Workforce crisis in primary healthcare worldwide: Hungarian example in a longitudinal follow-up study
Objective The study was designed to explore the development of the general practitioner (GP) shortage in primary care and its characteristics in Hungary.Design Longitudinal follow-up study over the decade 2007–2016.Methods Analyses were performed on changes in number, age and sex of GPs by practice...
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BMJ Publishing Group
2019-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/7/e024957.full |
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| author | Magor Papp László Kőrösi János Sándor Csilla Nagy Attila Juhász Róza Ádány |
| author_facet | Magor Papp László Kőrösi János Sándor Csilla Nagy Attila Juhász Róza Ádány |
| author_sort | Magor Papp |
| collection | DOAJ |
| description | Objective The study was designed to explore the development of the general practitioner (GP) shortage in primary care and its characteristics in Hungary.Design Longitudinal follow-up study over the decade 2007–2016.Methods Analyses were performed on changes in number, age and sex of GPs by practice type (adult, paediatric and mixed), as well as on their geographical distribution and migration between areas characterised by deprivation index (DI) at municipality level. The association between deprivation and vacancy for GPs was studied by risk analysis. The number of population underserved was defined by DI quintile.Setting and subjects The study involved all general practices and GPs in the period examined.Main outcome measure It is showed that the number of general practices with unfilled GP posts was increasing exponentially, mainly in the most deprived areas of the country.Results A decrease in the number of GPs in all types of practices, especially in mixed (by 7.7%; p<0.001) and paediatric (by 6.5%; p<0.001) ones, was shown; the number of adult practices with unfilled GP posts doubled, while the number of paediatric practices with a vacancy for a paediatrician more than tripled. The average age of GPs was increased by 3.7 years (p<0.001) in adult, by 5.4 years (p<0.001) in paediatric and by 4.2 years (p<0.001) in mixed practices. In 2007, 52.27% (95% CI 51.03 to 53.5) of the GPs were women, and this rate increased to 56.19% (95% CI 54.93 to 57.44) by the end of the decade. An exponential association between relative vacancy rate and deprivation was confirmed. As a result of the migration of GPs, in the most deprived areas, the number of GPs decreased by 8.43% (95% CI 5.86 to 10.99).Conclusions The workforce crisis in Hungarian primary care is progressively deepening and resulting in more severe inequity in access to healthcare. |
| format | Article |
| id | doaj-art-c3a33319e1cd4c038f4b625daafe2744 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-07-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-c3a33319e1cd4c038f4b625daafe27442025-08-20T02:01:54ZengBMJ Publishing GroupBMJ Open2044-60552019-07-019710.1136/bmjopen-2018-024957Workforce crisis in primary healthcare worldwide: Hungarian example in a longitudinal follow-up studyMagor Papp0László Kőrösi1János Sándor2Csilla Nagy3Attila Juhász4Róza Ádány51 National Public Health Institute, Budapest, Hungary2 National Institute of Health Insurance Fund Management, Budapest, Hungary3 Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, HungaryDepartment of Public Health, Government Office of the Capital City Budapest, Budapest, Hungary4 Public Health Administration Service of Government Office of Capital City Budapest, Budapest, HungaryMTA-DE-Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, HungaryObjective The study was designed to explore the development of the general practitioner (GP) shortage in primary care and its characteristics in Hungary.Design Longitudinal follow-up study over the decade 2007–2016.Methods Analyses were performed on changes in number, age and sex of GPs by practice type (adult, paediatric and mixed), as well as on their geographical distribution and migration between areas characterised by deprivation index (DI) at municipality level. The association between deprivation and vacancy for GPs was studied by risk analysis. The number of population underserved was defined by DI quintile.Setting and subjects The study involved all general practices and GPs in the period examined.Main outcome measure It is showed that the number of general practices with unfilled GP posts was increasing exponentially, mainly in the most deprived areas of the country.Results A decrease in the number of GPs in all types of practices, especially in mixed (by 7.7%; p<0.001) and paediatric (by 6.5%; p<0.001) ones, was shown; the number of adult practices with unfilled GP posts doubled, while the number of paediatric practices with a vacancy for a paediatrician more than tripled. The average age of GPs was increased by 3.7 years (p<0.001) in adult, by 5.4 years (p<0.001) in paediatric and by 4.2 years (p<0.001) in mixed practices. In 2007, 52.27% (95% CI 51.03 to 53.5) of the GPs were women, and this rate increased to 56.19% (95% CI 54.93 to 57.44) by the end of the decade. An exponential association between relative vacancy rate and deprivation was confirmed. As a result of the migration of GPs, in the most deprived areas, the number of GPs decreased by 8.43% (95% CI 5.86 to 10.99).Conclusions The workforce crisis in Hungarian primary care is progressively deepening and resulting in more severe inequity in access to healthcare.https://bmjopen.bmj.com/content/9/7/e024957.full |
| spellingShingle | Magor Papp László Kőrösi János Sándor Csilla Nagy Attila Juhász Róza Ádány Workforce crisis in primary healthcare worldwide: Hungarian example in a longitudinal follow-up study BMJ Open |
| title | Workforce crisis in primary healthcare worldwide: Hungarian example in a longitudinal follow-up study |
| title_full | Workforce crisis in primary healthcare worldwide: Hungarian example in a longitudinal follow-up study |
| title_fullStr | Workforce crisis in primary healthcare worldwide: Hungarian example in a longitudinal follow-up study |
| title_full_unstemmed | Workforce crisis in primary healthcare worldwide: Hungarian example in a longitudinal follow-up study |
| title_short | Workforce crisis in primary healthcare worldwide: Hungarian example in a longitudinal follow-up study |
| title_sort | workforce crisis in primary healthcare worldwide hungarian example in a longitudinal follow up study |
| url | https://bmjopen.bmj.com/content/9/7/e024957.full |
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