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001-es BibID:	BIBFORM080870
035-os BibID:	(cikkazonosító)e027296
Első szerző:	Kovács Nóra (népegészségügyi szakember)
Cím:	The impact of general practitioners' gender on process indicators in Hungarian primary healthcare: a nation-wide cross-sectional study / Nóra Kovács, Orsolya Varga, Attila Nagy, Anita Pálinkás, Valéria Sipos, László Kőrösi, Róza Ádány, János Sándor
Dátum:	2019
ISSN:	2044-6055 2044-6055
Megjegyzések:	Objectives The objectives of our study were (1) to investigate the association between gender of the general practitioner (GP) and the quality of primary care in Hungary with respect to process indicators for GP performance and (2) to assess the size of the gender impact. Study design A nation-wide cross-sectional study was performed in 2016. Setting and participants The study covered all general medical practices in Hungary (n=4575) responsible for the provision of primary healthcare (PHC) for adults. All GPs in their private practices are solo practitioners. Main outcome measures Multilevel logistic regression models were used to analyse the association between GP gender and process indicators of PHC, and attributable proportion (AP) was calculated. Results 48% of the GPs (n=2213) were women in the study. The crude rates of care provided by female GPs were significantly higher for seven out of eight evaluated indicators than those provided by male GPs. Adjusted for practice, physician and patient factors, GP gender was associated with the haemoglobin A1c (HbA1c) measurement: OR=1.18, 95%CI (1.14 to 1.23); serum creatinine measurement: OR=1.14, 95%CI (1.12 to 1.17); lipid measurement: R=1.14, 95%CI (1.11 to 1.16); eye examination: OR=1.06, 95%CI (1.03 to 1.08); mammography screening: OR=1.05, 95%CI (1.03 to 1.08); management of patients with chronic obstructive pulmonary disease: OR=1.05, 95%CI (1.01 to 1.09) and the composite indicator: OR=1.08, 95%CI (1.07 to 1.1), which summarises the number of care events and size of target populations of each indicator. The AP at the specific indicators varied from 0.97% (95% CI 0.49% to 1.44%) of influenza immunisation to 8.04% (95% CI 7.4% to 8.67%) of eye examinations. Conclusion Female GP gender was an independent predictor of receiving higher quality of care. The actual size of the gender effect on the quality of services seemed to be notable. Factors behind the gender effect should receive more attention in quality improvement particularly in countries where the primary care is organised around solo practices.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Gender General practitioner PRIMARY CARE Process indicators Quality of care
Megjelenés:	BMJ Open. - 9 : 9 (2019), p. 1-9. -
További szerzők:	Varga Orsolya (1977-) (orvos, jogász) Nagy Attila Csaba (1981-) (megelőző orvostan és népegészségtan szakorvos, epidemiológus) Pálinkás Anita (1988-) (népegészségügyi szakember) Sipos Valéria (1988-) (népegészségügyi szakember) Kőrösi László Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos) Sándor János (1966-) (orvos-epidemiológus)
Pályázati támogatás:	Swiss Contribution Programme SH/8/1 Egyéb GINOP-2.3.2-15-2016-00005 GINOP EFOP-3.6.3- VEKOP-16-2017-00009 EFOP Portugal/Hungary Bilateral Project FCT/NKFIH Egyéb János Bolyai Scholarship of the Hungarian Academy of Sciences Egyéb
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001-es BibID:	BIBFORM080512
035-os BibID:	(cikkazonosító)3153 (Scopus)85071778867 (WOS)000487037500148
Első szerző:	Kovács Nóra (népegészségügyi szakember)
Cím:	Factors associated with practice-level performance indicators in primary health care in Hungary : a nationwide cross-sectional study / Nóra Kovács, Anita Pálinkás, Valéria Sipos, Attila Nagy, Nouh Harsha, László Kőrösi, Magor Papp, Róza Ádány, Orsolya Varga, János Sándor
Dátum:	2019
ISSN:	1661-7827 1660-4601
Megjegyzések:	The performance of general practitioners (GPs) is frequently assessed without considering the factors causing variability among general medical practices (GMPs). Our cross-sectional national-based study was performed in Hungary to evaluate the influence of GMP characteristics on performance indicators. The relationship between patient's characteristics (age, gender, education) and GMP-specific parameters (practice size, vacancy of GP's position, settlement type, and county of GMP) and the quality of care was assessed by multilevel logistic regression models. The variations attributable to physicians were small (from 0.77% to 17.95%). The education of patients was associated with 10 performance indicators. Practicing in an urban settlement mostly increased the quality of care for hypertension and diabetes care related performance indicators, while the county was identified as one of the major determinants of variability among GPs' performance. Only a few indicators were affected by the vacancy and practice size. Thus, the observed variability in performance between GPs partially arose from demographic characteristics and education of patients, settlement type, and regional location of GMPs. Considering the real effect of these factors in evaluation would reflect better the personal performance of GPs.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk primary healthcare
Megjelenés:	International Journal of Environmental Research and Public Health. - 16 : 17 (2019), p. 1-15. -
További szerzők:	Pálinkás Anita (1988-) (népegészségügyi szakember) Sipos Valéria (1988-) (népegészségügyi szakember) Nagy Attila Csaba (1981-) (megelőző orvostan és népegészségtan szakorvos, epidemiológus) Harsha, Nouh (1979-) Kőrösi László Papp Magor Csongor (1978-) (háziorvostan szakorvos) Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos) Varga Orsolya (1977-) (orvos, jogász) Sándor János (1966-) (orvos-epidemiológus)
