IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v15y2018i7p1388-d155784.html
   My bibliography  Save this article

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

Author

Listed:
  • János Sándor

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • Anita Pálinkás

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • Ferenc Vincze

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • Valéria Sipos

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • Nóra Kovács

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • Tibor Jenei

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • Zsófia Falusi

    (Department of Financing, National Health Insurance Fund, 1139 Budapest, Hungary)

  • László Pál

    (Department of Financing, National Health Insurance Fund, 1139 Budapest, Hungary)

  • László Kőrösi

    (Department of Financing, National Health Insurance Fund, 1139 Budapest, Hungary)

  • Magor Papp

    (National Institute for Health Development, Budapest, Diószegi St 64, 1113 Budapest, Hungary)

  • Róza Ádány

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary
    MTA-DE-Public Health Research Group, University of Debrecen, 4028 Debrecen, Hungary
    WHO Collaborating Centre on Vulnerability and Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

Abstract

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 (beta 1601–2000 = −0.054; p < 0.001; beta 2001−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.

Suggested Citation

  • János Sándor & Anita Pálinkás & Ferenc Vincze & Valéria Sipos & Nóra Kovács & Tibor Jenei & Zsófia Falusi & László Pál & László Kőrösi & Magor Papp & Róza Ádány, 2018. "Association between the General Practitioner Workforce Crisis and Premature Mortality in Hungary: Cross-Sectional Evaluation of Health Insurance Data from 2006 to 2014," IJERPH, MDPI, vol. 15(7), pages 1-12, July.
  • Handle: RePEc:gam:jijerp:v:15:y:2018:i:7:p:1388-:d:155784
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/15/7/1388/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/15/7/1388/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Scutchfield, F.D. & Michener, J.L. & Thacker, S.B., 2012. "Are we there yet? Seizing the moment to integrate medicine and public health," American Journal of Public Health, American Public Health Association, vol. 102(S3), pages 312-316.
    2. Shi, L. & Starfield, B., 2001. "The effect of primary care physician supply and income inequality on mortality among Blacks and Whites in US metropolitan areas," American Journal of Public Health, American Public Health Association, vol. 91(8), pages 1246-1250.
    3. Marie-Laure Delamaire & Gaétan Lafortune, 2010. "Nurses in Advanced Roles: A Description and Evaluation of Experiences in 12 Developed Countries," OECD Health Working Papers 54, OECD Publishing.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Papp, Zsuzsanna K. & Somogyi, Borbála & Wilson, Cait & Török, Szabolcs, 2023. "Acquiring life skills at therapeutic recreational based camp among Hungarian youth," Children and Youth Services Review, Elsevier, vol. 150(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ruth Martin‐Misener & Faith Donald & Abigail Wickson‐Griffiths & Noori Akhtar‐Danesh & Jenny Ploeg & Kevin Brazil & Sharon Kaasalainen & Carrie McAiney & Nancy Carter & Lori Schindel Martin & Esther S, 2015. "A mixed methods study of the work patterns of full‐time nurse practitioners in nursing homes," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(9-10), pages 1327-1337, May.
    2. Helen Lee & Sarah Shea Crowne & Melanie Estarziau & Keith Kranker & Charles Michalopoulos & Anne Warren & Tod Mijanovich & Jill H. Filene & Anne Duggan & Virginia Knox, "undated". "The Effects of Home Visiting on Prenatal Health, Birth Outcomes, and Health Care Use in the First Year of Life: Final Implementation and Impact Findings from the Mother and Infant Home Visiting Progra," Mathematica Policy Research Reports a9626a8d90bf4f01811d0c9d7, Mathematica Policy Research.
    3. Propper, Carol & Rigg, John A. & Burgess, Simon, 2005. "Health supplier quality and the distribution of child health," LSE Research Online Documents on Economics 6252, London School of Economics and Political Science, LSE Library.
    4. Ryvicker, Miriam & Gallo, William T. & Fahs, Marianne C., 2012. "Environmental factors associated with primary care access among urban older adults," Social Science & Medicine, Elsevier, vol. 75(5), pages 914-921.
