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

Author

Listed:
  • 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
    MTA-DE-Public Health Research Group, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai St 26/B, H-4028 Debrecen, Hungary
    WHO Collaborating Centre on Vulnerability and Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai St 26/B, H-4028 Debrecen, Hungary)

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.

Suggested Citation

  • János Sándor & Anita Pálinkás & Ferenc Vincze & Nóra Kovács & Valéria Sipos & László Kőrösi & Zsófia Falusi & László Pál & Gergely Fürjes & Magor Papp & Róza Ádány, 2018. "Healthcare Utilization and All-Cause Premature Mortality in Hungarian Segregated Roma Settlements: Evaluation of Specific Indicators in a Cross-Sectional Study," IJERPH, MDPI, vol. 15(9), pages 1-13, August.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:9:p:1835-:d:165688
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    References listed on IDEAS

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    3. János Sándor & Zsigmond Kósa & Klára Boruzs & Julianna Boros & Ildikó Tokaji & Martin McKee & Róza Ádány, 2017. "The decade of Roma Inclusion: did it make a difference to health and use of health care services?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(7), pages 803-815, September.
    4. János Sándor & Zsigmond Kósa & Klára Boruzs & Julianna Boros & Ildikó Tokaji & Martin McKee & Róza Ádány, 2017. "Erratum to: The decade of Roma Inclusion: did it make a difference to health and use of health care services?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(7), pages 817-817, September.
    5. Dena Ringold & Mitchell A. Orenstein & Erika Wilkens, 2005. "Roma in an Expanding Europe : Breaking the Poverty Cycle," World Bank Publications - Books, The World Bank Group, number 14869.
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    Cited by:

    1. Bayu Begashaw Bekele & Bahaa Aldin Alhaffar & Rahul Naresh Wasnik & János Sándor, 2022. "The Effect of the COVID-19 Pandemic on the Social Inequalities of Health Care Use in Hungary: A Nationally Representative Cross-Sectional Study," IJERPH, MDPI, vol. 19(4), pages 1-16, February.
    2. Ferenc Vincze & Anett Földvári & Anita Pálinkás & Valéria Sipos & Eszter Anna Janka & Róza Ádány & János Sándor, 2019. "Prevalence of Chronic Diseases and Activity-Limiting Disability among Roma and Non-Roma People: A Cross-Sectional, Census-Based Investigation," IJERPH, MDPI, vol. 16(19), pages 1-14, September.
    3. Barbara Pavlikova & Lenka Freel & Jitse P. van Dijk, 2020. "To Comply or Not to Comply: Roma Approach to Health Laws," IJERPH, MDPI, vol. 17(9), pages 1-13, April.

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