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001-es BibID:	BIBFORM086813
035-os BibID:	(Scopus)85087398268 (cikkazonosító)4833 (WOS)000550348400001
Első szerző:	Ádány Róza (megelőző orvostan és népegészségtan szakorvos)
Cím:	Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey / Róza Ádány, Péter Pikó, Szilvia Fiatal, Zsigmond Kósa, János Sándor, Éva Bíró, Karolina Kósa, György Paragh, Éva Bácsné Bába, Ilona Veres-Balajti, Klára Bíró, Orsolya Varga, Margit Balázs
Dátum:	2020
ISSN:	1661-7827 1660-4601
Megjegyzések:	Data mainly from one-off surveys clearly show that the health of Roma, the largest ethnic minority of Europe, is much worse than that of the general population. However, results from comprehensive exploratory studies are missing. The aim of our study was to create a complex database for comparative and association studies to better understand the background of the very unfavourable health of Roma, especially the high burden of cardiometabolic diseases. A three-pillar (questionnaire-based, physical and laboratory examinations) health survey was carried out on randomly selected samples of the Hungarian general (HG, n = 417) and Roma (HR, n = 415) populations, and a database consisting of more than half a million datapoints was created. Using selected data, the prevalence rates of metabolic syndrome (MetS) and of its components were determined, and to estimate the risk of insulin resistance (IR), surrogate measures (the homeostasis model assessment of insulin resistance index, quantitative insulin sensitivity check index, McAuley and TyG indices and the TG/HDL-C ratio) were calculated. Receiver operating characteristic curve analysis and Youden's method were used to define the optimal cut-off values of each IR index. The prevalence of MetS was very high in both study populations (HG: 39.8%, HR: 44.0%) with no statistically significant difference between the two groups in females or males. The prevalence of MetS showed a very marked increase in the HR 35?49 years age group. Among surrogate measures, the TyG index showed the greatest power for predicting IR/MetS at a cut-off value of 4.69 (77% sensitivity, 84% specificity) and indicated a 42.3% (HG) and 40.5% (HR) prevalence of IR. The prevalence of MetS and IR is almost equally very unfavourable in both groups; thus, the factors underlying the high premature mortality burden of Roma should be further clarified by investigating the full spectrum of risk factors available in the database, with a special focus on the access of Roma people to preventive and curative health services.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Roma population health survey metabolic syndrome insulin resistance cut-off values for surrogate indices HOMA-IR QUICKI McAuley index TG/HDL-C ratio TyG index
Megjelenés:	International Journal of Environmental Research and Public Health. - 17 : 4833 (2020), p. 1-22. -
További szerzők:	Pikó Péter (1987-) (biológus) Fiatal Szilvia (1978-) (epidemiológus, népegészségügyi szakember) Kósa Zsigmond (1953-) (orvos) Sándor János (1966-) (orvos-epidemiológus) Bíró Éva (1980-) (megelőző orvostan és népegészségtan szakorvos, egészségfejlesztő) Kósa Karolina (1962-) (népegészségügyi szakember) Paragh György (1953-) (belgyógyász) Bácsné Bába Éva (1968-) (bölcsésztanár, szakközgazda) Veres-Balajti Ilona (1965-) (gyógytornász, egészségfejlesztő) Bíró Klára (1970-) (egészségügyi menedzsment) Varga Orsolya (1977-) (orvos, jogász) Balázs Margit (1952-) (sejtbiológus, molekuláris genetikus)
Pályázati támogatás:	GINOP-2.3.2-15-2016-00005 GINOP MTA11010 Egyéb TK2016-78 Egyéb
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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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