Expectations, values, preferences and experiences of Hungarian primary care population when accessing services: Evaluation of the patient's questionnaires of the international QUALICOPC study.

BACKGROUND: Preferences and wishes of patients is an important indicator of primary health care provision, although there are differences between national primary care systems. AIM: The aim of this paper is to describe and evaluate the preferences and values of Hungarian primary care (PC) patients before accessing and to analyse their experiences after attending PC services. METHODS: In the Hungarian arm of the European QUALICOPC Study, in 2013-2014, information was collected with questionnaires; the Patient Values contained 19 and the Patient Experiences had 41 multiple-choice questions. FINDINGS: The questionnaires were filled by 2149 (840 men, 1309 women) using PC services, aged 49.1 (SD ± 16.7) years, 73% of them having chronic morbidities. Women preferred to be accompanied and rated their own health better. Patients in the lowest educational category and women visited their GPs more often, and they are consulted more frequently by other doctors as well. Men, older and secondary educated people reported more frequently chronic morbidities. Longer opening hours were preferred by patients with higher education. The most preferred expectations were availability and polite communication of doctors, not pressures on consultation time, clear instructions provided during consultations, shared decisions about treatments and options for consultations, the knowledge of the doctors concerning the living conditions, social and cultural backgrounds of patients, updated medical records, short waiting times, options for home visits, wide scope of professional competences and trust in the doctor. CONCLUSION: Wishes, preferences of patients and fulfilment were similar than described in other participating countries of the study. Although there are room to improve PC services, most of the questioned population were satisfied with the provision.

[Obese Hungary. Trend and prevalence of overweight and obesity in Hungary, 2015]. / Elhízó Magyarország. A túlsúly és az elhízás trendje és prevalenciája Magyarországon, 2015.

INTRODUCTION: The prevalence of obesity is growing continuously worldwide, even in Hungary. Since 1988, when the first professional wide-range evaluation was performed, only limited data are available. AIM: Authors present the results of the ever largest Hungarian obesity-prevalence surveys, performed by family and occupational physicians. METHOD: Data from 0.55% of the population above 18 year were registered in all geographical regions of Hungary (43,287 persons; 17,901 males and 25,386 females), close to the proper national representativeness. Age, body mass index, waist circumference, educational level, presence of hypertension and/or diabetes were analyzed statistically and compared with previous data. RESULTS: The overall prevalence rate of overweight and obesity among men was 40% and 32%, respectively, while overweight and obesity occurred in 32% of women. In the different age groups of men, the prevalence of overweight and obesity was: 32.7% and 18.2% in 18-34 years; 40.1% and 34.4% in 35-59 years; 43.5% and 38.8% in over 60 years, respectively. In the same age groups of women, overweight and obesity occurred in 19.6% and 15.7%, 36.8% and 38.7%, and 36.5% and 39.7%, respectively. Body mass index and waist-circumference were presented according to age, by decades and by type of residency as well. The highest ratio of overweight was registered among men with the highest educational level, while highest ratio of obesity among women having the lowest education. Obesity according to Body mass index and abdominal obesity was the highest in the villages, especially among females. Registered metabolic morbidities were strongly correlated with body mass index and both were inversely related to the level of urbanization. CONCLUSIONS: Over the previous decades, the ratio of the overweight and even the number of obese persons increased significantly, and it was most prominent among males, mainly in younger generation. Obesity means a serious medical, public health and economic problem, and it requires higher public awareness and political support. Orv. Hetil., 2016, 157(31), 1248-1255.

A public health threat in Hungary: obesity, 2013.

