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001-es BibID:	BIBFORM083276
035-os BibID:	(cikkazonosító)19
Első szerző:	Kósa Karolina (népegészségügyi szakember)
Cím:	Health mediators as members of multidisciplinary group practice : lessons learned from a primary health care model programme in Hungary / Karolina Kósa, Cintia Katona, Magor Papp, Gergely Fürjes, János Sándor, Klára Bíró, Róza Ádány
Dátum:	2020
ISSN:	1471-2296
Megjegyzések:	Background A Model Programme of primary care group practices was implemented in Hungary between 2013 and 2017 - where virtually all GPs had worked in single practices - aiming to increase preventive service uptake and reduce inequalities based on a bilateral agreement between the Swiss and Hungarian governments. Group practices employed a wide variety of health professionals as well as support workers called health mediators. Employment of the latter was based on two decades of European experience of health mediators who specifically facilitate access to and use of health services in Roma minority groups. Health mediators had been recruited from local communities, received training on the job, and were tasked to increase uptake of new preventive services provided by the group practices by personal contacts in the local minority populace. The paper describes the contribution of the work of health mediators to the uptake of two new services provided by group practices. Methods Quantitative analysis of depersonalized administrative data mandatorily reported to the Management of the Programme during 43?months of operation was carried out on the employment of health mediators and their contribution to the uptake of two new preventive services (health status assessment and community health promoting programmes). Results 80% of all clients registered with the GPs participated at health status assessment by invitation that was 1.3-1.7 times higher than participation at the most successful national screening programmes in the past 15?years. Both the number of mediator work minutes per client and participation rate at health status assessment, as well as total work time of mediators and participants at community health events showed high correlation. Twice as many Roma minority patients were motivated for service use by health mediators compared to all patients. The very high participation rate reflects the wide impact of health mediators who probably reached not only Roma minority, but vulnerable population groups in general. Conclusion The future of general practices lays in multidisciplinary teams in which health mediators recruited from the serviced communities can be valuable members, especially in deprived areas.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Prevention Inequalities Professions allied to medicine (PAMs) Community health workers Health mediation, Primary health care Health status assessment
Megjelenés:	BMC Family Practice. - 21 : 1 (2020), p. 1-9. -
További szerzők:	Katona Cintia (1991-) (egészségpszichológus) Papp Magor Csongor (1978-) (háziorvostan szakorvos) Fürjes Gergely Sándor János (1966-) (orvos-epidemiológus) Bíró Klára (1970-) (egészségügyi menedzsment) Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos)
Pályázati támogatás:	Swiss Contribution Programme SH/8/1 Egyéb GINOP-2.3.2-15-2016-00005 GINOP
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001-es BibID:	BIBFORM086814
Első szerző:	Sándor János (orvos-epidemiológus)
Cím:	Organised and opportunistic prevention in primary health care : estimation of missed opportunities by population based health interview surveys in Hungary / János Sándor, Ildikó Tokaji, Nouh Harsha, Magor Papp, Róza Ádány, Árpád Czifra
Dátum:	2020
ISSN:	1471-2296
Megjegyzések:	Background: Improvement of preventive services for adults can be achieved by opportunistic or organised methods in primary care. The unexploited opportunities of these approaches were estimated by our investigation. Methods: Data from the Hungarian implementation of European Health Interview Surveys in 2009 (N = 4709) and 2014 (N = 5352) were analysed. Proportion of subjects used interventions in target group (screening for hypertension and diabetes mellitus, and influenza vaccination) within a year were calculated. Taking into consideration recommendations for the frequency of intervention, numbers of missed interventions among patients visited a general practitioner in a year and among patients did not visit a general practitioner in a year were calculated in order to describe missed opportunities that could be utilised by opportunistic or organised approaches. Numbers of missed interventions were estimated for the entire population of the country and for an average-sized general medical practice. Results: Implementation ratio were 66.8% for blood pressure measurement among subjects above 40 years and free of diagnosed hypertension; 63.5% for checking blood glucose among adults above 45 and overweighed and free of diagnosed diabetes mellitus; and 19.1% for vaccination against seasonal influenza. There were 4.1 million interventions implemented a year in Hungary, most of the (3.8 million) among adults visited general practitioner in a year. The number of missed interventions was 4.5 million a year; mostly (3.4 million) among persons visited general practitioner in a year. For Hungary, the opportunistic and organised missed opportunities were estimated to be 561,098, and 1,150,321 for hypertension screening; 363,270, and 227,543 for diabetes mellitus screening; 2,784,072, and 380,033 for influenza vaccination among the < 60 years old high risk subjects, and 3,029,700 and 494,150 for influenza vaccination among more than 60 years old adults, respectively. By implementing all missed services, the workload in an average-sized general medical practice would be increased by 12?13 opportunistic and 4?5 organised interventions a week. Conclusions: The studied interventions are much less used than recommended. The opportunistic missed opportunities is prevailing for influenza vaccination, and the organised one is for hypertension screening. The two approaches have similar significance for diabetes mellitus screening.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Organised prevention Opportunistic prevention Primary care Hypertension screening Diabetes mellitus screening Influenza vaccination
Megjelenés:	BMC Family Practice. - 21 : 1 (2020), p. 1-12. -
További szerzők:	Tokaji Ildikó Harsha, Nouh (1979-) Papp Magor Csongor (1978-) (háziorvostan szakorvos) Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos) Czifra Árpád (1983-) (belgyógyász)
Pályázati támogatás:	Hungarian Academy of Sciences MTA 11003 Egyéb Hungarian Academy of Sciences 2006TKI227 Egyéb GINOP-2.3.2-15-2016-00005 GINOP
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