Healthcare Utilization and All-Cause Premature Mortality in Hungarian Segregated Roma Settlements: Evaluation of Specific Indicators in a Cross-Sectional Study

János Sándor, Anita Pálinkás, Ferenc Vincze, Nóra Kovács, Valéria Sipos, László Kőrösi, Zsófia Falusi, László Pál, Gergely Fürjes, Magor Papp and Róza Ádány
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János Sándor: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai St 26/B, H-4028 Debrecen, Hungary
Anita Pálinkás: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai St 26/B, H-4028 Debrecen, Hungary
Ferenc Vincze: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai St 26/B, H-4028 Debrecen, Hungary
Nóra Kovács: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai St 26/B, H-4028 Debrecen, Hungary
Valéria Sipos: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai St 26/B, H-4028 Debrecen, Hungary
László Kőrösi: Department of Financing, National Health Insurance Fund, Váci Rd 73/A, H-1139 Budapest, Hungary
Zsófia Falusi: Department of Financing, National Health Insurance Fund, Váci Rd 73/A, H-1139 Budapest, Hungary
László Pál: Department of Financing, National Health Insurance Fund, Váci Rd 73/A, H-1139 Budapest, Hungary
Gergely Fürjes: National Institute for Health Development, Diószegi St 64, Budapest H-1113, Hungary
Magor Papp: National Institute for Health Development, Diószegi St 64, Budapest H-1113, Hungary
Róza Ádány: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai St 26/B, H-4028 Debrecen, Hungary

IJERPH, 2018, vol. 15, issue 9, 1-13

Abstract: Roma is the largest ethnic minority of Europe with deprived 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 54,682 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 all-cause 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, 95% CI: 1.177–1.405) and the reimbursement for inpatient care (RR = 1.060, 95% CI: 1.057–1.064) were elevated for SRS. All-cause 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 routine healthcare indicators without violating the protection of personal data by converting a sensitive ethical issue into 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 all-cause premature death.

Keywords: Roma minority; legal constraints; healthcare utilization; health status; geographical inequality (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 (4)

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