BACKGROUND: In Hungary, the last wide-range evaluation about nutritional status of the population was completed in 1988. Since then, only limited data were available. Our aim was to collect, analyze and present updated prevalence data. METHODS: Anthropometric, educational and morbidity data of persons above 18 y were registered in all geographical regions of Hungary, at primary care encounters and within community settings. RESULTS: Data (BMI, waist circumference, educational level) of 40,331 individuals (16,544 men, 23,787 women) were analyzed. Overall prevalence for overweight was 40.4% among men, 31.3% among women, while for obesity 32.0% and 31.5%, respectively. Abdominal obesity was 37.1% in males, 60.9% in females. Among men, the prevalence of overweight-obesity was: under 35 y = 32.5%-16.2%, between 35-60 y = 40.6%-34.7%, over 60 y = 44.3%-36.7%. Among women, in the same age categories were: 17.8%-13.8%, 29.7%-29.0%, and 36.9%-39.0%. Data were presented according to age by decades as well. The highest odds ratio of overweight (OR: 1.079; 95% CI [1.026-1.135]) was registered by middle educational level, the lowest odds ratio of obesity (OR: 0.500; 95% CI [0.463-0.539]) by the highest educational level. The highest proportion of obese people lived in villages (35.4%) and in Budapest (28.9%). Distribution of overweighed persons were: Budapest (37.1%), other cities (35.8%), villages (33.8%). Registered metabolic morbidities were strongly correlated with BMIs and both were inversely related to the level of urbanization. Over the previous decades, there has been a shift in the distribution of population toward being overweight and moreover obese, it was most prominent among males, mainly in younger generation. CONCLUSIONS: Evaluation covered 0.53% of the total population over 18 y and could be very close to the proper national representativeness. The threat of obesity and related morbidities require higher public awareness and interventions.

[A(H1N1)v cases of the 2009/2010 and 2010/2011 influenza seasons in the Medical and Health Sciences Centre of Debrecen University]. / A(H1N1)v-influenzaesetek a Debreceni Egyetem Orvos- és Egészségtudományi Centrumában a 2009/2010. évi és a 2010/2011. évi influenzaszezonban.

UNLABELLED: The swine-origin new influenza variant A(H1N1) emerged in 2009 and changed the epidemiology of the 2009/2010 influenza season globally and at national level. AIMS: The aim of the authors was to analyse the cases of two influenza seasons. METHODS: The Medical and Health Sciences Centre of Debrecen University has 1690 beds with 85 000 patients admitted per year. The diagnosis of influenza was conducted using real-time polymerase chain reaction in the microbiological laboratories of the University and the National Epidemiological Centre, according to the recommendation of the World Health Organization. RESULTS: The incidence of influenza was not higher than that observed in the previous season, but two high-risk patient groups were identified: pregnant women and patients with immunodeficiency (oncohematological and organ transplant patients). The influenza vaccine, which is free for high-risk groups and health care workers in Hungary, appeared to be effective for prevention, because in the 2010/2011 influenza season none of the 58 patients who were administered the vaccination developed influenza. CONCLUSION: It is an important task to protect oncohematological and organ transplant patients.

[Factors affecting influenza vaccine uptake among health care workers at the Medical and Health Sciences Center of Debrecen University, Hungary]. / Az influenzaátoltottságot befolyásoló tényezok vizsgálata egészségügyi dolgozók körében a Debreceni Egyetem Orvos- és Egészségtudományi Centrumában.

UNLABELLED: Influenza vaccination is the most effective way of influenza prevention. The vaccination rate is low worldwide. In Hungary, the vaccine is free of charge to health care workers and, therefore, the low vaccination rate is unaccountable. AIMS: In this study, the authors wanted to explore those factors which influence the refusal of vaccination. METHODS: The Health Science Center of Debrecen University has about 4000 employees. The authors adjusted a questionnaire with 45 questions and sent it to 525 randomly selected health care workers, 294 of whom responded (response rate, 56%). The Epiinfo software was used for statistical evaluation. RESULTS: The respondents strongly agreed that the vaccine is free and easy to obtain at the workplace. Official recommendations of the occupational health, the Medical Association of Hungary and advice of the family doctors failed to influence the decision. However, a significant impact of communication with family members, friends and colleagues on the decision was documented. CONCLUSIONS: The results indicate that the most important tool in decision making of influenza vaccination is the internal communication, but this effect is not a permanent one. International data show highly variable vaccination rates (between 2.1% and 82%). A better vaccination rate (98% or above) may be achieved with a mandatory influenza vaccination program among health care workers.