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001-es BibID:BIBFORM081165
035-os BibID:(cikkazonosító)3797 (Scopus)85073119873 (WOS)000494779100011
Első szerző:Harsha, Nouh
Cím:Enhancing Primary Adherence to Prescribed Medications through an Organized Health Status Assessment-Based Extension of Primary Healthcare Services / Nouh Harsha, Magor Papp, László Kőrösi, Árpád Czifra, Róza Ádány, János Sándor
Dátum:2019
ISSN:1661-7827 1660-4601
Megjegyzések:This study was part of monitoring an intervention aimed at developing a general practitioner cluster (GPC) model of primary healthcare (PHC) and testing its effectiveness in delivering preventive services integrated into the PHC system. The aim was to demonstrate whether GPC operation could increase the percentage of drugs actually dispensed. Using national reference data of the National Health Insurance Fund for each anatomical-therapeutic chemical classification ATC group of drugs, dispensed-to-prescribed ratios standardized (sDPR) for age, sex, and exemption certificate were calculated during the first quarter of 2012 (before-intervention) and the third quarter of 2015 (post-intervention). The after-to-before ratios of the sDPR as the relative dispensing ratio (RDR) were calculated to describe the impact of the intervention program. The general medication adherence increased significantly in the intervention area (RDR = 1.064; 95% confidence interval (CI): 1.054-1.073). The most significant changes were observed for cardiovascular system drugs (RDR = 1.062; 95% CI: 1.048-1.077) and for alimentary tract and metabolism-specific drugs (RDR = 1.072; 95% CI: 1.049-1.097). The integration of preventive services into a PHC without any specific medication adherence-increasing activities is beneficial for medication adherence, especially among patients with cardiovascular, alimentary tract, and metabolic disorders. Monitoring the percentage of drugs actually dispensed is a useful element of PHC-oriented intervention evaluation frames.
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
medication adherence
relative dispensing ratio
primary healthcare
health status assessment
patient-physician cooperation
Megjelenés:International Journal of Environmental Research and Public Health. - 16 : 20 (2019), p. 1-13. -
További szerzők:Papp Magor Csongor (1978-) (háziorvostan szakorvos) Kőrösi László Czifra Árpád (1983-) (belgyógyász) Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos) Sándor János (1966-) (orvos-epidemiológus)
Pályázati támogatás:Swiss Contribution Program (SH/8/1)
Egyéb
GINOP-2.3.2-15-2016-00005
GINOP
Stipendium Hungaricum Scholarship Program grant 124219
Egyéb
Internet cím:Szerző által megadott URL
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Intézményi repozitóriumban (DEA) tárolt változat
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2.

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)
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
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3.

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
Internet cím:Szerző által megadott URL
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Intézményi repozitóriumban (DEA) tárolt változat
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4.

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
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
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5.

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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6.

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
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
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7.

001-es BibID:BIBFORM066018
035-os BibID:(cikkazonosító)200 (WoS)000408383800003 (Scopus)85014259813
Első szerző:Sándor János (orvos-epidemiológus)
Cím:Capitation-Based Financing Hampers the Provision of Preventive Services in Primary Health Care / János Sándor, Karolina Kósa, Magor Papp, Gergő Fürjes, László Kőrösi, Mihajlo Jakovljevic, Róza Ádány
Dátum:2016
ISSN:2296-2565
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Frontiers in Public Health. - 4 (2016), p. 1-12. -
További szerzők:Kósa Karolina (1962-) (népegészségügyi szakember) Papp Magor Csongor (1978-) (háziorvostan szakorvos) Fürjes Gergely Kőrösi László Jakovljevic, Mihajlo Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos)
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Intézményi repozitóriumban (DEA) tárolt változat
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