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

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...

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Autores principales: Bekele, Bayu Begashaw, Alhaffar, Bahaa Aldin, Wasnik, Rahul Naresh, Sándor, János
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872504/
https://www.ncbi.nlm.nih.gov/pubmed/35206447
http://dx.doi.org/10.3390/ijerph19042258
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author Bekele, Bayu Begashaw
Alhaffar, Bahaa Aldin
Wasnik, Rahul Naresh
Sándor, János
author_facet Bekele, Bayu Begashaw
Alhaffar, Bahaa Aldin
Wasnik, Rahul Naresh
Sándor, János
author_sort Bekele, Bayu Begashaw
collection PubMed
description 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.
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spelling pubmed-88725042022-02-25 The Effect of the COVID-19 Pandemic on the Social Inequalities of Health Care Use in Hungary: A Nationally Representative Cross-Sectional Study Bekele, Bayu Begashaw Alhaffar, Bahaa Aldin Wasnik, Rahul Naresh Sándor, János Int J Environ Res Public Health Article 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. MDPI 2022-02-16 /pmc/articles/PMC8872504/ /pubmed/35206447 http://dx.doi.org/10.3390/ijerph19042258 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bekele, Bayu Begashaw
Alhaffar, Bahaa Aldin
Wasnik, Rahul Naresh
Sándor, János
The Effect of the COVID-19 Pandemic on the Social Inequalities of Health Care Use in Hungary: A Nationally Representative Cross-Sectional Study
title The Effect of the COVID-19 Pandemic on the Social Inequalities of Health Care Use in Hungary: A Nationally Representative Cross-Sectional Study
title_full The Effect of the COVID-19 Pandemic on the Social Inequalities of Health Care Use in Hungary: A Nationally Representative Cross-Sectional Study
title_fullStr The Effect of the COVID-19 Pandemic on the Social Inequalities of Health Care Use in Hungary: A Nationally Representative Cross-Sectional Study
title_full_unstemmed The Effect of the COVID-19 Pandemic on the Social Inequalities of Health Care Use in Hungary: A Nationally Representative Cross-Sectional Study
title_short The Effect of the COVID-19 Pandemic on the Social Inequalities of Health Care Use in Hungary: A Nationally Representative Cross-Sectional Study
title_sort effect of the covid-19 pandemic on the social inequalities of health care use in hungary: a nationally representative cross-sectional study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872504/
https://www.ncbi.nlm.nih.gov/pubmed/35206447
http://dx.doi.org/10.3390/ijerph19042258
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