A preliminary evaluation of a health monitoring programme in Hungary
György Széles1, Zoltán Vokó1, Tibor Jenei1, László Kardos1, Zsuzsa Pocsai1, András Bajtay2, Elemér Papp3, Gabriella Pásti4, Zsigmond Kósa5, Ilona Molnár6, Katalin Lun6 and Róza Ádány1
1 School of Public Health, University of Debrecen, Kassai street 26/b, Debrecen, Hungary, H-4012 PoB.2
2 County Office of the National Public Health and Medical Officer Service, Jósika street 16 Gy
r, Hungary, H-9002
3 County Office of the National Public Health and Medical Officer Service, Rózsahegyi street 4, Debrecen, Hungary, H-4028
4 County Office of the National Public Health and Medical Officer Service, Árok street 41, Nyíregyháza, Hungary, H-4401
5 County Office of the National Public Health and Medical Officer Service, Göcseji street 24, Zalaegerszeg, Hungary, H-8900
6 Office of the Chief Medical Officer of the National Public Health and Medical Officer Service, Gyáli street 2-6, Budapest, Hungary, H-1437 PoB.839
Correspondence: Professor Róza Ádány, School of Public Health, University of Debrecen, Kassai street 26/b, Debrecen, Hungary, H-4012 PoB.2, tel: +36-52-460 190, fax: +36-52-460 195, Email: adany{at}jaguar.dote.hu
Background: In 1998 a joint initiative of the Hungarian School of Public Health and the National Public Health Service created a network of sentinel stations based in primary care facilities in four Hungarian counties. The aim was to establish a system that will provide valid data on morbidity of selected diseases in Hungary. Methods: Based on standardized protocols, the participating centres have continuously reported data on the prevalence of cardiovascular diseases, diabetes mellitus, liver cirrhosis, and some malignant diseases, as well as supplying denominator data. The four counties represent both eastern and western parts of Hungary, reflecting the known geographical disparities in health. Each county office enrolled general practitioners maintaining representation in terms of both geography and distribution of settlement size. Results: A total of 73 general practitioners agreed to participate, providing care for 15.6% (138,088 people) of the population in the counties. The population registered with the practices were representative in terms of age and sex of both the participating counties and the entire country. The prevalence of hypertension, diabetes mellitus and liver cirrhosis is high in each county but varies considerably, with higher levels in the western counties, especially among older age groups of both sexes. Conclusions: The establishment of sentinel stations to collect morbidity data is feasible and sustainable in Hungarian primary care. The data that have been generated provide a valid and comprehensive picture of important aspects of the Hungarian population's health, with important implications for health policy and health service planning. In regions where low prevalence rates of diseases and high mortality rates simultaneously exist special attention is required to explore the background of this caveat.
Key points
- Till the end of 1998 no program operated in Hungary engaged with non-communicable disease morbidity data collection, except some hospital-based registries, which failed to produce reliable information.
- The establishment of sentinel stations to collect morbidity data is feasible and sustainable in Hungarian primary care, the valid morbidity data can be built into the decision making process in health service planning.
- Regular training, quality control and feedback are important contributors to the success of the program.
- The prevalence of hypertension, diabetes mellitus and liver cirrhosis is high in each county but varies considerably, with higher levels in the western counties, especially among older age groups of both sexes.
- More research needed to determine the possible contribution of unknown morbidity and health service utilisation to the different prevalence values in the two parts of Hungary.
Keywords: general practice, Hungary, morbidity data, sentinel stations network
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