    5. Catrin Evans & Ruth Pearce & Sarah Greaves & Holly Blake, 2020. "Advanced Clinical Practitioners in Primary Care in the UK: A Qualitative Study of Workforce Transformation," IJERPH, MDPI, vol. 17(12), pages 1-19, June.
    6. Mary Ryder & Elisabeth Jacob & Joyce Hendricks, 2019. "An inductive qualitative approach to explore Nurse Practitioners views on leadership and research: An international perspective," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(13-14), pages 2644-2658, July.
    7. Renin Toms & Xiaoqi Feng & Darren J Mayne & Andrew Bonney, 2020. "Role of Area-Level Access to Primary Care on the Geographic Variation of Cardiometabolic Risk Factor Distribution: A Multilevel Analysis of the Adult Residents in the Illawarra—Shoalhaven Region of NS," IJERPH, MDPI, vol. 17(12), pages 1-21, June.
    8. Lung-Chang Chien & Anjali D Deshpande & Donna B Jeffe & Mario Schootman, 2012. "Influence of Primary Care Physician Availability and Socioeconomic Deprivation on Breast Cancer from 1988 to 2008: A Spatio-Temporal Analysis," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-11, April.
    9. Chen, Zhuo & Roy, Kakoli & Haddix, Anne C. & Thacker, Stephen B., 2010. "Factors associated with differences in mortality and self-reported health across states in the United States," Health Policy, Elsevier, vol. 94(3), pages 203-210, March.
    10. Faith Donald & Kelley Kilpatrick & Kim Reid & Nancy Carter & Ruth Martin-Misener & Denise Bryant-Lukosius & Patricia Harbman & Sharon Kaasalainen & Deborah A. Marshall & Renee Charbonneau-Smith & Erin, 2014. "A Systematic Review of the Cost-Effectiveness of Nurse Practitioners and Clinical Nurse Specialists: What Is the Quality of the Evidence?," Nursing Research and Practice, Hindawi, vol. 2014, pages 1-28, September.
    11. Ruggeri, Matteo & Drago, Carlo & Moramarco, Vincenzo & Coretti, Silvia & Köppen, Julia & Islam, Muhammad Kamrul & Gibson, Jonathan & Busse, Reinhard & van Exel, Job & Sutton, Matthew & Askildsen, Jan , 2018. "New professional roles and patient satisfaction: Evidence from a European survey along three clinical pathways," Health Policy, Elsevier, vol. 122(10), pages 1078-1084.
    12. Maier, Claudia B., 2015. "The role of governance in implementing task-shifting from physicians to nurses in advanced roles in Europe, U.S., Canada, New Zealand and Australia," Health Policy, Elsevier, vol. 119(12), pages 1627-1635.
    13. Hendrik Jürges & Vincent Pohl, 2012. "Medical guidelines, physician density, and quality of care: evidence from German SHARE data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(5), pages 635-649, October.
    14. Maier, Claudia B. & Batenburg, Ronald & Birch, Stephen & Zander, Britta & Elliott, Robert & Busse, Reinhard, 2018. "Health workforce planning: which countries include nurse practitioners and physician assistants and to what effect?," Health Policy, Elsevier, vol. 122(10), pages 1085-1092.
    15. Jatrana, Santosh & Crampton, Peter, 2009. "Affiliation with a primary care provider in New Zealand: Who is, who isn't," Health Policy, Elsevier, vol. 91(3), pages 286-296, August.
    16. Zheng, Hui, 2012. "Do people die from income inequality of a decade ago?," Social Science & Medicine, Elsevier, vol. 75(1), pages 36-45.
    17. Felipa de Mello-Sampayo, 2020. "Spatial Interaction Model for Healthcare Accessibility: What Scale Has to Do with It," Sustainability, MDPI, vol. 12(10), pages 1-19, May.
    18. Craig Gallet, 2009. "The Determinants of AIDS Mortality: Evidence from a State-Level Panel," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 37(4), pages 425-436, December.
    19. Catriona Kennedy & Patricia Brooks Young & Jacqueline Nicol & Karen Campbell & Carol Gray Brunton, 2015. "Fluid role boundaries: exploring the contribution of the advanced nurse practitioner to multi‐professional palliative care," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(21-22), pages 3296-3305, November.
    20. Gerard M Fealy & Mary Casey & Denise F O'Leary & Martin S McNamara & Denise O'Brien & Laserina O'Connor & Rita Smith & Diarmuid Stokes, 2018. "Developing and sustaining specialist and advanced practice roles in nursing and midwifery: A discourse on enablers and barriers," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(19-20), pages 3797-3809, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:15:y:2018:i:7:p:1388-:d:155784. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.