The impact of digital healthcare and teledentistry on dentistry in the 21st Century: a survey of Hungarian dentists.

BACKGROUND: The era of digitalization has arrived in the field of dentistry. Teledentistry (TD), the use of digital solutions in dentistry, is already used in practice; however, only some possibilities are considered. During the COVID-19 pandemic, remote patient monitoring and patient communication had to be solved with TD, thus causing a rapid spread of new tools. In addition to digital workflows, patient communication, AI, and online forums are also available. METHODS: An online self-administered survey was developed for the study. The Hungarian Medical Chamber contacted potential respondents in a newsletter or e-mail. The Evasys survey system was used. The weighting procedure was executed for gender, age group, and type of settlement. A digital dental index variable was created and built with a linear regression model as a dependent variable. Explanatory variables are advantages, disadvantages, what would be necessary, experienced needs from the patients, and age. RESULTS: A total of 171 dentists completed the survey. The best-known digital technologies are online conferences (96.5%), E-prescriptions (94.6%), and digital impressions (86.0%). Unawareness is the highest in the field of artificial intelligence in dentistry (50.5%), store-forward solutions (43.5%), and real-time solutions (41.8%). The digital dental index is 14.24 (standard deviation (SD) = 5.5), with a high power of the model. CONCLUSION: Hungarian dentists need to be made aware of all the possibilities of TD. In addition to digital workflows, store-forward and real-time solutions can be beneficial to substitute face-to-face visits. TD can be used effectively to monitor oral cavity changes and develop dental confidence and proper oral care habits. Our survey suggests that it is necessary and inevitable to integrate TD into both graduate and postgraduate education, which may form the basis of primary health care in the next decade.

Older adults in the digital health era: insights on the digital health related knowledge, habits and attitudes of the 65 year and older population.

BACKGROUND: The COVID-19 pandemic has increased internet use by older age groups to an unprecedented level in Hungary mirroring the general tendency in the total population. Nevertheless, international trends indicate that this group is less likely to use digital health technologies than younger ones. The aging population raises the question of successfully integrating elderly people into the digital health ecosystem. Our research aim is to investigate the digital health usage patterns and attitudes of the population aged 65 and over through a representative sample. METHODS: A national representative questionnaire survey was conducted by telephone (CATI), interviewing 1723 respondents. Within this sample we examined 428 people in the over-65 age group, 246 in the 65-74 age group and 182 in the over-75 age group. Predictors of demand for digital solutions were tested using binary logistic regression model. RESULTS: 50.8% of people aged 65-74 and 37.1. % of people aged 75 + use the internet for health-related purposes, mostly to access websites. 85% of respondents in 65-74 and 74% in 75 + age group have used more than one digital health device and around 70% of both age groups have a need for more than one digital solution. 90.2% (64-75 age group) and 85.7% (75 + age group) of respondents are familiar with e-prescription, 86.4% and 81.4% of them use it. 77.1% of 65-74-year-olds have heard of and nearly half 45.5% have used online appointment. More than half (52.7%) of the respondents in this age group have heard of and used electronic transmission of medical records and data. A similar proportion has heard about and used apps: 54.3% has heard of them, but only 17.3% has used them. The multivariate analyses emphasized that the need for digital solutions increases with the level of education and the more benefits one perceives in using digital solutions. CONCLUSION: Our research has shown that the senior age group has measurable needs in the field of digital health, so helping them on this journey is in the interest of the whole health ecosystem. Their high level of interest is indicated by the fact that more than a fifth of older adults would like to have access to between 7 and 10 of the maximum number of digital devices available. The differences between the two age groups - with younger people being more open to digital solutions and using them more - and the fact that the under 65s are better adapted digitally in all respects, raises the possibility that the specific trends in digital health for older people may virtually disappear in 10 years' time (when the under 65s now enter this age group).

Creating work-life balance among physicians in the age of digitalization: the role of self-consciousness and communication - a qualitative study.

