Next Article in Journal
Enhancing the Quality and Utility of Content Analyses for Addictive Disorders
Next Article in Special Issue
Can Urban-Rural Patterns of Hospital Selection Be Changed Using a Report Card Program? A Nationwide Observational Study
Previous Article in Journal
Descriptive Epidemiology of Uruguayan Adults’ Leisure Time Physical Activity
Previous Article in Special Issue
Evaluating Disparities in Elderly Community Care Resources: Using a Geographic Accessibility and Inequality Index
Open AccessArticle

Association between the General Practitioner Workforce Crisis and Premature Mortality in Hungary: Cross-Sectional Evaluation of Health Insurance Data from 2006 to 2014

1
Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary
2
Department of Financing, National Health Insurance Fund, 1139 Budapest, Hungary
3
National Institute for Health Development, Budapest, Diószegi St 64, 1113 Budapest, Hungary
4
MTA-DE-Public Health Research Group, University of Debrecen, 4028 Debrecen, Hungary
5
WHO Collaborating Centre on Vulnerability and Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(7), 1388; https://doi.org/10.3390/ijerph15071388
Received: 29 May 2018 / Revised: 26 June 2018 / Accepted: 30 June 2018 / Published: 2 July 2018
(This article belongs to the Special Issue Health Care Equity)
The workforce crisis of primary care is reflected in the increasing number of general medical practices (GMP) with vacant general practitioner (GP) positions, and the GPs’ ageing. Our study aimed to describe the association between this crisis and premature mortality. Age-sex-standardized mortality for 18–64 years old adults was calculated for all Hungarian GMPs annually in the period from 2006 to 2014. The relationship of premature mortality with GPs’ age and vacant GP positions was evaluated by standardized linear regression controlled for list size, urbanization, geographical location, clients’ education, and type of the GMP. The clients’ education was the strongest protective factor (beta = −0175; p < 0.001), followed by urban residence (beta = −0.149; p < 0.001), and bigger list size (beta1601–2000 = −0.054; p < 0.001; beta2001−X = −0.096; p < 0.001). The geographical localization also 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 GP position is associated with a significant but hardly detectable increased risk of premature mortality without considerable public health importance. Nevertheless, employment of GPs aged more than 65 does not impose premature mortality risk elevation. View Full-Text
Keywords: primary health care; workforce crisis; general practitioner vacancy; aging of general practitioners; premature mortality primary health care; workforce crisis; general practitioner vacancy; aging of general practitioners; premature mortality
Show Figures

Graphical abstract

MDPI and ACS Style

Sándor, J.; Pálinkás, A.; Vincze, F.; Sipos, V.; Kovács, N.; Jenei, T.; Falusi, Z.; Pál, L.; Kőrösi, L.; Papp, M.; Ádány, R. Association between the General Practitioner Workforce Crisis and Premature Mortality in Hungary: Cross-Sectional Evaluation of Health Insurance Data from 2006 to 2014. Int. J. Environ. Res. Public Health 2018, 15, 1388.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop