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Article

Healthcare Utilization and All-Cause Premature Mortality in Hungarian Segregated Roma Settlements: Evaluation of Specific Indicators in a Cross-Sectional Study

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Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai St 26/B, H-4028 Debrecen, Hungary
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Department of Financing, National Health Insurance Fund, Váci Rd 73/A, H-1139 Budapest, Hungary
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National Institute for Health Development, Diószegi St 64, Budapest H-1113, Hungary
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MTA-DE-Public Health Research Group, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai St 26/B, H-4028 Debrecen, Hungary
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WHO Collaborating Centre on Vulnerability and Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai St 26/B, H-4028 Debrecen, Hungary
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(9), 1835; https://doi.org/10.3390/ijerph15091835
Received: 22 July 2018 / Revised: 13 August 2018 / Accepted: 23 August 2018 / Published: 24 August 2018
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 indicators for 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 all adults 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 on healthcare 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. View Full-Text
Keywords: Roma minority; legal constraints; healthcare utilization; health status; geographical inequality Roma minority; legal constraints; healthcare utilization; health status; geographical inequality
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MDPI and ACS Style

Sándor, J.; Pálinkás, A.; Vincze, F.; Kovács, N.; Sipos, V.; Kőrösi, L.; Falusi, Z.; Pál, L.; Fürjes, G.; Papp, M.; Ádány, R. Healthcare Utilization and All-Cause Premature Mortality in Hungarian Segregated Roma Settlements: Evaluation of Specific Indicators in a Cross-Sectional Study. Int. J. Environ. Res. Public Health 2018, 15, 1835. https://doi.org/10.3390/ijerph15091835

AMA Style

Sándor J, Pálinkás A, Vincze F, Kovács N, Sipos V, Kőrösi L, Falusi Z, Pál L, Fürjes G, Papp M, Ádány R. Healthcare Utilization and All-Cause Premature Mortality in Hungarian Segregated Roma Settlements: Evaluation of Specific Indicators in a Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2018; 15(9):1835. https://doi.org/10.3390/ijerph15091835

Chicago/Turabian Style

Sándor, János, Anita Pálinkás, Ferenc Vincze, Nóra Kovács, Valéria Sipos, László Kőrösi, Zsófia Falusi, László Pál, Gergely Fürjes, Magor Papp, and Róza Ádány. 2018. "Healthcare Utilization and All-Cause Premature Mortality in Hungarian Segregated Roma Settlements: Evaluation of Specific Indicators in a Cross-Sectional Study" International Journal of Environmental Research and Public Health 15, no. 9: 1835. https://doi.org/10.3390/ijerph15091835

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