BACKGROUND: Besides the positive effects of using digital health solutions, digitalization can affect the healthcare worker burnout. The ability to coordinate different aspects of life (WLB) also plays a significant role in the development of burnout among medical workers. The aim of our study is to show, through qualitative interviews, the impact of digitalization on work-life balance in Hungarian physicians. METHODS: 62 semi-structured interviews were conducted between October 2021 and June 2022, of which, a total of 31 interviews were used for the analysis, which were all related to the theme of work-life balance. Purposive sampling and inductive thematic approach were used to collect and analyse the data and identify patterns of the themes. RESULTS: Based on this analysis, 5 main themes emerged: (1) the use of digital health tools, (2) Impact of digital tools on everyday work, (3) Work-life balance, (4) Setting and maintaining work-life boundaries, (5) Potential solutions. With the spread of digital communication, most of the respondents feel that their working hours increased even at the expense of their private life. The majority considers constant availability as a serious problem, however, several physicians indicated that as a result of a learning curve, they are able to change and set the necessary boundaries. Respondents were divided on whether or not they were successful in setting and maintaining boundaries. The 2 most important factors of establishing WLB in a digital age are self-consciousness and communication. However, these skills are not self-evident: the responses also show that in many cases there is a need for external support, but also for health professionals to actively reflect from time to time on their role as healers and their relationship with technology. CONCLUSION: Basic principles and tools for establishing successful digital work-life balance in healthcare should be involved in the training curriculum of future physicians and healthcare professionals, while institutions should elaborate specific policies to include digital work-life balance in the institutional setting, as part of the preventive measures against burnout.

Socio-economic differences among low-birthweight infants in Hungary. Results of the Cohort '18 -Growing Up in Hungary birth cohort study.

BACKGROUND: As Hungary had the fifth-highest rate of low-birthweight (LBW) in the EU27 in 2020, LBW still remains a public health problem for the country. OBJECTIVE: Our goal is to examine whether LBW in Hungary is determined by the mothers' educational attainment, adjusted for other maternal characteristics (SES, health behaviour and psychological status during pregnancy) among mothers who gave birth in 2018-2019 in Hungary. METHODS: Source of data is the first and second wave of the Cohort '18 -Growing Up in Hungary longitudinal birth cohort study (n = 8185). It is based on a nationwide representative sample of pregnant women who gave birth between March 2018 and April 2019. All data were self-reported by mothers. We examined the association between maternal educational attainment and the risk of giving birth to an LBW-child (<2500g) by using logistic regression analysis. The highest educational attainment of the mother is measured by a five-value categorical variable (ISCED 97: 0-1; 2; 3C; 3-4; 5-6). RESULTS: 5.9% of women had LBW children. This rate is 18.0% among the lowest educated women with ISCED 97: 0-1; and it is 3.6% among the highest educated women with ISCED 97: 5-6. The adjusted predicted probabilities of LBW for these two groups of women are 13.5%, and 3.4% respectively, adjusted for household income quantiles, Roma ethnic background, residence place, smoking, alcohol consumption, and depression during pregnancy; controlled for mother's height, age at birth, parity and child's sex. Compared to women with the lowest level of education, the risk of giving birth to an LBW child decreases by 34.6% for those with the second level of education, by 60.1% for those with the third level of education, by 72.5% for those with the fourth level of education and by 77.2% for those with the highest level of education. Smoking during pregnancy significantly increases the risk of giving birth to an LBW by 54.9%. Being depressed at 7th month of pregnancy decreased the risk of giving birth to an LBW child in our sample by 13.2%, however the relationship is not significant. CONCLUSION: Our analysis confirmed that maternal educational attainment has a significant impact on the risk of LBW net of by other maternal SES and health behaviour factors. Nevertheless, even after adjusting for these covariates, inequality in LBW by maternal educational attainment persists.

State of vulnerable populations in the techquity framework in Hungary.

Digital health solutions could alleviate the needs of vulnerable populations in the recent period of the permacrisis, however, there are several barriers that limit their use for certain individuals. We use the four-pillar model of the novel concept of techquity to provide original evidence of the discrepancy in the willingness to try and the ability to harness healthtech in Hungary. We identified three underserved segments of society: older adults, people with long-term activity-limiting conditions, and people experiencing homelessness who could greatly benefit from digital technologies and yet use them less than the general population. We also discuss potential strategic considerations in order to promote techquity and digital inclusion among people living in vulnerable situations.

[E-physicians in Hungary: Experiences and opinions related to digital health among Hungarian physicians]. / E-orvosok Magyarországon: Digitális egészséggel kapcsolatos tapasztalatok és vélemények a hazai orvosok körében.

INTRODUCTION: The digitalization of healthcare is one of the most topical issues in terms of the present and future of healthcare. The coronavirus pandemic has shed light on the potential inherent in these technologies, and at the same time brought to the surface countless tasks and problems that need to be solved. OBJECTIVE: In our national survey, our aim is to find out how medical doctors are adapting to digital healthcare solutions. METHOD: Between July 2021 and May 2022, we conducted an online questionnaire survey among doctors working in Hungary. 1774 people answered our questions, including 1576 general practitioners and 198 dentists. In this paper, the 1576 general practitioners' responses are presented. RESULTS: 78.8% of the respondent doctors recommend websites to their patients on a more or less regular basis, 52.8% have recommended apps and 46.0% have recommended social media resources. The respondent doctors perceive a high demand from patients for communication by e-mail (83.7% indicated). 86.4% of doctors are aware of telemedicine solutions and 47.5% of respondents would like to use them intensively in the next 3 years. A significant proportion of respondents would like to use apps (56.2%), sensors, portable diagnostic devices (49.0%) and artificial intelligence (28.3%) in the next 3 years. Websites, apps and social media resources are significantly more frequently recommended by general practitioners and they are the ones who are most in favour of the use of the internet for patient health and telemedicine. CONCLUSION: Our respondents manifest fundamentally positive feelings towards the digitalization of healthcare and are characterized by a cautious openness regarding the implementation and adaptation of technologies. Orv Hetil. 2023; 164(4): 132-139.

E-patients in Hungary: Digital health use and attitudes based on a representative nationwide survey / E-páciensek Magyarországon: Digitális egészséggel kapcsolatos ismeretek, szokások egy országos reprezentatív felmérés tükrében

Introduction: The impact of digitalisation on healthcare has become one of the most important research areas in re-cent years. The COVID-19 epidemic has been a major driver in this process. Objective: In our nationally representative, population-based survey (n = 1500), we sought to find out how patients in Hungary use digital health tools, what the advantages and disadvantages of introducing and using these technolo-gies are, and how this is transforming the doctor-patient relationship. Methods: We conducted a national representative telephone questionnaire survey (CATI). The sample is representa-tive of the adult population of Hungary in terms of gender, age, type of settlement and education. Results: 81.3% of the respondents use the internet - 87.6% of whom use it in relation to health and illness, too. This is 71.2% of the total sample. Websites (76 .3%) and social media (47.3%) are the main sources of information on the internet; e-prescription and online appointment booking are the most known by patients (92.6% and 85.2%, respec-tively), while almost half of the respondents would like to try telehealth and would welcome a recommendation from their doctor on reliable websites, apps and sensors. Our results highlighted that the effect of the type of settlement on access to digital health is not significant, but that the effect of age, education and gender is decisive. Conclusion: Data from our national representative population survey indicate that the use of digital health solutions is already an integral part of care and that there is a strong demand for further digital options.

Characteristics of the Hungarian pregnancy care system: background inequalities in the preferences for private and public care / A magyarországi várandósgondozási rendszer sajátosságai: a magán- és állami ellátások igénybevétele mögött húzódó egyenlotlenségek.

