{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:03:08Z","timestamp":1784286188441,"version":"3.55.0"},"reference-count":29,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Background\/Objectives: Chronic non-communicable diseases remain one of the main public health problems. Increasing multimorbidity and the importance of health literacy (HL) emphasize the need for a comprehensive assessment of health indicators. The aim of this study was to assess the main health indicators of the Lithuanian population and trends in the use of healthcare services and to discuss the relevance of these indicators in the context of HL, based on the links between HL and these indicators described in the scientific literature. Methods: A retrospective longitudinal descriptive study was performed using publicly available Lithuanian population health statistics of 2005\u20132024. Mortality, morbidity, avoidable hospitalizations, subjective health assessment, and utilization of healthcare services and preventive programs were analyzed using descriptive statistical analysis. HL was not directly measured but was used as a conceptual framework for interpreting the findings. Results: In Lithuania, the highest mortality rate is due to cardiovascular diseases (CVDs) (~50.8%). CVD and infectious diseases also dominate the structure of avoidable hospitalizations, and their rates vary greatly across municipalities, being higher in less urbanized areas. The assessment of the population\u2019s health is improving over time, but gender differences remain in the use of healthcare services and preventive programs. Conclusions: The findings demonstrate a high burden of chronic diseases and regional disparities in healthcare utilization in Lithuania. HL may provide a useful context for interpreting these findings, although it was not directly assessed. Future studies should directly evaluate HL and its association with health indicators in the Lithuanian population.<\/jats:p>","DOI":"10.3390\/clinpract16070134","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T09:00:52Z","timestamp":1784278852000},"page":"134","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare Indicators in Lithuania: A Descriptive Analysis of Their Contextual Relevance to Health Literacy"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0184-9204","authenticated-orcid":false,"given":"Sonata","family":"\u010cerkauskait\u0117","sequence":"first","affiliation":[{"name":"Healthcare Research Center, SMK College of Applied Sciences, Vilties St. 2, LT-46326 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Liepinaitien\u0117","sequence":"additional","affiliation":[{"name":"Healthcare Research Center, SMK College of Applied Sciences, Vilties St. 2, LT-46326 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref_1","unstructured":"GBD 2023 Disease and Injury and Risk Factor Collaborators (2025). Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990\u20132023: A systematic analysis for the Global Burden of Disease Study 2023. Lancet, 406, 1873\u20131922."},{"key":"ref_2","unstructured":"OECD European Observatory on Health Systems and Policies (2023). Lithuania: Country Health Profile 2023. State of Health in the EU, OECD Publishing."},{"key":"ref_3","unstructured":"OECD (2025). The State of Cardiovascular Health in the European Union, OECD Publishing."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Ferede, Y.M., Erlandsson, K., Gebrie, M.H., Beshah, D.T., Mohammed, O.Y., Azagew, A.W., and Westerbotn, M. (2025). Global prevalence of multimorbidity among people living with type 2 diabetes: A systematic review and meta-analysis. BMC Public Health, 26.","DOI":"10.1186\/s12889-025-25570-3"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Zhong, Y., Qin, G., Xi, H., Cai, D., Wang, Y., Wang, T., and Gao, Y. (2023). Prevalence, patterns of multimorbidity and associations with health care utilization among middle-aged and older people in China. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-15412-5"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"97","DOI":"10.7326\/0003-4819-155-2-201107190-00005","article-title":"Low health literacy and health outcomes: An updated systematic review","volume":"155","author":"Berkman","year":"2011","journal-title":"Ann. Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.11124\/JBISRIR-D-18-00023","article-title":"Effects of health literacy interventions on health-related outcomes in socioeconomically disadvantaged adults living in the community: A systematic review","volume":"18","author":"Stormacq","year":"2020","journal-title":"JBI Evid. Synth."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e48","DOI":"10.1161\/CIR.0000000000000579","article-title":"Health Literacy and Cardiovascular Disease: Fundamental Relevance to Primary and Secondary Prevention: A Scientific Statement from the American Heart Association","volume":"138","author":"Magnani","year":"2018","journal-title":"Circulation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1186\/s13690-022-00886-3","article-title":"Level of health literacy in Latvia and Lithuania: A population-based study","volume":"80","year":"2022","journal-title":"Arch. Public Health"},{"key":"ref_10","unstructured":"Hygiene Institute (2025). Health Statistics of Lithuania, Hygiene Institute. Available online: https:\/\/www.hi.lt\/sveikatos-statistika\/."},{"key":"ref_11","unstructured":"State Data Agency (2026, January 10). Official Statistics Portal, Available online: https:\/\/osp.stat.gov.lt\/."