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The in-hospital mortality following myocardial infarction has decreased substantially over the last two decades in Poland. However, according to the available evidence approximately every 10th patient discharged after myocardial infarction (MI) dies during next 12 months. We identified the most important barriers (e.g. insufficient risk factors control, insufficient and delayed cardiac rehabilitation, suboptimal pharmacotherapy, delayed complete myocardial revascularisation) and proposed a new nation-wide system of coordinated care after MI. The system should consist of four modules: complete revascularisation, education and rehabilitation programme, electrotherapy (including ICDs and BiVs when appropriate) and periodical cardiac consultations. At first stage the coordinated care programme should last 12 months. The proposal contains also the quality of care assessment based on clinical measures (e.g. risk factors control, rate of complete myocardial revascularisation, etc.) as well as on the rate of cardiovascular events. The wide implementation of the proposed system is expected to decrease one year mortality after MI and allow for better financial resources allocation in Poland.

Novel drugs for melanoma provide a significant advantage in survival over classic chemotherapy. Comparative assessment of IPI and VEM indicated no difference, but only immunotherapy-treated patients achieved long-lasting results. Our data on sequential treatment indicate that immunotherapy might be a better option for the first line rather than targeted therapy, but that conclusion requires further studies of the best way to manage the treatment of melanoma patients.

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By disease: ischemic heart disease, 1.9 times or 10 days longer; hypertension 1.3 times or 4 days longer; congestive heart failure, 1.2 times or 3 days longer; and rheumatoid arthritis, 1.4 times or 2 days longer. Obese patients with diabetes and s/p cerebral vascular accident had a shorter LOS (0.8 times or 3 days, and 0.8 times or 4 days respectively). CONCLUSIONS: Obesity increases the LOS for all-cause hospital admissions among patients with various underlying chronic diseases. This may be due to insufficient diagnosis by the primary provider or specialist, inadequate medication dosing (eg, pain management), or inadequate support during an inpatient stay. A proactive health care policy is needed to guide the management of patients with chronic disease who are also obese, with the potential for cost-savings of interventional, pharmaceutical, or surgical treatment of obesity at baseline.