Irina Stirbu - Academia.edu (original) (raw)
Papers by Irina Stirbu
International Journal of Integrated Care, 2013
BMC public health, 2006
The quality of the healthcare system and its role in influencing mortality of migrant groups can ... more The quality of the healthcare system and its role in influencing mortality of migrant groups can be explored by examining ethnic variations in 'avoidable' mortality. This study investigates the association between the level of mortality from 'avoidable' causes and ethnic origin in the Netherlands and identifies social factors that contribute to this association. Data were obtained from cause of death and population registries in the period 1995-2000. We compared mortality rates for selected 'avoidable' conditions for Turkish, Moroccan, Surinamese and Antillean/Aruban groups to native Dutch. We found slightly elevated risk in total 'avoidable' mortality for migrant populations (RR = 1.13). Higher risks of death among migrants were observed from almost all infectious diseases (most RR > 3.00) and several chronic conditions including asthma, diabetes and cerebro-vascular disorders (most RR > 1.70). Migrant women experienced a higher risk of death f...
![Research paper thumbnail of [People with dementia have more contact with their general practitioners: contact with GPs peaks around the time of diagnosis]](https://attachments.academia-assets.com/48277471/thumbnails/1.jpg)
](Nederlands tijdschrift voor geneeskunde, 2014
To investigate how often and why people with dementia and their partners have contact with the ge... more To investigate how often and why people with dementia and their partners have contact with the general practitioner (GP) before and after the diagnosis of dementia. Retrospective cohort study. Patients given the diagnosis of 'dementia' in the period 2006-2011 were selected from patient records of GP practices participating in the NIVEL Primary Care Database; data were also collected from the patients' partners. Patients and their partners were compared with a reference group. The number of GP contacts from 2 years before until 1 year after diagnosis were analysed. There were data on 823 patients with dementia and 184 partners. People with dementia had more frequent GP contacts from 4 months before diagnosis until 8 months thereafter. The mean number of GP contacts was 21.5 for people with dementia versus 17.4 for people without dementia in the total 3-year period. Reasons for more frequent contact were depression, abrasions/scratches/blisters and memory/concentration/ori...
Huisarts en wetenschap, 2011
Journal of Epidemiology & Community Health, 2006
Objectives: To prepare a comprehensive overview of ethnic differences in injury related mortality... more Objectives: To prepare a comprehensive overview of ethnic differences in injury related mortality in the Netherlands and to determine the role of area income and urbanisation degree. Methods: Data for the period 1995-2000 were obtained from the population and cause of death registries. Injury related death rates were compared for persons from Turkish, Moroccans, Surinamese, and Antillean/Aruban origin with rates for the native Dutch population. Results: Compared with the native Dutch population, all ethnic minorities combined had an increased mortality for all injuries together (RR = 1.29). Ethnic minorities experienced a significantly higher risk of death from pedestrian accidents (RR = 1.87), drowning (RR = 2.58), poisoning (RR = 1.76), fire and scalds (RR = 1.95), and homicide (RR = 3.24). Mortality for cyclists (RR = 0.53) and motorcycle drivers (RR = 0.47) was significantly lower among ethnic minorities compared with the native Dutch. Adjustment for area income and urbanisation decreased the mortality risk difference for most of the non-traffic injuries, but showed a difference in risk for car driver and passenger accidents (RR = 1.37). Compared with the native Dutch inhabitants, Surinamese and Antillean/Aruban population had a higher risk of total injury mortality (RR = 1.33 and 1.53 respectively), while Turkish and Moroccans had increased risk only for selected conditions. Inequalities in injury mortality were the highest among children and young adults, but persisted in the age group above 50 years old. Conclusion: Ethnic differences in injury mortality in the Netherlands strongly depended on type of injury, ethnic group, sex, and age. Policies should be aimed at the prevention of high risk injuries among the most vulnerable ages and ethnic groups.
Journal of Epidemiology & Community Health, 2012
To perform the first European overview of educational inequalities in the use of blood pressure a... more To perform the first European overview of educational inequalities in the use of blood pressure and cholesterol screening. Data were obtained on the use of screening services according to educational level from nationally representative cross-sectional surveys in Belgium, Czech Republic, Denmark, Estonia, Finland, Hungary, Italy, Latvia and Lithuania. Screening rates were examined in the preceding 12 months and 5 years, for respondents 35+ years (45+ for women). ORs comparing low- to high-educated respondents were estimated using logistic regression controlling for age. Inequalities in cholesterol screening favouring higher socioeconomic groups were demonstrated with statistical significance among men in four countries, whereby men with higher education were more likely to receive screening, with 1.22 as the highest OR. Among women, a similar pattern was found. Inequalities in blood pressure screening were even smaller and less often statistically significant. Hungary was the only country with higher rates of both types of screening in the low-educated group. In other countries, pro-high inequalities were slightly increased after controlling for self-rated health. All European countries in this study had small educational inequalities in the utilisation of blood pressure and cholesterol screening. These inequalities are smaller than those previously observed in the USA. Further comparative studies need to distinguish between screening for preventive purposes and screening for treatment and control.
International Journal of Cancer, 2006
This is a NIVEL certified Post Print, more info at http://www.nivel.eu Stirbu, I., Kunst, A.E., V... more This is a NIVEL certified Post Print, more info at http://www.nivel.eu Stirbu, I., Kunst, A.E., Vlems, F.A., Devillé, W., Nijhuis, H.G.J., Coebergh, J.W. Cancer mortality rates among first and second generation migrants in the Netherlands: convergence toward the rates of the native Dutch population. mortality among migrants will gradually increase in future years if no specific preventive measurements are taken.
BMC Health Services Research, 2009
Background: Studies on the association between access to health care and household income have ra... more Background: Studies on the association between access to health care and household income have rarely included an assessment of 'forgone care', but this indicator could add to our understanding of the inverse care law. We hypothesize that reporting forgone care is more prevalent in low income groups.
Pharmacoepidemiology and drug safety, Jan 2, 2016
Complex medication management in older people with multiple chronic conditions can introduce prac... more Complex medication management in older people with multiple chronic conditions can introduce practice variation in polypharmacy prevalence. This study aimed to determine the inter-practice variation in polypharmacy prevalence and examine how this variation was influenced by patient and practice characteristics. This cohort study included 45,731 patients aged 55 years and older with at least one prescribed medication from 126 general practices that participated in NIVEL Primary Care Database in the Netherlands. Medication dispensing data of the year 2012 were used to determine polypharmacy. Polypharmacy was defined as the chronic and simultaneous use of at least five different medications. Multilevel logistic regression models were constructed to quantify the polypharmacy prevalence variation between practices. Patient characteristics (age, gender, socioeconomic status, number, and type of chronic conditions) and practice characteristics (practice location and practice population) we...
International Journal of Cancer Journal International Du Cancer, Aug 1, 2007
Inequalities in alcohol related cancers were larger in Southern Europe (Spain, France and Switzer... more Inequalities in alcohol related cancers were larger in Southern Europe (Spain, France and Switzerland) than in Northern Europe.
British Journal of Cancer, Mar 4, 2008
Carme Borrell, et al.. Educational differences in cancer mortality among women and men: a gender ... more Carme Borrell, et al.. Educational differences in cancer mortality among women and men: a gender pattern that differs across Europe.
Inleiding: Pijn in de (lage)rug is een klacht die vaak voorkomt. De opties voor behandeling zijn ... more Inleiding: Pijn in de (lage)rug is een klacht die vaak voorkomt. De opties voor behandeling zijn groot en varieert mogelijk per leeftijdscategorie. Onderzoeksvraag: Wat is de medische consumptie van patiënten die met rugklachten bij de huisarts komen en verschilt dit per leeftijdscategorie (0-17, 18-34, 35-54, 55-74, en 75+ jaar). Methode: Met gegevens van het Landelijk Informatie Netwerk Huisartsenzorg (LINH) (n=83
![Research paper thumbnail of [Gonococci change more quickly than prescribing practices; resistance to frequently prescribed antibiotics]](https://attachments.academia-assets.com/48277460/thumbnails/1.jpg)
](Nederlands tijdschrift voor geneeskunde, 2013
Gonococcal resistance to antibiotics is increasing worldwide. In patients tested in Dutch STI cli... more Gonococcal resistance to antibiotics is increasing worldwide. In patients tested in Dutch STI clinics in 2009, gonococcal resistance to ciprofloxacin was over 50%. Ceftriaxone, a third-generation cephalosporin, has been the first-choice medication since 2004. General practitioners treated 25% of their gonorrhoea patients with ciprofloxacin in 2010. There is a need for up-to-the-minute, dynamic guidelines for treating gonorrhoea as well as the more systematic use of an up-to-date digital prescription system.
British journal of cancer, Jan 11, 2008
We used longitudinal mortality data sets for the 1990s to compare socioeconomic inequalities in t... more We used longitudinal mortality data sets for the 1990s to compare socioeconomic inequalities in total cancer mortality between women and men aged 30-74 in 12 different European populations (Madrid, Basque region, Barcelona, Slovenia, Turin, Switzerland, France, Belgium, Denmark, Norway, Sweden, Finland) and to investigate which cancer sites explain the differences found. We measured socioeconomic status using educational level and computed relative indices of inequality (RII). We observed large variations within Europe for educational differences in total cancer mortality among men and women. Three patterns were observed: Denmark, Norway and Sweden (significant RII around 1.3-1.4 among both men and women); France, Switzerland, Belgium and Finland (significant RII around 1.7-1.8 among men and around 1.2 among women); Spanish populations, Slovenia and Turin (significant RII from 1.29 to 1.88 among men; no differences among women except in the Basque region, where RII is significantly ...
Introduction: Because of variability in published A(H1N1)pdm09 influenza vaccine effectiveness es... more Introduction: Because of variability in published A(H1N1)pdm09 influenza vaccine effectiveness estimates, we conducted a study in the adults belonging to the risk groups to assess the A(H1N1)pdm09 MF59-adjuvanted influenza vaccine effectiveness.
International Journal of Integrated Care, 2013
BMC public health, 2006
The quality of the healthcare system and its role in influencing mortality of migrant groups can ... more The quality of the healthcare system and its role in influencing mortality of migrant groups can be explored by examining ethnic variations in 'avoidable' mortality. This study investigates the association between the level of mortality from 'avoidable' causes and ethnic origin in the Netherlands and identifies social factors that contribute to this association. Data were obtained from cause of death and population registries in the period 1995-2000. We compared mortality rates for selected 'avoidable' conditions for Turkish, Moroccan, Surinamese and Antillean/Aruban groups to native Dutch. We found slightly elevated risk in total 'avoidable' mortality for migrant populations (RR = 1.13). Higher risks of death among migrants were observed from almost all infectious diseases (most RR > 3.00) and several chronic conditions including asthma, diabetes and cerebro-vascular disorders (most RR > 1.70). Migrant women experienced a higher risk of death f...
Nederlands tijdschrift voor geneeskunde, 2014
To investigate how often and why people with dementia and their partners have contact with the ge... more To investigate how often and why people with dementia and their partners have contact with the general practitioner (GP) before and after the diagnosis of dementia. Retrospective cohort study. Patients given the diagnosis of 'dementia' in the period 2006-2011 were selected from patient records of GP practices participating in the NIVEL Primary Care Database; data were also collected from the patients' partners. Patients and their partners were compared with a reference group. The number of GP contacts from 2 years before until 1 year after diagnosis were analysed. There were data on 823 patients with dementia and 184 partners. People with dementia had more frequent GP contacts from 4 months before diagnosis until 8 months thereafter. The mean number of GP contacts was 21.5 for people with dementia versus 17.4 for people without dementia in the total 3-year period. Reasons for more frequent contact were depression, abrasions/scratches/blisters and memory/concentration/ori...
