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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.
Bekele, Bayu Begashaw; Alhaffar, Bahaa Aldin; Wasnik, Rahul Naresh; Sándor, János.
  • Bekele BB; Doctoral School of Health Sciences, University of Debrecen, 4028 Debrecen, Hungary.
  • Alhaffar BA; Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman 260, Ethiopia.
  • Wasnik RN; Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary.
  • Sándor J; Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary.
Int J Environ Res Public Health ; 19(4)2022 02 16.
Article in English | MEDLINE | ID: covidwho-1708747
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 (Nprepandemic = 5603 and Npandemic = 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 (iORGP visits, high-school vs. primary-education = 0.434; 95% CI 0.243-0.776, ORspecialist visit, high-school vs. primary-education = 0.598; 95% CI 0.364-0.985), and stronger among married adults (iORGP visit, widowed vs. married = 2.284; 95% CI 1.043-4.998, iORspecialist 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 (iORhigh-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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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Humans Country/Region as subject: Europa Language: English Year: 2022 Document Type: Article Affiliation country: Ijerph19042258

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Humans Country/Region as subject: Europa Language: English Year: 2022 Document Type: Article Affiliation country: Ijerph19042258