Variation Of Comorbidities In Romania At The Lau2 Level, A Cross-Sectional Analysis

Introduction: Romania is still lagging behind in regard to main health indicators when compared to average values of European Union countries with a disproportionate share of disability due mainly to chronic diseases. There are tools available to quantify the negative health outcomes due to comorbidities, and among them the Elixhauser Index was found to be the best to predict health care utilization and expenditures. Objective: To measure the extent of comorbidities at the LAU2 level using the Elixhauser Index. Methods: All relevant comorbidities at the local level were summed-up using the Elixhauser index. This was followed with standardization by population number and then by 10-year age group. Due to large oscillation from one year to another during the 2014-2016 period, the geometrical mean was computed, then few measures of the variation such as decile ratio and variation coefficient were also computed. Results: High variability of comorbidities is observed at the local level (LAU2). Clusters of comorbidities concentration are found near medical university centers and localities in non-MUC districts located at the furthest distance from the county residential center. Conclusions: Several factors such as proximity to referral hospitals, increased accessibility to these hospitals due to low control at primary healthcare levels, availability of diagnostic technologies and different diagnostic coding patterns, as well as isolation and unavailability of primary health care services are listed as possible factors that can explain these results. Classification-JEL: