CCL

Összesen 5 találat.
#/oldal:
Részletezés:
Rendezés:

1.

001-es BibID:BIBFORM092154
Első szerző:Bekele, Bayu Begashaw (PhD hallgató)
Cím:Is Prescription Nonredemption a Source of Poor Health Among the Roma? Cross-Sectional Analysis of Drug Consumption Data From the National Health Insurance Fund of Hungary / Bayu Begashaw Bekele, Nouh Harsha, László Korösi, Ferenc Vincze, Árpád Czifra, Róza Ádány, János Sándor
Dátum:2021
ISSN:1663-9812
Megjegyzések:Background: The health status of the Roma is inferior to that of the general population. The causes of poor health among this population are still ambiguous, but they include low utilization of healthcare services. Our study aimed to investigate prescription redemptions in segregated Roma colonies (SRC) where the most disadvantaged quartile of Roma people are living. Methods: A cross-sectional study was carried out with data obtained from the National Institute of Health Insurance Fund Management in the settlements belonging to the study area of the "Public Health-Focused Model Program for Organizing Primary Care Services." The study included 4,943 residents of SRC and 62,074 residents of the complementary area (CA) of the settlements where SRC were located. Crude and age- and sexstandardized redemption ratios for SRC and CA were calculated for each Anatomic Therapeutic Chemical (ATC) group and for the total practice by ATC group. Standardized relative redemptions (RR) with 95% confidence intervals were calculated for SRC, with CA as a reference. Results: The crude redemption ratios were 73.13% in the SRC and 71.15% in the CA. RRs were higher in the SRC than in the CA for cardiovascular, musculoskeletal system, and alimentary tract and metabolism drugs (11.5, 3.7, and 3.5%, respectively). In contrast, RRs were lower in the SRC than in the CA for anti-infective agents (22.9%) due to the poor redemption of medicines prescribed for children or young adults. Despite the overall modest differences in redemption ratios, some ATC groups showed remarkable differences. Those include cardiovascular, alimentary and musculoskeletal drugs. Conclusion: Redemption of prescriptions was significantly higher among Roma people living in SRC than among those living in CA. The better redemption of cardiovascular and alimentary tract drugs was mainly responsible for this effect. These findings contradict the stereotype that the Roma do not use health services properly and that prescription nonredemption is responsible for their poor health.
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
prescription non-redemption
Roma people
cardiovascular drugs
alimentary tract drugs
anti-infective agents
Megjelenés:Frontiers in Pharmacology. - 12 (2021), p. 1-9. -
További szerzők:Harsha, Nouh (1979-) Kőrösi László Vincze Ferenc (1987-) (táplálkozástudomány) 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
Egyéb
SHE-15324-002/2018
Egyéb
SHE-124219
Egyéb
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
Borító:

2.

001-es BibID:BIBFORM081769
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
Dátum:2019
ISSN:1663-9812
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
folyóiratcikk
medication adherence
dispensed prescriptions
urbanization
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)
Egyéb
GINOP-2.3.2-15-2016-00005
GINOP
Stipendium Hungaricum Scholarship Programme (grant 124219 to NH)
Egyéb
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
Borító:

3.

001-es BibID:BIBFORM081165
035-os BibID:(cikkazonosító)3797
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
DOI
Intézményi repozitóriumban (DEA) tárolt változat
Borító:

4.

001-es BibID:BIBFORM080512
035-os BibID:(cikkazonosító)3153
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
DOI
Borító:

5.

001-es BibID:BIBFORM086814
Első szerző:Sándor János (orvos-epidemiológus)
Cím:Organised and opportunistic prevention in primary health care : estimation of missed opportunities by population based health interview surveys in Hungary / János Sándor, Ildikó Tokaji, Nouh Harsha, Magor Papp, Róza Ádány, Árpád Czifra
Dátum:2020
ISSN:1471-2296
Megjegyzések:Background: Improvement of preventive services for adults can be achieved by opportunistic or organised methods in primary care. The unexploited opportunities of these approaches were estimated by our investigation. Methods: Data from the Hungarian implementation of European Health Interview Surveys in 2009 (N = 4709) and 2014 (N = 5352) were analysed. Proportion of subjects used interventions in target group (screening for hypertension and diabetes mellitus, and influenza vaccination) within a year were calculated. Taking into consideration recommendations for the frequency of intervention, numbers of missed interventions among patients visited a general practitioner in a year and among patients did not visit a general practitioner in a year were calculated in order to describe missed opportunities that could be utilised by opportunistic or organised approaches. Numbers of missed interventions were estimated for the entire population of the country and for an average-sized general medical practice. Results: Implementation ratio were 66.8% for blood pressure measurement among subjects above 40 years and free of diagnosed hypertension; 63.5% for checking blood glucose among adults above 45 and overweighed and free of diagnosed diabetes mellitus; and 19.1% for vaccination against seasonal influenza. There were 4.1 million interventions implemented a year in Hungary, most of the (3.8 million) among adults visited general practitioner in a year. The number of missed interventions was 4.5 million a year; mostly (3.4 million) among persons visited general practitioner in a year. For Hungary, the opportunistic and organised missed opportunities were estimated to be 561,098, and 1,150,321 for hypertension screening; 363,270, and 227,543 for diabetes mellitus screening; 2,784,072, and 380,033 for influenza vaccination among the < 60 years old high risk subjects, and 3,029,700 and 494,150 for influenza vaccination among more than 60 years old adults, respectively. By implementing all missed services, the workload in an average-sized general medical practice would be increased by 12?13 opportunistic and 4?5 organised interventions a week. Conclusions: The studied interventions are much less used than recommended. The opportunistic missed opportunities is prevailing for influenza vaccination, and the organised one is for hypertension screening. The two approaches have similar significance for diabetes mellitus screening.
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Organised prevention
Opportunistic prevention
Primary care
Hypertension screening
Diabetes mellitus screening
Influenza vaccination
Megjelenés:BMC Family Practice. - 21 : 1 (2020), p. 1-12. -
További szerzők:Tokaji Ildikó Harsha, Nouh (1979-) Papp Magor Csongor (1978-) (háziorvostan szakorvos) Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos) Czifra Árpád (1983-) (belgyógyász)
Pályázati támogatás:Hungarian Academy of Sciences MTA 11003
Egyéb
Hungarian Academy of Sciences 2006TKI227
Egyéb
GINOP-2.3.2-15-2016-00005
GINOP
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
Borító:
Rekordok letöltése1