IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i17p3153-d262051.html
   My bibliography  Save this article

Factors Associated with Practice-Level Performance Indicators in Primary Health Care in Hungary: A Nationwide Cross-Sectional Study

Author

Listed:
  • Nóra Kovács

    (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)

  • Valéria Sipos

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

  • Attila Nagy

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

  • Nouh Harsha

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

  • László Kőrösi

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

  • Magor Papp

    (Health Promotion Center, Semmelweis University, 1085 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)

  • Orsolya Varga

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

  • János Sándor

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

Abstract

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.

Suggested Citation

  • Nóra Kovács & Anita Pálinkás & Valéria Sipos & Attila Nagy & Nouh Harsha & László Kőrösi & Magor Papp & Róza Ádány & Orsolya Varga & János Sándor, 2019. "Factors Associated with Practice-Level Performance Indicators in Primary Health Care in Hungary: A Nationwide Cross-Sectional Study," IJERPH, MDPI, vol. 16(17), pages 1-15, August.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:17:p:3153-:d:262051
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/17/3153/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/16/17/3153/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Chalmer Labig, 2009. "Bad Measures Don’t Make Good Medicine: The Ethical Implications of Unreliable and Invalid Physician Performance Measures," Journal of Business Ethics, Springer, vol. 88(2), pages 287-295, August.
    2. Groenewegen, Peter P. & Dourgnon, Paul & Greß, Stefan & Jurgutis, Arnoldas & Willems, Sara, 2013. "Strengthening weak primary care systems: Steps towards stronger primary care in selected Western and Eastern European countries," Health Policy, Elsevier, vol. 113(1), pages 170-179.
    3. Ammi, Mehdi & Fortier, Grant, 2017. "The influence of welfare systems on pay-for-performance programs for general practitioners: A critical review," Social Science & Medicine, Elsevier, vol. 178(C), pages 157-166.
    4. Antonio Giuffrida & Hugh Gravelle & Martin Rowland, 1998. "Performance indicators for primary care management in the NHS," Working Papers 160chedp, Centre for Health Economics, University of York.
    5. Jason M. Fletcher & David E. Frisvold, 2009. "Higher Education and Health Investments: Does More Schooling Affect Preventive Health Care Use?," Journal of Human Capital, University of Chicago Press, vol. 3(2), pages 144-176.
    6. Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
    7. repec:dau:papers:123456789/12226 is not listed on IDEAS
    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. Feras Kasabji & Alaa Alrajo & Ferenc Vincze & László Kőrösi & Róza Ádány & János Sándor, 2020. "Self-Declared Roma Ethnicity and Health Insurance Expenditures: A Nationwide Cross-Sectional Investigation at the General Medical Practice Level in Hungary," IJERPH, MDPI, vol. 17(23), pages 1-17, December.

    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. Bautista, María Angélica & González, Felipe & Martinez, Luis R. & Muñoz, Pablo & Prem, Mounu, 2020. "Does Higher Education Reduce Mortality? Evidence from a Natural Experiment in Chile," SocArXiv 5s2px, Center for Open Science.
    2. Frisvold, David & Golberstein, Ezra, 2011. "School quality and the education–health relationship: Evidence from Blacks in segregated schools," Journal of Health Economics, Elsevier, vol. 30(6), pages 1232-1245.
    3. Fletcher, Jason M. & Frisvold, David E., 2011. "College selectivity and young adult health behaviors," Economics of Education Review, Elsevier, vol. 30(5), pages 826-837, October.
    4. Felipe González & Luis R Martínez & Pablo Muñoz & Mounu Prem, 2024. "Higher Education and Mortality: Legacies of an Authoritarian College Contraction," Journal of the European Economic Association, European Economic Association, vol. 22(4), pages 1762-1797.
    5. Cook, C. Justin & Fletcher, Jason M., 2015. "Can education rescue genetic liability for cognitive decline?," Social Science & Medicine, Elsevier, vol. 127(C), pages 159-170.
    6. David Frisvold & Ezra Golberstein, 2013. "The Effect of School Quality on Black-White Health Differences: Evidence From Segregated Southern Schools," Demography, Springer;Population Association of America (PAA), vol. 50(6), pages 1989-2012, December.
    7. Bauldry, Shawn, 2014. "Conditional health-related benefits of higher education: An assessment of compensatory versus accumulative mechanisms," Social Science & Medicine, Elsevier, vol. 111(C), pages 94-100.
    8. Aniko Biro;, 2012. "An analysis of mammography decisions with a focus on educational differences," Health, Econometrics and Data Group (HEDG) Working Papers 12/11, HEDG, c/o Department of Economics, University of York.
    9. Eide, Eric R. & Showalter, Mark H., 2011. "Estimating the relation between health and education: What do we know and what do we need to know?," Economics of Education Review, Elsevier, vol. 30(5), pages 778-791, October.
    10. Anikó Bíró, 2013. "Discount Rates And The Education Gradient In Mammography In The Uk," Health Economics, John Wiley & Sons, Ltd., vol. 22(9), pages 1021-1036, September.
    11. Olga N. Volkova & Aleksandra N. Volkova, 2024. "Empirical Testing of Grossman’s the Demand for Health Model: The Case of Russia," Journal of Applied Economic Research, Graduate School of Economics and Management, Ural Federal University, vol. 23(1), pages 33-58.
    12. Jason Fletcher & David Frisvold, 2014. "The long run health returns to college quality," Review of Economics of the Household, Springer, vol. 12(2), pages 295-325, June.
    13. Lange, Fabian, 2011. "The role of education in complex health decisions: Evidence from cancer screening," Journal of Health Economics, Elsevier, vol. 30(1), pages 43-54, January.
    14. Joseph L Ward & Russell M Viner, 2016. "Secondary Education and Health Outcomes in Young People from the Cape Area Panel Study (CAPS)," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-14, June.
    15. G. Miller & Yuriy Pylypchuk, 2014. "Marital Status, Spousal Characteristics, and the Use of Preventive Care," Journal of Family and Economic Issues, Springer, vol. 35(3), pages 323-338, September.
    16. Bergvall, Sanna & Fernström, Clara & Ranehill, Eva & Sandberg, Anna, 2024. "The Impact of PhD Studies on Mental Health—A Longitudinal Population Study," Working Papers in Economics 846, University of Gothenburg, Department of Economics.
    17. Michael Geruso & Dean Spears, 2018. "Neighborhood Sanitation and Infant Mortality," American Economic Journal: Applied Economics, American Economic Association, vol. 10(2), pages 125-162, April.
    18. Resul Cesur & Naci H. Mocan, 2013. "Does Secular Education Impact Religiosity, Electoral Participation and the Propensity to Vote for Islamic Parties? Evidence from an Education Reform in a Muslim Country," NBER Working Papers 19769, National Bureau of Economic Research, Inc.
    19. Olof Östergren & Pekka Martikainen & Olle Lundberg, 2018. "The contribution of alcohol consumption and smoking to educational inequalities in life expectancy among Swedish men and women during 1991–2008," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(1), pages 41-48, January.
    20. Dalton, Patricio S. & Nhung, Nguyen & Rüschenpöhler, Julius, 2020. "Worries of the poor: The impact of financial burden on the risk attitudes of micro-entrepreneurs," Journal of Economic Psychology, Elsevier, vol. 79(C).

    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:16:y:2019:i:17:p:3153-:d:262051. 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.