Összefoglaló. Bevezetés: Jóllehet Magyarországon a várandósok a társadalombiztosítási rendszer által támogatott komplex várandósgondozási ellátásra jogosultak, mégis sokan vesznek közülük igénybe privát szolgáltatásokat. Ezt a döntést többek között a biztonságérzet fokozása és a várandósgondozást végzo szakember szülésig tartó folytonosságának biztosítása motiválja. Nemzetközi szakirodalmi adatok alapján mindemellett feltételezheto, hogy hazánkban is befolyásolja a választást a társadalmi-gazdasági helyzet. Célkituzés: A jelen elemzés célja annak vizsgálata magyarországi várandósok reprezentatív mintáján, hogy az állami/magán/vegyes finanszírozású várandósellátás igénybevétele mennyiben kapcsolódik bizonyos demográfiai, szocioökonómiai, egészségi és pszichológiai változókhoz. Módszer: Az elemzés a Kohorsz '18 Magyar Születési Kohorszvizsgálat elso, várandós anyák körében zajló szakaszának súlyozott adatain történt (n = 8287). Az adatok forrását a védonok által szóbeli interjúk során felvett, valamint önkitöltos formában begyujtött kérdoíves adatok szolgáltatták. Eredmények: Az egyes várandósgondozási formák igénybevétele erosen összefüggött a várandós korával, iskolai végzettségével, anyagi helyzetével és foglalkozási presztízsével. Közepes erosségu kapcsolatban állt a várandós partnerkapcsolati helyzetével és meglévo gyermekeinek számával, míg gyenge összefüggésben az egészségi állapotával és pszichés tüneteivel. A finanszírozási formához mindemellett erosen kapcsolódott az, hogy a várandós választott orvossal, szülésznovel tervezte-e szülését. Megbeszélés: A kapott eredmények rámutatnak, hogy a várandósellátás különbözo finanszírozású formáinak igénybevétele jelentos mértékben együtt jár a várandós szocioökonómiai és demográfiai sajátosságaival, míg egészségi és pszichés állapotával csupán gyenge összefüggésben áll. Következtetés: A hazai várandósgondozást jellemzo kettos finanszírozás háttér-egyenlotlenségek egész sorát hordozza magában. Jövobeli elemzésekben vizsgálat tárgyává szükséges tenni, hogy ez mennyiben mutat összefüggést ellátásminoségi és -hozzáférési különbségekkel, valamint ezeken keresztül a várandós és gyermeke egészségével. Orv Hetil. 2021; 162(35): 1402-1412. INTRODUCTION: While pregnant women in Hungary are entitled to complex pregnancy care financed by the social security system, many of them do use private services. This decision is motivated, among other things, by increasing the sense of security and ensuring the presence of the doctor providing pregnancy care at the birth. However, based on the international literature, it can be assumed that this decision is influenced by the socio-economic background as well. OBJECTIVE: The aim of the present analysis is to examine the extent to which the use of public/private/mixed funded pregnancy care is related to certain demographic, socioeconomic, health related and psychological variables on a representative sample of pregnant women in Hungary. METHOD: The analysis was performed on the weighted data of the first, pregnant wave of the Cohort '18 Growing Up in Hungary (n = 8287). The analysis is based on data from personal interviews and self-administered questionnaires conducted by the health visitors among pregnant women in 2018. RESULTS: The use of different forms of pregnancy care was strongly related to the age of the pregnant women, their education, financial situation and occupational prestige. It was moderately correlated with the pregnant woman's partnership status and their parity, while it was weakly correlated with her health status and psychological symptoms. The form of financing of the pregnancy care was, however, strongly related to whether the pregnant woman planned to give birth with a chosen doctor or midwife. DISCUSSION: The results show that the use of different forms of pregnancy care is greatly associated with the socioeconomic and demographic characteristics of the pregnant women, while it is only weakly related to the health status and mental wellbeing. CONCLUSION: Double funding in the Hungarian pregnancy care system carries a whole range of background inequalities. Future analyses should examine whether this has an impact on the quality and availability of care and, indirectly, on the health of pregnant women and their children. Orv Hetil. 2021; 162(35): 1402-1412.

The decade of Roma Inclusion: did it make a difference to health and use of health care services?

