Human resources development for the operation of general practitioners' cluster

Kósa, Karolina; Sándor, János; Dobos, Erik; Papp, M.; Fürjes, Gergely; Ádány, Róza

doi:10.1093/eurpub/ckt097

Cited by 11 publications

(10 citation statements)

References 2 publications

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“…General practitioners (GPs) constitute a significant component of the Hungarian primary healthcare system and are in regular contact with both the healthy and ailing people. According to our data and previous research, lifestyle counselling is the kind of service that patients need most and one of the leading drivers of medical litigation [57]. Coverage and quality of nutritional counselling services, within primary healthcare settings are limited and primarily focused on those suffering from diet-related NCDs, particularly among type 2 diabetes patients [58,59].…”

Section: Discussionmentioning

confidence: 88%

Deteriorated Dietary Patterns with Regards to Health and Environmental Sustainability among Hungarian Roma Are Not Differentiated from Those of the General Population

et al. 2021

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Nutritional epidemiology studies on Roma people are scarce and, to date, their nutrient-based dietary patterns with regards to both healthy and sustainable dietary considerations have never been reported. We report, for the first time, adherence to healthy and sustainable dietary patterns using scoring and regression models, based on recommendations defined by the World Health Organization, in the Dietary Approaches to Stop Hypertension (DASH) study and the EAT-Lancet report, as well as dietary quality based on Dietary Inflammatory Index (DII) among the Hungarian Roma (HR) population living in North East Hungary, with Hungarian general (HG) adults as reference. Data were obtained from a complex, comparative health survey involving dietary assessment, structured questionnaire-based interview, physical and laboratory examinations on 359 HG and 344 HR subjects in Northeast Hungary. Poisson regressions were fit to models that included DASH, EAT, DII and Healthy Diet Indicator as dependent variables to assess the influence of ethnicity on healthy and sustainable nutrient-based patterns. Adjusted models controlled for all relevant covariates using the residual method indicated poor dietary quality with regards to the selected dietary patterns. These associations were not ethnicity-sensitive, except for DII, where Roma ethnicity was linked to a decrease of DII score (β = −0.455, 95%CI: −0.720; −0.191, p < 0.05). Currently, HR dietary patterns appear to be relatively unhealthy and unsustainable, rendering them vulnerable to elevated risk of ill-health. Nevertheless, their dietary patterns did not strongly differ from HG, which may contribute to Hungarians being one of the most obese and malnourished nations in Europe. Further prospective research on the potential public and environmental health effects of these findings is warranted.

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Section: Discussionmentioning

confidence: 88%

Deteriorated Dietary Patterns with Regards to Health and Environmental Sustainability among Hungarian Roma Are Not Differentiated from Those of the General Population

et al. 2021

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“…Our investigation was part of monitoring the “Public Health-Focused Model Program for Organizing Primary Care Services Backed by a Virtual Care Service Center” [55], which is aimed at developing a general practitioner cluster (GPC) model of primary healthcare (PHC) and testing its effectiveness in delivering preventive services integrated into the PHC system. The goal of this model, in line with the recommendations of the WHO [56], was to complete a traditional core PHC team of one GP and one nurse with other health professionals who were formerly not available at the PHC level [57,58]. The GPC is a multimodal PHC intervention based on (1) organized, population-level general health checks implemented by public health experts and nurses to explore unmet needs, (2) follow-ups of at-risk patients by providing care via the extended PHC team, (3) new services and nonmedical activities (counseling by a dietitian and psychologist, treatment by a physiotherapist, supporting patient–GP cooperation with mediators), and (4) supervision by a GP.…”

Section: Introductionmentioning

confidence: 99%

Enhancing Primary Adherence to Prescribed Medications through an Organized Health Status Assessment-Based Extension of Primary Healthcare Services