Huisarts en wetenschap, 2011
Journal of Epidemiology & Community Health, 2006
Objectives: To prepare a comprehensive overview of ethnic differences in injury related mortality... more Objectives: To prepare a comprehensive overview of ethnic differences in injury related mortality in the Netherlands and to determine the role of area income and urbanisation degree. Methods: Data for the period 1995-2000 were obtained from the population and cause of death registries. Injury related death rates were compared for persons from Turkish, Moroccans, Surinamese, and Antillean/Aruban origin with rates for the native Dutch population. Results: Compared with the native Dutch population, all ethnic minorities combined had an increased mortality for all injuries together (RR = 1.29). Ethnic minorities experienced a significantly higher risk of death from pedestrian accidents (RR = 1.87), drowning (RR = 2.58), poisoning (RR = 1.76), fire and scalds (RR = 1.95), and homicide (RR = 3.24). Mortality for cyclists (RR = 0.53) and motorcycle drivers (RR = 0.47) was significantly lower among ethnic minorities compared with the native Dutch. Adjustment for area income and urbanisation decreased the mortality risk difference for most of the non-traffic injuries, but showed a difference in risk for car driver and passenger accidents (RR = 1.37). Compared with the native Dutch inhabitants, Surinamese and Antillean/Aruban population had a higher risk of total injury mortality (RR = 1.33 and 1.53 respectively), while Turkish and Moroccans had increased risk only for selected conditions. Inequalities in injury mortality were the highest among children and young adults, but persisted in the age group above 50 years old. Conclusion: Ethnic differences in injury mortality in the Netherlands strongly depended on type of injury, ethnic group, sex, and age. Policies should be aimed at the prevention of high risk injuries among the most vulnerable ages and ethnic groups.
Journal of Epidemiology & Community Health, 2012
To perform the first European overview of educational inequalities in the use of blood pressure a... more To perform the first European overview of educational inequalities in the use of blood pressure and cholesterol screening. Data were obtained on the use of screening services according to educational level from nationally representative cross-sectional surveys in Belgium, Czech Republic, Denmark, Estonia, Finland, Hungary, Italy, Latvia and Lithuania. Screening rates were examined in the preceding 12 months and 5 years, for respondents 35+ years (45+ for women). ORs comparing low- to high-educated respondents were estimated using logistic regression controlling for age. Inequalities in cholesterol screening favouring higher socioeconomic groups were demonstrated with statistical significance among men in four countries, whereby men with higher education were more likely to receive screening, with 1.22 as the highest OR. Among women, a similar pattern was found. Inequalities in blood pressure screening were even smaller and less often statistically significant. Hungary was the only country with higher rates of both types of screening in the low-educated group. In other countries, pro-high inequalities were slightly increased after controlling for self-rated health. All European countries in this study had small educational inequalities in the utilisation of blood pressure and cholesterol screening. These inequalities are smaller than those previously observed in the USA. Further comparative studies need to distinguish between screening for preventive purposes and screening for treatment and control.
International Journal of Cancer, 2006
This is a NIVEL certified Post Print, more info at http://www.nivel.eu Stirbu, I., Kunst, A.E., V... more This is a NIVEL certified Post Print, more info at http://www.nivel.eu Stirbu, I., Kunst, A.E., Vlems, F.A., Devillé, W., Nijhuis, H.G.J., Coebergh, J.W. Cancer mortality rates among first and second generation migrants in the Netherlands: convergence toward the rates of the native Dutch population. mortality among migrants will gradually increase in future years if no specific preventive measurements are taken.
BMC Health Services Research, 2009
Background: Studies on the association between access to health care and household income have ra... more Background: Studies on the association between access to health care and household income have rarely included an assessment of 'forgone care', but this indicator could add to our understanding of the inverse care law. We hypothesize that reporting forgone care is more prevalent in low income groups.