},{"key":"ref_12","unstructured":"Hygiene Institute (2024). Avoidable Hospitalization Rates in Lithuania, 2024, Hygiene Institute. Available online: https:\/\/sam.lrv.lt\/public\/canonical\/1733755205\/26544\/I%C5%A1vengiam%C5%B3%20hospitalizacij%C5%B3%20rodikliai%20Lietuvoje.pdf."},{"key":"ref_13","unstructured":"Rajan, D., Papanicolas, I., Karanikolos, M., Koch, K., Rohrer-Herold, K., and Figueras, J. (2022). Health System Performance Assessment: A Primer for Policy-Makers, WHO Regional Office for Europe."},{"key":"ref_14","first-page":"1","article-title":"Health literacy interventions and outcomes: An updated systematic review","volume":"199","author":"Berkman","year":"2011","journal-title":"Evid. Rep.\/Technol. Assess."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Shahid, R., Shoker, M., Chu, L.M., Frehlick, R., Ward, H., and Pahwa, P. (2022). Impact of low health literacy on patients\u2019 health outcomes: A multicenter cohort study. BMC Health Serv. Res., 22.","DOI":"10.1186\/s12913-022-08527-9"},{"key":"ref_16","unstructured":"World Health Organization (2023). Noncommunicable Diseases, World Health Organization. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/noncommunicable-diseases."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2350","DOI":"10.1016\/j.jacc.2023.11.007","article-title":"Global Burden of Cardiovascular Diseases and Risks, 1990\u20132022","volume":"82","author":"Mensah","year":"2023","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1093\/ije\/dyz078","article-title":"Smoking, drinking, diet and physical activity-modifiable lifestyle risk factors and their associations with age to first chronic disease","volume":"49","author":"Ng","year":"2020","journal-title":"Int. J. Epidemiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1177\/2047487319882821","article-title":"Health literacy is independently and inversely associated with carotid artery plaques and cardiovascular risk","volume":"27","author":"Lindahl","year":"2020","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.jchf.2019.11.007","article-title":"Health Literacy and Outcomes Among Patients with Heart Failure: A Systematic Review and Meta-Analysis","volume":"8","author":"Fabbri","year":"2020","journal-title":"JACC Heart Fail."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1111\/jocn.17669","article-title":"How Nurses\u2019 Interventions Promote Health Literacy in Patients with Non-Communicable Diseases: A Systematic Review","volume":"34","author":"Boumendil","year":"2025","journal-title":"J. Clin. Nurs."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Gao, S., Chakraborty, A.K., Greiner, R., Lewis, M.A., and Wang, H. (2025). Early detection of disease outbreaks and non-outbreaks using incidence data: A framework using feature-based time series classification and machine learning. PLoS Comput. Biol., 21.","DOI":"10.1371\/journal.pcbi.1012782"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1089\/jwh.2011.2876","article-title":"Gender differences in utilization of preventive care services in the United States","volume":"21","author":"Vaidya","year":"2012","journal-title":"J. Women\u2019s Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e045343","DOI":"10.1136\/bmjopen-2020-045343","article-title":"Impact of COVID-19 pandemic on utilisation of healthcare services: A systematic review","volume":"11","author":"Moynihan","year":"2021","journal-title":"BMJ Open"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1016\/j.pec.2016.01.020","article-title":"Health literacy and adherence to medical treatment in chronic and acute illness: A meta-analysis","volume":"99","author":"Miller","year":"2016","journal-title":"Patient Educ. Couns."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1080\/10810730.2020.1761913","article-title":"The Association between Health Literacy and Self-Rated Health Amongst Australian University Students","volume":"25","author":"Storey","year":"2020","journal-title":"J. Health Commun."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.amepre.2020.05.032","article-title":"The Association Between Health Literacy and Self-rated Health Among Residents of China Aged 15\u201369 Years","volume":"60","author":"Nie","year":"2021","journal-title":"Am. J. Prev. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1177\/2374373519895680","article-title":"Patient-Provider Relationships Among Vulnerable Patients: The Association with Health Literacy, Continuity of Care, and Self-Rated Health","volume":"7","author":"Kamimura","year":"2020","journal-title":"J. Patient Exp."},{"key":"ref_29","first-page":"554","article-title":"Factors Affecting the Utilization of Preventive Health Services by Middle-Aged Population: A Scoping Review","volume":"54","author":"Yarifard","year":"2025","journal-title":"Iran. J. Public Health"}],"container-title":["Clinics and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-7283\/16\/7\/134\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T10:03:58Z","timestamp":1784282638000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-7283\/16\/7\/134"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,17]]},"references-count":29,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["clinpract16070134"],"URL":"https:\/\/doi.org\/10.3390\/clinpract16070134","relation":{},"ISSN":["2039-7283"],"issn-type":[{"value":"2039-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,17]]}}}