The Effect of the COVID-19 Pandemic on the Social Inequalities of Health Care Use in Hungary: A Nationally Representative Cross-Sectional Study

Bayu Begashaw Bekele, Bahaa Aldin Alhaffar, Rahul Naresh Wasnik and János Sándor
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Bayu Begashaw Bekele: Doctoral School of Health Sciences, University of Debrecen, 4028 Debrecen, Hungary
Bahaa Aldin Alhaffar: Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary
Rahul Naresh Wasnik: Doctoral School of Health Sciences, University of Debrecen, 4028 Debrecen, Hungary
János Sándor: Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary

IJERPH, 2022, vol. 19, issue 4, 1-16

Abstract: Background: The social representation of restricted health care use during the COVID-19 pandemic has not been evaluated properly yet in Hungary. Objective: Our study aimed to quantify the effect of COVID-19 pandemic measures on general practitioner (GP) visits, specialist care, hospitalization, and cost-related prescription nonredemption (CRPNR) among adults, and to identify the social strata susceptible to the pandemic effect. Methods: This cross-sectional study was based on nationally representative data of 6611 (N prepandemic = 5603 and N pandemic = 1008) adults. Multivariable logistic regression models were applied to determine the sociodemographic and clinical factors influencing health care use by odds ratios (ORs) along with the corresponding 95% confidence intervals (CI). To identify the social strata susceptible to the pandemic effect, the interaction of the time of data collection with the level of education, marital status, and Roma ethnicity, was tested and described by iORs. Results: While the CRPNR did not change, the frequency of GP visits, specialist care, and hospitalization rates was remarkably reduced by 22.2%, 26.4%, and 6.7%, respectively, during the pandemic. Roma proved to be not specifically affected by the pandemic in any studied aspect, and the pandemic restructuring of health care impacted the social subgroups evenly with respect to hospital care. However, the pandemic effect was weaker among primary educated adults (iOR GP visits, high-school vs. primary-education = 0.434; 95% CI 0.243–0.776, OR specialist visit, high-school vs. primary-education = 0.598; 95% CI 0.364–0.985), and stronger among married adults (iOR GP visit, widowed vs. married = 2.284; 95% CI 1.043–4.998, iOR specialist visit, widowed vs. married = 1.915; 95% CI 1.157–3.168), on the frequency of GP visits and specialist visits. The prepandemic CRPNR inequality by the level of education was increased (iOR high-school vs. primary-education = 0.236; 95% CI 0.075–0.743). Conclusion: Primary educated and widowed adults did not follow the general trend, and their prepandemic health care use was not reduced during the pandemic. This shows that although the management of pandemic health care use restrictions was implemented by not increasing social inequity, the drug availability for primary educated individuals could require more support.

Keywords: CRPNR; COVID-19 pandemic; hospital admission; GP visit; Hungary; interaction effect; Roma; specialist care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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