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001-es BibID:	BIBFORM074749
035-os BibID:	(Scopus)85052505330 (WOS)000445765600044 (cikkazonosító)1835
Első szerző:	Sándor János (orvos-epidemiológus)
Cím:	Healthcare utilization and all-cause premature mortality in Hungarian segregated roma settlements : evaluation of specific indicators in a cross-sectional study / János Sándor, Anita Pálinkás, Ferenc Vincze, Nóra Kovács, Valéria Sipos, László Kőrösi, Zsófia Falusi, László Pál, Gergely Fürjes, Magor Papp, Róza Ádány
Dátum:	2018
ISSN:	1661-7827 1660-4601
Megjegyzések:	Roma is the largest ethnic minority of Europe with deprived health status, which is poorly explored due to legal constrains of ethnicity assessment. We aimed to elaborate health indicatorsfor adults living in segregated Roma settlements (SRS), representing the most vulnerable Roma subpopulation. SRSs were mapped in a study area populated by 54,682 adults. Records of alladults living in the study area were processed in the National Institute of Health Insurance Fund Management. Aggregated, age-sex standardized SRS-specific and non-SRS-specific indicators onhealthcare utilization and all-cause premature death along with the ratio of them (RR) were computed with 95% confidence intervals. The rate of GP appointments was significantly higher among SRS inhabitants (RR = 1.152, 95% CI: 1.136?1.167). The proportion of subjects hospitalized (RR = 1.286, 95% CI: 1.177?1.405) and the reimbursement for inpatient care (RR = 1.060, 95% CI: 1.057?1.064) were elevated for SRS. All-cause premature mortality was significantly higher in SRSs (RR = 1.711, 1.085?2.696). Our study demonstrated that it is possible to compute the SRS-specific version of routine healthcare indicators without violating the protection of personal data by converting a sensitive ethical issue into a non-sensitive small-area geographical analysis; there is an SRS-specific healthcare utilization pattern, which is associated with elevated costs and increased risk of all-cause premature death.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Roma minority legal constraints healthcare utilization health status geographical inequality
Megjelenés:	International Journal of Environmental Research and Public Health. - 15 : 9 (2018), p. 1-13. -
További szerzők:	Pálinkás Anita (1988-) (népegészségügyi szakember) Vincze Ferenc (1987-) (táplákozástudományi szakember, epidemiológus) Kovács Nóra (1989-) (népegészségügyi szakember) Sipos Valéria (1988-) (népegészségügyi szakember) Kőrösi László Falusi Zsófia Pál László Fürjes Gergely Papp Magor Csongor (1978-) (háziorvostan szakorvos) Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos)
Pályázati támogatás:	MTA 11003 MTA MTA 2006TKI227 MTA TÁMOP-4.2.2.AA-11/1/KONV-2012-0031) TÁMOP GINOP-2.3.2-15-2016-00005 GINOP
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001-es BibID:	BIBFORM074305
035-os BibID:	(Scopus)85049535475 (WOS)000445543500094 (cikkazonosító)1388
Első szerző:	Sándor János (orvos-epidemiológus)
Cím:	Association between the General Practitioner Workforce Crisis and Premature Mortality in Hungary : cross-Sectional Evaluation of Health Insurance Data from 2006 to 2014 / János Sándor, Anita Pálinkás, Ferenc Vincze, Valéria Sipos, Nóra Kovács, Tibor Jenei, Zsófia Falusi, László Pál, László Kőrösi, Magor Papp, Róza Ádány
Dátum:	2018
ISSN:	1661-7827 1660-4601
Megjegyzések:	The workforce crisis of primary care is reflected in the increasing number of general medicalpractices (GMP) with vacant general practitioner (GP) positions, and the GPs' ageing. Our studyaimed to describe the association between this crisis and premature mortality. Age-sex-standardizedmortality for 18?64 years old adults was calculated for all Hungarian GMPs annually in the periodfrom 2006 to 2014. The relationship of premature mortality with GPs' age and vacant GP positionswas evaluated by standardized linear regression controlled for list size, urbanization, geographicallocation, clients' education, and type of the GMP. The clients' education was the strongest protectivefactor (beta = ??0175; p < 0.001), followed by urban residence (beta = ??0.149; p < 0.001), and bigger listsize (beta1601?2000 = ??0.054; p < 0.001; beta2001??X = ??0.096; p < 0.001). The geographical localizationalso significantly influenced the risk. Although GMPs with a GP aged older than 65 years (beta = 0;p = 0.995) did not affect the risk, GP vacancy was associated with higher risk (beta = 0.010; p = 0.033),although the corresponding number of attributable cases was 23.54 over 9 years. The vacant GPposition is associated with a significant but hardly detectable increased risk of premature mortalitywithout considerable public health importance. Nevertheless, employment of GPs aged more than65 does not impose premature mortality risk elevation.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk primary health care workforce crisis general practitioner vacancy aging of general practitioners premature mortality
Megjelenés:	International Journal of Environmental Research and Public Health. - 15 : 7 (2018), p. 1388-. -
További szerzők:	Pálinkás Anita (1988-) (népegészségügyi szakember) Vincze Ferenc (1987-) (táplákozástudományi szakember, epidemiológus) Sipos Valéria (1988-) (népegészségügyi szakember) Kovács Nóra (1989-) (népegészségügyi szakember) Jenei Tibor (1963-) (programtervező informatikus) Falusi Zsófia Pál László Kőrösi László Papp Magor Csongor (1978-) (háziorvostan szakorvos) Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos)
Pályázati támogatás:	Swiss Contribution Programme Egyéb MTA 11003 OTKA 2006TKI227 OTKA GINOP-2.3.2-15-2016-00005 GINOP
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