Association between the General Practitioner Workforce Crisis and Premature Mortality in Hungary: Cross-Sectional Evaluation of Health Insurance Data from 2006 to 2014

János Sándor, Anita Pálinkás, Ferenc Vincze, Valéria Sipos, Nóra Kovács, Tibor Jenei, Zsófia Falusi, László Pál, László Kőrösi, Magor Papp and Róza Ádány
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János Sándor: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary
Anita Pálinkás: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary
Ferenc Vincze: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary
Valéria Sipos: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary
Nóra Kovács: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary
Tibor Jenei: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary
Zsófia Falusi: Department of Financing, National Health Insurance Fund, 1139 Budapest, Hungary
László Pál: Department of Financing, National Health Insurance Fund, 1139 Budapest, Hungary
László Kőrösi: Department of Financing, National Health Insurance Fund, 1139 Budapest, Hungary
Magor Papp: National Institute for Health Development, Budapest, Diószegi St 64, 1113 Budapest, Hungary
Róza Ádány: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary

IJERPH, 2018, vol. 15, issue 7, 1-12

Abstract: The workforce crisis of primary care is reflected in the increasing number of general medical practices (GMP) with vacant general practitioner (GP) positions, 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 was calculated for all Hungarian GMPs annually in the period from 2006 to 2014. The relationship of premature mortality with GPs’ age and vacant GP positions was 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 bigger list size (beta 1601–2000 = −0.054; p < 0.001; beta 2001−X = −0.096; p < 0.001). The geographical localization also significantly influenced the risk. Although GMPs with a GP aged older than 65 years (beta = 0; p = 0.995) did not affect the risk, GP vacancy was associated with higher risk (beta = 0.010; p = 0.033), although the corresponding number of attributable cases was 23.54 over 9 years. The vacant GP position is associated with a 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 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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