1. Department of Preventive Medicine Faculty of Public Health University of Debrecen General Practitioners’ Morbidity Sentinel Stations Program (GPMSSP) to monitor NCDs in Hungary

2. Aim Collecting valid data on the prevalence and incidence of NCDs with high public health importance Support priority setting and capacity development in health care Database for planning, monitoring and controlling public health programs

3. *Standard: A 25-64 éves európai standard populáció Forrás: WHO/Európa, HFA adatbázis, 2011. január Males Females Cardiovascular diseases Malignant diseases Gastrointestinal diseases External causes

4. Data collection to monitoring morbidity can be based on: hospital discharge records population surveys general practitioners’ reporting

5. Aim Description of morbidity structure in the Hungarian adult population Monitoring the quality of primary health care Contribution to the evaluation of primary health care from economic and management points of view

6. Case-based - General Practice Research Database Program (NHS) Network of GPs Core data reported for all patients Disease-based - Continuous Morbidity Registration Centers - CMR Sentinel Stations (NIVEL -Netherlands Institute for Health Services Research) Network of GPs Focusing selected diseases

7. General Practitioners’ Morbidity Sentinel Stations Program (GPMSSP) Established by: University of Debrecen National Public Health Medical Officer Services General Practitioners

8. - Hypertension - Ischaemic heart disease - Myocardial infraction - Stroke - Diabetes mellitus - Liver cirrhosis - Lung cancer - Colorectal cancer - Breast cancer - Cervical cancer - Prostate cancer NCDs with high public health importance ( 11 diseases )

14. GP New cases  continuous (monthly reporting) Demographic data  at the beginning of year

15. Study center on-line GP New cases  continuous (monthly reporting) Demographic data  at the beginning of year Incidence rates  at the end of years Sample maintaining  continuous

16. Study center on-line GP New cases  continuous (monthly reporting) Demographic data  at the beginning of year Incidence rates  at the end of years Sample maintaining  continuous Prevalences  at the end of year

17. Study center on-line GP New cases  continuous (monthly reporting) Demographic data  at the beginning of year Incidence rates  at the end of years Sample maintaining  continuous Prevalences  at the end of year Reporting year ly

18. Definition for diseases Operations Manual Quality indicators Regular site visits Comparison to external study results

19. Strengthens Standardized case definitions and data collection Flexible structure Motivated participants Regular feed-back for GPs Low resource demand from GPs Weaknesses Lack of standardized disease definition in hospitals No supportive input from hospitals Lack of international guideline for GP morbidity monitoring No input data on risk factors Opportunities Needs for reliable data for chronic non-communicable disease Extension of the network is easy process Governmental commitment for improving population health status Risks Long term sustainability Sensitivity to changes of governmental policy Some GPs are not committed enough

20. Crude estimated prevalence for Hungary: males:25,52% females:31,16% Crude estimated incidence for Hungary: males:1,38% females:1,27% Age and gender specific prevalence and incidence observed in 2013 by General Practitioners’ Morbidity Sentinel Stations Program.

21. Standardized prevalence ratio in 2013 for Hungary: males:133% females:108% Standardized incidence ratio in 2013 for Hungary: males:84% females:73% Age and gender standardized prevalence and incidence ratios in 1998-2013 observed by General Practitioners’ Morbidity Sentinel Stations Program.

22. Crude estimated prevalence for Hungary: males:6,65% females:6,58% Crude estimated incidence for Hungary: males:0,52% females:0,56% Age and gender specific prevalence and incidence observed in 2013 by General Practitioners’ Morbidity Sentinel Stations Program.

23. Standardized prevalence ratio in 2013 for Hungary: males:162% females:133% Standardized incidence ratio in 2013 for Hungary: males:96% females:95% Age and gender standardized prevalence and incidence ratios in 1998-2013 observed by General Practitioners’ Morbidity Sentinel Stations Program.

25. 1.Unknown morbidity (hypertension, diabetes) study (2001) Representative DNA bank for Hungary (2001) 2.Case-control study on the risk factors for chronic liver diseases (2005) 3.Epidemiology of metabolic syndrome in Hungary (2006) 4.Prevention (screening) of cardiovascular diseases in primary health care (2008) 5.Role of general practitioners in organization of cervical cancer screening (2008) 6.Type 2 diabetes mellitus care in primary health care (2008) 7.Knowledge, attitude and risk perception related to non-communicable diseases (2009) 8.Public health focused model program for organizing primary care services (2012-2016) 9.IGEN-Hungarian – Identification of Disease Related GENes in the Hungarian Population (2012-2015) Number of publications: 39 Cumulative impact factor: 80.812

27. ……….

28. Reference samples: 4267 (randomly selected, representative for the Hungarian general population by sex, age, geographical distribution) Type II DM: 1300 Reference samples for Roma people: 1252 (randomly selected, representative for the Roma population living in segregated colonies in North-East Hungary by sex, age, geographical distribution)