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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:	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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