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001-es BibID:	BIBFORM072270
Első szerző:	Dombrádi Viktor (egészségpolitikai szakember)
Cím:	Investigation of the conditions affecting the joining of Hungarian hospitals to an accreditation programme : a crosssectional study / Viktor Dombrádi, Barnabás Margitai, Csaba Dózsa, Orsolya Karola Bárdos-Csenteri, János Sándor, Tibor Gáll, Sándor Gődény
Dátum:	2018
ISSN:	2044-6055
Megjegyzések:	Objective Quantitative studies have shown the various benefits for having accreditation in hospitals. However, neither of these explored the general conditions before applying for an accreditation. To close this gap, this study aimed to investigate the possible association between joining an accreditation programme with various hospital characteristics.Design A cross-sectional study was implemented using the databases of the 2013 Hungarian hospital survey and of the Hungarian State Treasury.Setting Public general hospitals in Hungary. Participants The analysis involved 44 public generalhospitals, 14 of which joined the preparatory project for a newly developed accreditation programme.Main outcome measures The outcomes included the percentage of compliance in quality management, patient information and identification, internal professional regulation, safe surgery, pressure sore prevention, infection control, the opinions of the heads of quality management regarding the usefulness of quality management and clinical audits, and finally, the total debt of the hospital per bed and per discharged patient.Results According to our findings, the general hospitals joining the preparatory project of the accreditation programme performed better in four of the six investigated activities, the head of quality management had a better opinion on the usefulness of quality management, and both the debt per bed number and the debt per discharged patient were lower than those who did not join. However, no statistically significant differences between the two groups were found in any of the examined outcomes.Conclusions The findings suggest that hospitals applying for an accreditation programme do not differ significantly in characteristics from those which did not apply. This means that if in the future the accredited hospitals become better than other hospitals, then the improvement could be solely contributed to the accreditation.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	BMJ Open. - 8 (2018), p. 1-9. -
További szerzők:	Margitai Barnabás (Budapest) Dózsa Csaba Csenteri Orsolya Karola (1987-) (népegészségügyi ellenőr, rehabilitációs szakember) Sándor János (1966-) (orvos-epidemiológus) Gáll Tibor (1969-) (egészségügyi menedzser) Gődény Sándor (1951-) (nőgyógyász, egészségügyi minőségbiztosítási szakember)
Pályázati támogatás:	GINOP-2.3.2-15-2016-00005 GINOP
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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:	BIBFORM080044
Első szerző:	Papp Magor Csongor (háziorvostan szakorvos)
Cím:	Workforce crisis in primary healthcare worldwide : Hungarian example in a longitudinal follow-up study / Magor Papp, László Kőrösi, János Sándor, Csilla Nagy, Attila Juhász, Róza Ádány
Dátum:	2019
Megjegyzések:	Objective The study was designed to explore the development of the general practitioner (GP) shortage in primary care and its characteristics in Hungary. Design Longitudinal follow-up study over the decade 2007?2016. Methods Analyses were performed on changes in number, age and sex of GPs by practice type (adult, paediatric and mixed), as well as on their geographical distribution and migration between areas characterised by deprivation index (DI) at municipality level. The association between deprivation and vacancy for GPs was studied by risk analysis. The number of population underserved was defined by DI quintile. Setting and subjects The study involved all general practices and GPs in the period examined. Main outcome measure It is showed that the number of general practices with unfilled GP posts was increasing exponentially, mainly in the most deprived areas of the country. Results A decrease in the number of GPs in all types of practices, especially in mixed (by 7.7%; p<0.001) and paediatric (by 6.5%; p<0.001) ones, was shown; the number of adult practices with unfilled GP posts doubled, while the number of paediatric practices with a vacancy for a paediatrician more than tripled. The average age of GPs was increased by 3.7 years (p<0.001) in adult, by 5.4 years (p<0.001) in paediatric and by 4.2 years (p<0.001) in mixed practices. In 2007, 52.27% (95% CI 51.03 to 53.5) of the GPs were women, and this rate increased to 56.19% (95% CI 54.93 to 57.44) by the end of the decade. An exponential association between relative vacancy rate and deprivation was confirmed. As a result of the migration of GPs, in the most deprived areas, the number of GPs decreased by 8.43% (95% CI 5.86 to 10.99). Conclusions The workforce crisis in Hungarian primary care is progressively deepening and resulting in more severe inequity in access to healthcare.