Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Special Health Care Utilization Pattern with Elevated Costs and High Risk of Premature Death Among Adults Living in Segregated Roma Settlements

Version 1 : Received: 22 July 2018 / Approved: 23 July 2018 / Online: 23 July 2018 (14:27:34 CEST)

A peer-reviewed article of this Preprint also exists.

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. 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.

Journal reference: Int. J. Environ. Res. Public Health 2018, 15, 1835
DOI: 10.3390/ijerph15091835

Abstract

Roma is the largest ethnic minority of Europe with poor 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 54682 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 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, 1.177–1.405), and the reimbursement for inpatient care (RR=1.060, 1.057–1.064) were elevated for SRS. 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 the routine healthcare indicators without violating the protection of personal data by converting a sensitive ethical issue to 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 premature death.

Keywords

Roma minority, legal constrains, health care utilization, health status, geographical inequality

Subject

MEDICINE & PHARMACOLOGY, Other

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