Pharmacoepidemiology and drug safety, Jan 2, 2016
Complex medication management in older people with multiple chronic conditions can introduce prac... more Complex medication management in older people with multiple chronic conditions can introduce practice variation in polypharmacy prevalence. This study aimed to determine the inter-practice variation in polypharmacy prevalence and examine how this variation was influenced by patient and practice characteristics. This cohort study included 45,731 patients aged 55 years and older with at least one prescribed medication from 126 general practices that participated in NIVEL Primary Care Database in the Netherlands. Medication dispensing data of the year 2012 were used to determine polypharmacy. Polypharmacy was defined as the chronic and simultaneous use of at least five different medications. Multilevel logistic regression models were constructed to quantify the polypharmacy prevalence variation between practices. Patient characteristics (age, gender, socioeconomic status, number, and type of chronic conditions) and practice characteristics (practice location and practice population) we...
International Journal of Cancer Journal International Du Cancer, Aug 1, 2007
Inequalities in alcohol related cancers were larger in Southern Europe (Spain, France and Switzer... more Inequalities in alcohol related cancers were larger in Southern Europe (Spain, France and Switzerland) than in Northern Europe.
British Journal of Cancer, Mar 4, 2008
Carme Borrell, et al.. Educational differences in cancer mortality among women and men: a gender ... more Carme Borrell, et al.. Educational differences in cancer mortality among women and men: a gender pattern that differs across Europe.
Inleiding: Pijn in de (lage)rug is een klacht die vaak voorkomt. De opties voor behandeling zijn ... more Inleiding: Pijn in de (lage)rug is een klacht die vaak voorkomt. De opties voor behandeling zijn groot en varieert mogelijk per leeftijdscategorie. Onderzoeksvraag: Wat is de medische consumptie van patiënten die met rugklachten bij de huisarts komen en verschilt dit per leeftijdscategorie (0-17, 18-34, 35-54, 55-74, en 75+ jaar). Methode: Met gegevens van het Landelijk Informatie Netwerk Huisartsenzorg (LINH) (n=83
Nederlands tijdschrift voor geneeskunde, 2013
Gonococcal resistance to antibiotics is increasing worldwide. In patients tested in Dutch STI cli... more Gonococcal resistance to antibiotics is increasing worldwide. In patients tested in Dutch STI clinics in 2009, gonococcal resistance to ciprofloxacin was over 50%. Ceftriaxone, a third-generation cephalosporin, has been the first-choice medication since 2004. General practitioners treated 25% of their gonorrhoea patients with ciprofloxacin in 2010. There is a need for up-to-the-minute, dynamic guidelines for treating gonorrhoea as well as the more systematic use of an up-to-date digital prescription system.
British journal of cancer, Jan 11, 2008
We used longitudinal mortality data sets for the 1990s to compare socioeconomic inequalities in t... more We used longitudinal mortality data sets for the 1990s to compare socioeconomic inequalities in total cancer mortality between women and men aged 30-74 in 12 different European populations (Madrid, Basque region, Barcelona, Slovenia, Turin, Switzerland, France, Belgium, Denmark, Norway, Sweden, Finland) and to investigate which cancer sites explain the differences found. We measured socioeconomic status using educational level and computed relative indices of inequality (RII). We observed large variations within Europe for educational differences in total cancer mortality among men and women. Three patterns were observed: Denmark, Norway and Sweden (significant RII around 1.3-1.4 among both men and women); France, Switzerland, Belgium and Finland (significant RII around 1.7-1.8 among men and around 1.2 among women); Spanish populations, Slovenia and Turin (significant RII from 1.29 to 1.88 among men; no differences among women except in the Basque region, where RII is significantly ...
Introduction: Because of variability in published A(H1N1)pdm09 influenza vaccine effectiveness es... more Introduction: Because of variability in published A(H1N1)pdm09 influenza vaccine effectiveness estimates, we conducted a study in the adults belonging to the risk groups to assess the A(H1N1)pdm09 MF59-adjuvanted influenza vaccine effectiveness.