Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Association Between the General Practitioner Workforce Crisis and Premature Mortality in Hungary: Nationwide Evaluation of Health Insurance Data from 2006 to 2014

János Sándor
* ,
Anita Pálinkás
,
Ferenc Vincze
ORCID logo ,
Valéria Sipos
,
Nóra Kovács
,
Tibor Jenei
,
Zsófia Falusi
,
László Pál
,
László Kőrösi
,
Magor Papp
,
Róza Ádány
Version 1 : Received: 29 May 2018 / Approved: 30 May 2018 / Online: 30 May 2018 (05:47:53 CEST)

A peer-reviewed article of this Preprint also exists.

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. 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.

Abstract

The workforce crisis of primary care is reflected in the increasing number of general medical practices (GMP) with vacant general practitioner (GP) position, 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 were calculated for all Hungarian GMPs annually in the period from 2006 to 2014. The relationship of premature mortality with GPs’ age and vacant GP position were 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 the bigger list size (beta1601-2000=-0.054; p<0.001; beta2001-X=-0.096; p<0.001). The geographical localization influenced significantly also the risk. Although, GMP with a GP aged older than 65 years (beta=0; p=0.995) did not affected the risk, GP vacancy was associated with higher risk (beta=0.010; p=0.033), but the corresponding number of attributable cases was 23.54 for 9 years. The vacant GP position is associated with 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.

Keywords

primary health care; workforce crisis; general practitioner vacancy; aging of general practitioners; premature mortality

Subject

Biology and Life Sciences, Other

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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