The impact of general practitioners' gender on process indicators in Hungarian primary healthcare: A nation-wide cross-sectional study

Nóra Kovács, Orsolya Varga, Attila Nagy, Anita Pálinkás, Valéria Sipos, L. Kõrösi, R. Ádány, J. Sándor

Research output: Article

Abstract

Objectives The objectives of our study were (1) to investigate the association between gender of the general practitioner (GP) and the quality of primary care in Hungary with respect to process indicators for GP performance and (2) to assess the size of the gender impact. Study design A nation-wide cross-sectional study was performed in 2016. Setting and participants The study covered all general medical practices in Hungary (n=4575) responsible for the provision of primary healthcare (PHC) for adults. All GPs in their private practices are solo practitioners. Main outcome measures Multilevel logistic regression models were used to analyse the association between GP gender and process indicators of PHC, and attributable proportion (AP) was calculated. Results 48% of the GPs (n=2213) were women in the study. The crude rates of care provided by female GPs were significantly higher for seven out of eight evaluated indicators than those provided by male GPs. Adjusted for practice, physician and patient factors, GP gender was associated with the haemoglobin A1c (HbA1c) measurement: OR=1.18, 95% CI (1.14 to 1.23); serum creatinine measurement: OR=1.14, 95% CI (1.12 to 1.17); lipid measurement: OR=1.14, 95% CI (1.11 to 1.16); eye examination: OR=1.06, 95% CI (1.03 to 1.08); mammography screening: OR=1.05, 95% CI (1.03 to 1.08); management of patients with chronic obstructive pulmonary disease: OR=1.05, 95% CI (1.01 to 1.09) and the composite indicator: OR=1.08, 95% CI (1.07 to 1.1), which summarises the number of care events and size of target populations of each indicator. The AP at the specific indicators varied from 0.97% (95% CI 0.49% to 1.44%) of influenza immunisation to 8.04% (95% CI 7.4% to 8.67%) of eye examinations. Conclusion Female GP gender was an independent predictor of receiving higher quality of care. The actual size of the gender effect on the quality of services seemed to be notable. Factors behind the gender effect should receive more attention in quality improvement particularly in countries where the primary care is organised around solo practices.

Original languageEnglish
Article numbere027296
JournalBMJ open
Volume9
Issue number9
DOIs
Publication statusPublished - szept. 1 2019

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General Practitioners
Primary Health Care
Cross-Sectional Studies
Hungary
Quality of Health Care
Private Practice
Logistic Models
Health Services Needs and Demand
Mammography
Quality Improvement
General Practice
Chronic Obstructive Pulmonary Disease
Human Influenza
Immunization
Creatinine
Hemoglobins
Outcome Assessment (Health Care)
Physicians
Lipids
Serum

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The impact of general practitioners' gender on process indicators in Hungarian primary healthcare : A nation-wide cross-sectional study. / Kovács, Nóra; Varga, Orsolya; Nagy, Attila; Pálinkás, Anita; Sipos, Valéria; Kõrösi, L.; Ádány, R.; Sándor, J.

In: BMJ open, Vol. 9, No. 9, e027296, 01.09.2019.

Research output: Article

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AU - Nagy, Attila

AU - Pálinkás, Anita

AU - Sipos, Valéria

AU - Kõrösi, L.

AU - Ádány, R.

AU - Sándor, J.

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N2 - Objectives The objectives of our study were (1) to investigate the association between gender of the general practitioner (GP) and the quality of primary care in Hungary with respect to process indicators for GP performance and (2) to assess the size of the gender impact. Study design A nation-wide cross-sectional study was performed in 2016. Setting and participants The study covered all general medical practices in Hungary (n=4575) responsible for the provision of primary healthcare (PHC) for adults. All GPs in their private practices are solo practitioners. Main outcome measures Multilevel logistic regression models were used to analyse the association between GP gender and process indicators of PHC, and attributable proportion (AP) was calculated. Results 48% of the GPs (n=2213) were women in the study. The crude rates of care provided by female GPs were significantly higher for seven out of eight evaluated indicators than those provided by male GPs. Adjusted for practice, physician and patient factors, GP gender was associated with the haemoglobin A1c (HbA1c) measurement: OR=1.18, 95% CI (1.14 to 1.23); serum creatinine measurement: OR=1.14, 95% CI (1.12 to 1.17); lipid measurement: OR=1.14, 95% CI (1.11 to 1.16); eye examination: OR=1.06, 95% CI (1.03 to 1.08); mammography screening: OR=1.05, 95% CI (1.03 to 1.08); management of patients with chronic obstructive pulmonary disease: OR=1.05, 95% CI (1.01 to 1.09) and the composite indicator: OR=1.08, 95% CI (1.07 to 1.1), which summarises the number of care events and size of target populations of each indicator. The AP at the specific indicators varied from 0.97% (95% CI 0.49% to 1.44%) of influenza immunisation to 8.04% (95% CI 7.4% to 8.67%) of eye examinations. Conclusion Female GP gender was an independent predictor of receiving higher quality of care. The actual size of the gender effect on the quality of services seemed to be notable. Factors behind the gender effect should receive more attention in quality improvement particularly in countries where the primary care is organised around solo practices.

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