Harsha

Papp

Kőrösi³

et al. 2019

IJERPH

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This study was part of monitoring an intervention aimed at developing a general practitioner cluster (GPC) model of primary healthcare (PHC) and testing its effectiveness in delivering preventive services integrated into the PHC system. The aim was to demonstrate whether GPC operation could increase the percentage of drugs actually dispensed. Using national reference data of the National Health Insurance Fund for each anatomical–therapeutic chemical classification ATC group of drugs, dispensed-to-prescribed ratios standardized (sDPR) for age, sex, and exemption certificate were calculated during the first quarter of 2012 (before-intervention) and the third quarter of 2015 (post-intervention). The after-to-before ratios of the sDPR as the relative dispensing ratio (RDR) were calculated to describe the impact of the intervention program. The general medication adherence increased significantly in the intervention area (RDR = 1.064; 95% confidence interval (CI): 1.054–1.073). The most significant changes were observed for cardiovascular system drugs (RDR = 1.062; 95% CI: 1.048–1.077) and for alimentary tract and metabolism-specific drugs (RDR = 1.072; 95% CI: 1.049–1.097). The integration of preventive services into a PHC without any specific medication adherence-increasing activities is beneficial for medication adherence, especially among patients with cardiovascular, alimentary tract, and metabolic disorders. Monitoring the percentage of drugs actually dispensed is a useful element of PHC-oriented intervention evaluation frames.

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“…Briefly, four groups of general practitioners were established as primary care group practices (called "GP clusters"). Each group practice consisted of six general practitioners who received funding to employ a range of ancillary health professionals such as public health specialist, dietitian, physiotherapist, health psychologist, and non-professional health mediators [16]; and offered new, preventive services not available from other GPs [17]. The Programme started in 2013 and ended in 2017.…”

Section: Introductionmentioning

confidence: 99%

Facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model programme in Hungary

et al. 2020

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Background A Primary Care Model Programme was implemented in Hungary between 2013 and 2017 in order to increase access of disadvantaged population groups to primary care and to offer new preventive services for all clients. In a country with single-handed practices, four group practices or GP clusters were created in the Programme. Six GPs comprised one cluster who together employed nonmedical health professionals and nonprofessional health mediators, the latter recruited from the serviced communities, many of them of Roma ethnicity. Health mediators were tasked by improving access of the local communities – including its vulnerable Roma members – to existing and new services. Health mediators were interviewed about their work experiences, motivation, and overall opinion as members of the clusters as part of the Programme evaluation. Methods As part of the Programme evaluation, structured interviews were conducted with all 40 health mediators employed at the time in the Programme. Interviews were transcribed and content analysis was carried out. Results Three themes emerged from the transcripts. The first focused on the health mediators’ personal characteristics such as motivation to join the Programme, the way their job increased their self-esteem, social status and health consciousness. Domains of the second theme of their work included importance of on-the-job training and of their insider knowledge of local communities, as well as their pride to have become members of the primary care team. The third theme covered overall functioning of the Programme of which they had mostly positive opinions, notwithstanding some criticism regarding procurement. Conclusions Health mediators had earlier worked in various European countries specifically to improve access of Roma ethnic groups to health services but the Hungarian Model Programme was globally the first in which health mediators as non-professional workers became equal members of the primary care team as employees. Their contribution and overwhelmingly positive experiences, along with their useful insights for improvement call for the establishment and funding of health mediator positions in primary care especially in areas with large numbers of disadvantaged Roma populations.

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Human resources development for the operation of general practitioners' cluster

Cited by 11 publications

References 2 publications

Deteriorated Dietary Patterns with Regards to Health and Environmental Sustainability among Hungarian Roma Are Not Differentiated from Those of the General Population

Deteriorated Dietary Patterns with Regards to Health and Environmental Sustainability among Hungarian Roma Are Not Differentiated from Those of the General Population

Enhancing Primary Adherence to Prescribed Medications through an Organized Health Status Assessment-Based Extension of Primary Healthcare Services

Facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model programme in Hungary

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