OBJECTIVES: We investigated whether the severely disadvantaged health of Hungarian Roma adults living in segregated settlements changed by the Decade of Roma Inclusion program. METHODS: We compared the results of two paired health interview surveys that we carried out using the same methodology before and after the Decade, on the general Hungarian and Roma populations. RESULTS: Self-perceived health status of younger Roma worsened, while it improved among older Roma. Reported experience of discrimination reduced considerably and health care utilization improved in general. Positive changes in smoking and nutrition, and negative changes in alcohol consumption and overweight were observed. Many of observed changes can plausibly be linked to various government policies, including a quadrupling of public works expenditure, banning smoking in public places, restricting marketing of tobacco products, increasing cigarette prices, and a new tax on unhealthy foods. Liberalization of rules on alcohol distillation coincided with worsening alcohol consumption. CONCLUSIONS: We have shown that Roma remain severely disadvantaged and present an innovative sampling method which can be used to monitor changes in groups where identification is a challenge.

[Dietary survey in Hungary, 2003-2004. Micronutrients: vitamins]. / Táplálkozási vizsgálat Magyarországon, 2003-2004. Mikrotápanyagok: vitaminok.

The 3rd Hungarian National Nutritional Survey was carried out as a part of the National Population Health Study and the data collection was done in November/December of 2003. The survey comprised a sample of adults above 19 year of age, the dietary questionnaires of 1179 people could be evaluated. The results of energy and macro-nutrient intake were published in 2005, and the results of the mineral intake in 2007, in the Hungarian Medical Journal. This paper focuses on the intake of vitamins. For the evaluation of the results authors used the data of the two previous national surveys, data of some dietary studies of other countries, and the home and international intake recommendations. In respect of the data found in the present survey, it is a favourable trend that the intake of vitamins retinol equivalent, B1 , B6 and B12 , and niacin, as well as biotin was sufficient both in case of men and women, together with adequate vitamin E intake for men. However the intake of vitamin B2 , C, D, together with pantothenic acid and folic acid of both men and women did not meet the criteria of the Hungarian recommendations, besides the vitamin E intake of women was insufficient as well. In Hungary the intake of vitamin D, biotin, folic acid and pantothenic acid was measured at first at this National Dietary Survey. The authors vigorously stress the importance of the varied and healthy nutrition in the adequate vitamin supply of the population.

[Hungarian national dietary survey, 2003-2004. Micronutrients: mineral salts]. / Táplálkozási vizsgálat Magyarországon, 2003-2004. Mikro-tápanyagok: ásványi sók.

In the course of the 3rd national nutritional survey data were collected in 2003, and the paper on the energy and nutrition intake of a sample group consisting of 1179 people all aged above 19, was published in the Hungarian Medical Journal (Vol. 146, No. 34, 2005). The present paper focuses on one group of micronutrients, namely the minerals' intake. The authors evaluated the results mainly in comparison with the data of the two previous Hungarian national surveys, and the international and national recommendations. The average magnesium intake was considered adequate in both sexes, while iron, zinc and copper intakes also met the recommended level in men. On the other hand, the insufficient calcium and the excessive phosphorus intakes, as well as the disproportionate calcium-phosphorus ratio in both sexes are unfavourable facts. The adverse results include insufficient iron, zinc and copper intake in women and the excessive sodium intake in both sexes, as well. The authors emphasize the importance of spreading the principles of healthy nutrition as well as co-operating with the food industry in order to prevent the occurrence of mineral nutrients deficiency.

[Dietary survey in Hungary, 2003-2004]. / Táplálkozási vizsgálat Magyarországon, 2003-2004.

The third Hungarian national dietary survey was conducted in 2003-2004. This publication describes the first part of the energy and nutrient intake findings in a sample consisting of a population of 1179 persons over 19 years of age (energy and macro nutrients). Energy and nutrient intake values were calculated based on 3 x 24- hour dietary records filled out by the subjects themselves. The authors evaluated the results in light of the two previous dietary surveys in Hungary and the Hungarian and international reference intake data. The total fat intake found in this survey lower than the previous data marks a favourable development, just as the higher unsaturated fatty acid and lower saturated fatty acid energy percent, and furthermore the lower cholesterol intake level. The favourable developments include further a polyunsaturated/saturated fatty acid ratio considerably higher than that obtained earlier (the values conforming to the international reference data), a higher carbohydrate energy percentage, as well as lower added sugar energy percentage, this latter being in the recommended range. The overweight ratio in men was 58.9%, while the female value was 49.5%, not much different from the previous survey data.