Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Geroscience. 2024 Apr;46(2):2017-2031. doi: 10.1007/s11357-023-00926-y. Epub 2023 Oct 6.
The demographic transition poses a significant challenge for health systems, especially in Central and Eastern European (CEE) countries, where the healthcare needs of aging populations are on the rise. This study aimed to describe and compare the health status and utilization of health services among the elderly residing in urban and rural areas of the most deprived region in Hungary. A comprehensive health survey was conducted in 2022, involving a randomly selected sample of 443 older adults (≥ 65 years) in Northeast Hungary. Multivariable logistic regression models adjusting for age, sex, education, financial status, chronic diseases, and activity limitations were used to investigate the association between type of residence and health service use. Among the study participants, 62.3% were female, 38.3% attained primary education, 12.5% reported a bad or very bad financial situation and 52.6% lived in urban areas. Overall, 24% of the elderly rated their health as very good or good (27.8% in urban and 19.7% in rural areas), while 57.8% (52.6% and 63.5% in urban and rural areas) reported limitations in daily activities. Compared to urban residents, rural residents reported lower rates of dentist visits (p = 0.006), specialist visits (p = 0.028), faecal occult blood testing (p < 0.001), colorectal cancer screening with colonoscopy (p = 0.014), and breast cancer screening (p = 0.035), and a higher rate of blood pressure measurement (p = 0.042). Multivariable models indicated that urban residence was positively associated with faecal occult blood testing (OR = 2.32, p = 0.014), but negatively associated with blood pressure (OR = 0.42, p = 0.017) and blood glucose measurements (OR = 0.48, p = 0.009). These findings highlight the influence of residence on health service utilization among older adults in Hungary. Further comprehensive studies are needed to better understand the health needs of the elderly population and to develop policies aimed at promoting healthy aging in CEE countries.
人口结构转变给医疗体系带来了重大挑战，尤其是在中东欧（CEE）国家，这些国家的老年人口对医疗保健的需求正在上升。本研究旨在描述和比较匈牙利最贫困地区城乡老年人的健康状况和卫生服务利用情况。2022 年，在匈牙利东北部进行了一项综合健康调查，随机抽取了 443 名≥65 岁的老年人作为样本。采用多变量逻辑回归模型，调整年龄、性别、教育、经济状况、慢性疾病和活动能力受限等因素，研究居住地类型与卫生服务利用之间的关系。研究对象中，62.3%为女性，38.3%接受过小学教育，12.5%经济状况较差或非常差，52.6%居住在城市。总体而言，24%的老年人自评健康状况非常好或好（城市为 27.8%，农村为 19.7%），57.8%（城市和农村分别为 52.6%和 63.5%）报告存在日常活动受限的情况。与城市居民相比，农村居民看牙医的比例较低（p=0.006）、看专科医生的比例较低（p=0.028）、粪便潜血检测的比例较低（p<0.001）、接受结肠镜结直肠癌筛查的比例较低（p=0.014）、接受乳腺癌筛查的比例较低（p=0.035），而血压测量的比例较高（p=0.042）。多变量模型表明，城市居住与粪便潜血检测呈正相关（OR=2.32，p=0.014），与血压（OR=0.42，p=0.017）和血糖测量（OR=0.48，p=0.009）呈负相关。这些发现强调了居住地对匈牙利老年人卫生服务利用的影响。需要进一步开展全面研究，以更好地了解老年人口的健康需求，并制定旨在促进 CEE 国家老年人健康老龄化的政策。
