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001-es BibID:	BIBFORM074165
035-os BibID:	(WoS)000463842500012 (Scopus)85048581396
Első szerző:	Pálinkás Anita (népegészségügyi szakember)
Cím:	Associations between untreated depression and secondary health care utilization in patients with hypertension and/or diabetes / Anita Pálinkás, János Sándor, Magor Papp, László Kőrösi, Zsófia Falusi, László Pál, Zsuzsanna Bélteczki, Zoltán Rihmer, Péter Döme
Dátum:	2019
ISSN:	0933-7954 1433-9285
Megjegyzések:	Purpose. We determined the prevalence of untreated depression in patients with hypertension (HT) and/or diabetes (DM) and estimated the extra health care use and expenditures associated with this comorbidity in a rural Hungarian adult population. We also assessed the potential workload of systematic screening for depression in this patient group.Methods. General health check database from a primary care programme containing survey data of 2027 patients with HT and/or DM was linked to the outpatient secondary care use database of National Institute of Health Insurance Fund Management. Depression was ascertained by Beck Depression Inventory score and antidepressant drug use. The association between untreated depression and secondary healthcare utilization indicated by number of visits and expenses was evaluated by multiple logistic regression analysis controlled for socioeconomic/lifestyle factors and comorbidity. The age-, sex- and education-specific observations were used to estimate the screening workload for an average general medical practice.Results. The frequency of untreated depression was 27.08%. The untreated severe depression (7.45%) was associated with increased number of visits (OR 1.60, 95% CI 1.11-2.31) and related expenses (OR 2.20, 95% CI 1.50-3.22) in a socioeconomic status-independent manner. To identify untreated depression cases among patients with HT and/or DM, an average GP has to screen 42 subjects a month.Conclusion. It seems to be reasonable and feasible to screen for depression in patients with HT and/or DM in the primary care, in order to detect cases without treatment (which may be associated with increase of secondary care visits and expenditures) and to initiate the adequate treatment of them.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Comorbid depression Hypertension Diabetes Health care utilization Linkage study
Megjelenés:	Social Psychiatry and Psychiatric Epidemiology. - 54 : 2 (2019), p. 255-276. -
További szerzők:	Sándor János (1966-) (orvos-epidemiológus) Papp Magor Csongor (1978-) (háziorvostan szakorvos) Kőrösi László Falusi Zsófia Pál László Bélteczki Zsuzsanna Rihmer Zoltán Döme Péter
Pályázati támogatás:	GINOP-2.3.2-15-2016-00005 GINOP
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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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