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001-es BibID:BIBFORM081769
035-os BibID:(scopus)85074827384 (wos)000497407500001
Első szerző:Harsha, Nouh
Cím:Determinants of Primary Nonadherence to Medications Prescribed by General Practitioners Among Adults in Hungary : cross-Sectional Evaluation of Health Insurance Data / Nouh Harsha, László Kőrösi, Anita Pálinkás, Klára Bíró, Klára Boruzs, Róza Ádány, János Sándor, Árpád Czifra
Megjegyzések:Background: Primary nonadherence to prescribed medications occurs when patients do not fill or dispense prescriptions written by healthcare providers. Although it has become an important public health issue in recent years, little is known about its frequency, causes, and consequences. Moreover, the pattern of risk factors shows remarkable variability across countries according to the published results. Our study aimed to assess primary nonadherence to medications prescribed by general practitioners (GPs) and its associated factors among adults in Hungary for the period of 2012?2015. Methods: Data on all general medical practices (GMPs) of the country were obtained from the National Health Insurance Fund and the Central Statistical Office. The ratio of the number of dispensed medications to the number of prescriptions written by a GP for adults was used to determine the medication adherence, which was aggregated for GMPs. The effect of GMP characteristics (list size, GP vacancy, patients' education provided by a GMP, settlement type [urban or rural], and geographical location [by county] of the center) on adherence, standardized for patients' age, sex, and eligibility for an exemption certificate, were investigated through generalized linear regression modeling. Results: A total of 281,315,386 prescriptions were dispensed out of 438,614,000 written by a GP. Overall, 64.1% of prescriptions were filled. According to the generalized linear regression coefficients, there was a negative association between standardized adherence and urban settlement type (b = ?0.099, 95%CI = ?0.103 to ?0.094), higher level of education (b = ?0.440, 95%CI = ?0.468 to ?0.413), and vacancy of the general practices (b = ?0.193, 95%CI = ?0.204 to ?0.182). The larger GMP size proved to be a risk factor, and there was a significant geographical inequality for counties as well. Conclusions: More than one-third of the written prescriptions of GPs for adults in Hungary were not dispensed. This high level of nonadherence had great variability across GMPs, and can be explained by structural characteristics of GMPs, the socioeconomic status of patients provided, and the quality of cooperation between patients and GPs. Moreover, our findings suggest that the use of the dispensed-to-prescribed medication ratio in routine monitoring of primary health care could effectively support the necessary interventions.
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
medication adherence
dispensed prescriptions
level of education
GP vacancy
GMP size
geographical inequality
exemption certificate
Megjelenés:Frontiers in Pharmacology. - 10 (2019), p. 1-9. -
További szerzők:Kőrösi László Pálinkás Anita (1988-) (népegészségügyi szakember) Bíró Klára (1970-) (egészségügyi menedzsment) Boruzs Klára (1983-) (környezetkutató vegyész és MBA) Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos) Sándor János (1966-) (orvos-epidemiológus) Czifra Árpád (1983-) (belgyógyász)
Pályázati támogatás:"Public Health Focused Model Programme for Organising Primary Care Services Backed by a Virtual Care Service Centre" (SH/8/1)
Stipendium Hungaricum Scholarship Programme (grant 124219 to NH)
Internet cím:Szerző által megadott URL
Intézményi repozitóriumban (DEA) tárolt változat


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
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
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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