of references follows the text.

78
Term United States Poland

Discharge

rate

Fatality

Fatality

rate

Hospital

Newborn infant

Normal

delivery

Patient care

days

Population

Rute of patient

care days

For patients I year of age and over, the ratio of the

number of hospital discharges during the year to the

number of persons in the civilian population determines

the discharge rate. For infants under 1 year of age,

the number of live births during the year rather than

the population was used to compute the discharge rate.

A fatality is an inpatient whose hospitalization is terminated by death.

The ratio of the number of patients discharged dead

during the year to the total number of discharges is

the fatality rate.

Short-stay general and specialized hospitals have six

or more beds and an average length of stay of less

than 30 days. Federal hospitals and hospital units of

institutions are not included.

A newborn infant is defined as a patient admitted

to the hospital by birth. Newborn infants are not included in this report unless they were sick.

A normal delivery is a spontaneous cephalic delivery

(that is, presentation of the child head first and delivery

of the child without external aid). No mention is made

of any abnormality or complication, and the single

ICD-9-CM code of 650 is assigned to the patient.

Normal deliveries are not included in this report.

The total number of days of inpatient hospital care

accumulated at the time of discharge by patients discharged during a year constitutes patient care days.

A stay of less than 1 day (patient admission and discharge on the same day) is counted as 1 day in the

summation of total patient care days. For patients admitted and discharged on different days, the number

of patient care days is computed by counting all days

from (and including) the day of admission to (but

not including) the day of discharge.

The civilian population on July 1, 1980, is the resident

population excluding members of the Armed Services.

The estimate is based on the 1980 census and ongoing

surveys of the U.S. Bureau of the Census. The number

of live births is the number reported for 1980.

For patients 1 year of age and over, the rate of patient

care days is the ratio of the number of days of hospitalization accumulated at the time of discharge by patients

discharged during the year to the number of persons

in the civilian population on July 1. For infants under

1 year, the number of live births rather than the population was used to compute the rate of patient care days.

The definition is the same as for the United States,

except that the resident population on June 30 was

used to calculate dkcharge rates for patients over 1

year of age.

The definition is the same as for the United States.

The definition is the same as for the United States.

General and specialized hospitals are operated by the

Ministry of Health and Social Welfare and the Ministry

of Transportation. None of these hospitals is excluded

because of size or length of stay. Psychiatric units

and the few hospitals of the Ministries of National

Defense and of Internal Affairs and Justice are not

included.

Infants under 1 month of age at the time of admission

are considered newborn infants. They are not included

in this report unless they were sick.

A normal delivery is one without complications or

other conditions that lengthen hospitalization. Normal

deliveries are not included in this report.

The definition is the same as for the United States.

The resident population on June 30, 1980, is based

on the 1978 census, birth and death registers, and

migration data. The number of live births is one-fourth

of. the number of live births in 1979 plus three-fourths

of the number of live births in 1980.

The definition is the same as for the United States

except that the resident population on June 30 was

used to calculate the rate of patient care days for patients

1 year of age and over.

79
Term United States Poland

Sick newborn Sick newborn infants have a diagnosis in addition to Newborn infants are defined as sick if they have condiinfant the designation of single or multiple birth (ICD-9-CM tions that require treatment during their hospitalization.

codes V30-V39). Sick newborn infants are included Sick newborns are included in this report.

in this report.

80
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Vital and Health Statistics

series descriptions

SERIES 1.

SERIES 2.

SERIES 3.

SERIES 4.

SERIES 5,

SERIES 10.

SERIES 11.

SERIES 12.

SERIES 13.

Programs and CoflectiorrProcedures-Reports describing the

general programs of the National Center for Health Statistics

and its offices and divisions and the data collection methods

used. They also include definitions and other material necessary

for understanding the data.

Data Evaluation and Methods ResearcHtudies of new statistical methodology including experimental tests of new survey

methods, studies of vital statistics collection methods, new analytical techniques, objective evaluations of reliability of collected

data, and contributions to statistical theory. Studies also include

comparison of U.S. methodology with those of other countries.

Analytical and Epidemiobgbal Studiie-Reports presenting

analytical or interpretive studies based on vital and health statistics, canying the analysis further than the exposito~ types of

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Documents and Committee Reports-Final reports of major

committees concerned with vital and health statistics and documents such as recommended model vital registration laws and

revised birth and death certificates.

comparative Interrtatiinal Vtal and Heafth Statistics Report~Analytical and descriptive reports comparing U.S. vital

and health statistics with those of other countries.

Data From the National Health Interview Survey-Statistics

on illness, accidental injuries, disability, use of hospital, medical,

dental, and other services, and other health-related topics, all

based on data collected in the continuing national household

interview survey.

Data From the National Heafth Examination Survey and the

Natbnal Haatth and Nutdtion Examination Survey-Data from

direct examination, testing, and measurement of nationai samples

of the civilian noninstitutionalized population provide the basis

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flatsFrom the Institutionalized Po@atiorr Surveys-Discontinued in 1975. Reports from these surveys are included in Series

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Data on Heatth Resources Utilb!atiorl+3tatistics on the utilization of health manpower and facilities providing long-term care,

ambulatory care, hospital care, and family planning services.

SERIES 14.

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SERIES 21.

SERIES 22.

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health occupations, hospitals, nursing homes, and outpatient facilities.

Data From Special Surveys-Statistics on health and heaithrelated topics collected in special surveys that are not a pafi

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Data on Mortetii-Various statistics on mortality other than

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Date on Natefii, Marriage, and Divorce-Various statistics

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variables; geographic and time series analyses; studies of fertility;

and statistics on characteristics of births not available from the

vital records based on sample surveys of those records.

Date From the National Mortality and Natality Surveye-Discontinued in 1975. Reports from these sample surveys based

on vital records are included in Series 20 and 21, respectively.

Data From the National Survey of Family Growth-statistics

on fertility, family f&mation and dissolution, family planning, and

related maternal and infant health topics derived from a periodic

survey of a nationwide probability sample of women 15-44 years

of age.

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