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Factors Associated with Practice-Level Performance Indicators in Primary Health Care in Hungary: A Nationwide Cross-Sectional Study

Author

Listed:
  • Nóra Kovács

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • Anita Pálinkás

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • Valéria Sipos

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • Attila Nagy

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • Nouh Harsha

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • László Kőrösi

    (Department of Financing, National Institute of Health Insurance Fund Management, 1139 Budapest, Hungary)

  • Magor Papp

    (Health Promotion Center, Semmelweis University, 1085 Budapest, Hungary)

  • Róza Ádány

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary
    MTA-DE Public Health Research Group, University of Debrecen, 4028 Debrecen, Hungary
    WHO Collaborating Centre on Vulnerability and Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • Orsolya Varga

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

  • János Sándor

    (Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary)

Abstract

The performance of general practitioners (GPs) is frequently assessed without considering the factors causing variability among general medical practices (GMPs). Our cross-sectional national-based study was performed in Hungary to evaluate the influence of GMP characteristics on performance indicators. The relationship between patient’s characteristics (age, gender, education) and GMP-specific parameters (practice size, vacancy of GP’s position, settlement type, and county of GMP) and the quality of care was assessed by multilevel logistic regression models. The variations attributable to physicians were small (from 0.77% to 17.95%). The education of patients was associated with 10 performance indicators. Practicing in an urban settlement mostly increased the quality of care for hypertension and diabetes care related performance indicators, while the county was identified as one of the major determinants of variability among GPs’ performance. Only a few indicators were affected by the vacancy and practice size. Thus, the observed variability in performance between GPs partially arose from demographic characteristics and education of patients, settlement type, and regional location of GMPs. Considering the real effect of these factors in evaluation would reflect better the personal performance of GPs.

Suggested Citation

  • Nóra Kovács & Anita Pálinkás & Valéria Sipos & Attila Nagy & Nouh Harsha & László Kőrösi & Magor Papp & Róza Ádány & Orsolya Varga & János Sándor, 2019. "Factors Associated with Practice-Level Performance Indicators in Primary Health Care in Hungary: A Nationwide Cross-Sectional Study," IJERPH, MDPI, vol. 16(17), pages 1-15, August.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:17:p:3153-:d:262051
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    References listed on IDEAS

    as
    1. Chalmer Labig, 2009. "Bad Measures Don’t Make Good Medicine: The Ethical Implications of Unreliable and Invalid Physician Performance Measures," Journal of Business Ethics, Springer, vol. 88(2), pages 287-295, August.
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    3. Ammi, Mehdi & Fortier, Grant, 2017. "The influence of welfare systems on pay-for-performance programs for general practitioners: A critical review," Social Science & Medicine, Elsevier, vol. 178(C), pages 157-166.
    4. Jason M. Fletcher & David E. Frisvold, 2009. "Higher Education and Health Investments: Does More Schooling Affect Preventive Health Care Use?," Journal of Human Capital, University of Chicago Press, vol. 3(2), pages 144-176.
    5. Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
    6. Antonio Giuffrida & Hugh Gravelle & Martin Rowland, 1998. "Performance indicators for primary care management in the NHS," Working Papers 160chedp, Centre for Health Economics, University of York.
    7. repec:dau:papers:123456789/12226 is not listed on IDEAS
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    Cited by:

    1. Feras Kasabji & Alaa Alrajo & Ferenc Vincze & László Kőrösi & Róza Ádány & János Sándor, 2020. "Self-Declared Roma Ethnicity and Health Insurance Expenditures: A Nationwide Cross-Sectional Investigation at the General Medical Practice Level in Hungary," IJERPH, MDPI, vol. 17(23), pages 1-17, December.

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