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	BMJ Open. - 2019 (2019), p. 1-11. -
További szerzők:	Kőrösi László Sándor János (1966-) (orvos-epidemiológus) Nagy Csilla (1970-) (epidemiológus, népegészségügyi szakember) Juhász Attila (1970-) (epidemiológus) Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos)
Pályázati támogatás:	TK2016-78 MTA GINOP-2.3.2-15-2016-00005 GINOP
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001-es BibID:	BIBFORM072271
035-os BibID:	(Scopus)85052165373 (WOS)000433129800215 (cikkazonosító)e018932
Első szerző:	Sipos Valéria (népegészségügyi szakember)
Cím:	Smoking cessation support for regular smokers in Hungarian primary care : a nationwide representative crosssectional study / Valéria Sipos, Anita Pálinkás, Nóra Kovács, Karola Orsolya Csenteri, Ferenc Vincze, József Gergő Szőllősi, Tibor Jenei, Magor Papp, Róza Ádány, János Sándor
Dátum:	2018
ISSN:	2044-6055
Megjegyzések:	Objectives Our study aimed to evaluate the effectiveness of general practitioners' (GPs') smoking cessation support (SCS).Study design We carried out a cross-sectional study between February and April 2016.Setting and participant A sample of 2904 regular smokers aged 18 years or older was selected randomly from 18 general medical practices involved in a national representative, general medical practice-based morbidity monitoring system. The GPs surveyed the selected adults and identified 708 regular smokers.Main outcome measures Multivariate logistic regression models have been applied to evaluate the determinants (age, gender, education, smoking-related comorbidity, smoking intensity, intention to quit smoking and nicotine dependence) of provision of GP-mediated SCS such as brief intervention, pharmacological and nonpharmacological programmatic support.Results According to the survey, 24.4% of the adults were regular smokers, 30% of them showedhigh nicotine dependence and 38.2% willing to quit smoking. Most of the smokers were not participated in SCS by GPs: brief intervention, programmatic nonpharmacological support and pharmacotherapy were provided for 25%, 7% and 2% of smokers, respectively. Low-nicotine-dependence individuals were less (OR 0.30, 95% CI 0.12 to 0.75), patients with intention to quit were more (OR 1.49, 95% CI 1.00 to 2.22) likely to receive a brief intervention. Vocational (OR 1.71, 95% CI 1.13 to 2.59) and high school education (OR 2.08, 95% CI 1.31 to 3.31), chronic obstructive pulmonary disease and cardiovascular diseases (OR 3.34, 95% CI 1.04 to 10.68; OR 3.91, 95% CI 2.33 to 6.54) increased the probability to receive support by GP.Conclusions Although there are differences among smokers' subgroups, the SCS in Hungarian primarycare is generally insufficient, compared with guidelines. Practically, the pharmacological support is not included in Hungarian GPs' practice. GPs should increase substantially the working time devoted to SCS, and the organisation of primary healthcare should support GPs in improving SCS services.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	BMJ Open. - 8 : 2 (2018), p. 1-8. -
További szerzők:	Pálinkás Anita (1988-) (népegészségügyi szakember) Kovács Nóra (1989-) (népegészségügyi szakember) Csenteri Orsolya Karola (1987-) (népegészségügyi ellenőr, rehabilitációs szakember) Vincze Ferenc (1987-) (táplákozástudományi szakember, epidemiológus) Szőllősi Gergő József (1991-) (népegészségügyi ellenőr, népegészségügyi szakember) Jenei Tibor (1963-) (programtervező informatikus) Papp Magor Csongor (1978-) (háziorvostan szakorvos) Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos) Sándor János (1966-) (orvos-epidemiológus)
Pályázati támogatás:	Swiss Contribution Programme SH/8/1 Egyéb MTA 11003, 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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