Publications

Effects of lower screening activity during the COVID-19 pandemic on breast cancer patient pathways: Evidence from the age cut-off of organized screening (Elek et al. 2022)

Health Policy, DOI: 10.1016/j.healthpol.2022.05.013 We examined the effects of the COVID-19 pandemic on the screening, diagnosis and treatment of breast cancer in Hungary based on administrative data until June 2021, covering three pandemic waves. After correcting for trend and seasonality, the number of mammography examinations decreased by 68% in 2020q2, was around its usual level in 2020q3 and was reduced by 20–35% throughout 2020q4-2021q2. The reduction was caused by a combination of supply-side (temporary suspensions of screening) and demand-side (lower screening participation during the pandemic waves) factors. The number of new breast cancer diagnoses and mastectomy surgeries responded with a lag, and were below their...

Heterogeneous impact of the COVID-19 pandemic on lung, colorectal and breast cancer incidence in Hungary: results from time series and panel data models (Elek et al. 2022)

BMJ Open, DOI 10.1136/bmjopen-2022-061941 Objective During the COVID-19 pandemic, health system resources were reallocated to provide care for patients with COVID-19, limiting access for others. Patients themselves also constrained their visits to healthcare providers. In this study, we analysed the heterogeneous effects of the pandemic on the new diagnoses of lung, colorectal and breast cancer in Hungary. Design Time series and panel models of quarterly administrative data, disaggregated by gender, age group and district of residence. Participants Data for the whole population of Hungary between the first quarter of 2017 and the second quarter of 2021. Main outcome measures Number of patients newly diagnosed with...

The effect of involuntary retirement on healthcare use (Bíró, Branyiczki, Elek, 2022)

Health Economics, DOI 10.1002/hec.4493 We analyze the causal effect of involuntary retirement on detailed indicators of healthcare use and mortality. We leverage a pension reform in Hungary which forced public sector workers above the statutory retirement age to full time retirement. Using rich administrative data, we find that on the 3-year horizon, involuntary retirement decreases the number of primary care doctor visits, the use of systemic antiinfectives and respiratory drugs, and the non-zero spending on antiinfectives, the drugs of the alimentary tract and metabolism and of the cardiovascular system. The impact on the latter two drug categories is driven by the...

Income gradient of pharmaceutical panic buying at the outbreak of the COVID-19 pandemic (Elek, Bíró, Fadgyas-Freyler, 2021)

Health Economics, DOI: 10.1002/hec.4378 We analyze the timing, magnitude, and income dependence of pharmaceutical panic buying around the outbreak of the COVID-19 pandemic in Hungary. We use district-level monthly and daily administrative data on detailed categories of pharmaceutical purchases, merge them to income statistics, and estimate multilevel panel models. Our main results are as follows. First, the days of therapy (DOT) of pharmaceutical purchases increased by more than 30% in March 2020, when major lockdown measures were announced. This pattern holds for almost all categories of pharmaceuticals. Second, shortly after the panic reactions, the aggregate amount of pharmaceutical purchases returned...

Time patterns of precautionary health behaviours during an easing phase of the COVID-19 pandemic in Europe (Bíró, Branyiczki, Elek, 2021)

European Journal of Ageing, DOI: 10.1007/s10433-021-00636-4 Using data from the COVID-19 questionnaire of the Survey of Health, Ageing and Retirement in Europe (SHARE), we investigate the time patterns of precautionary health behaviours of individuals aged 50 years and above during the summer of 2020, an easing phase of the COVID-19 pandemic in Europe. We also examine how these health behaviours differ by the presence of chronic conditions such as hypertension, high cholesterol level, heart disease, diabetes or chronic bronchitis, which can be considered as risk factors for COVID-19. Our results suggest that while on average, people became less precautious during the...

The impact of sweet food tax on producers and household spending—Evidence from Hungary (Bíró 2021)

Agricultural Economics, DOI: 10.1111/agec.12634 Since 2011, a wide range of unhealthy food and drink are subject to a specific excise tax in Hungary. We analyze how this tax affected the revenue, sales volume, personnel costs, and size of sweet food producers, and compare these results to estimated effects on household spending on sugary food. We base our analysis on administrative data sets of firm level indicators, and survey data on household spending. We apply the estimation method of difference-in-differences, where firms producing untaxed processed food (in the firm level analysis) and household spending on food categories directly not affected by the...

Mass media coverage and vaccination uptake: evidence from the demand for meningococcal vaccinations in Hungary (Bíró & Szabó-Morvai, 2021)

The European Journal of Health Economics, DOI: 10.1007/s10198-021-01296-y We estimate the effect of mass media coverage of the meningococcal disease on the uptake of meningococcal vaccinations in Hungary. Our analysis is based on administrative county-level data on vaccination purchases linked to indicators of media coverage of the meningococcal disease and to administrative records of disease incidence. Using geographical and time variations in these indicators, our fixed effects estimates indicate a strong positive effect of mass media coverage of the disease on the rate of vaccination with all types of the meningococcal vaccine. At the same time, we do not find evidence...

Life expectancy inequalities in Hungary over 25 years: The role of avoidable deaths (Bíró, Hajdu, Kertesi, Prinz 2021)

Population Studies, DOI: 10.1080/00324728.2021.1877332 Using mortality registers and administrative data on income and population, we develop new evidence on the magnitude of life expectancy inequality in Hungary and the scope for health policy in mitigating this. We document considerable inequalities in life expectancy at age 45 across settlement-level income groups, and show that these inequalities have increased between 1991–96 and 2011–16 for both men and women. We show that avoidable deaths play a large role in life expectancy inequality. Income-related inequalities in health behaviours, access to care, and healthcare use are all closely linked to the inequality in life expectancy.

The long-term impact of restricted access to abortion on children’s socioeconomic outcomes (Hajdu, Hajdu 2021)

Plos One, DOI: 10.1371/journal.pone.0248638 We examine the long-term consequences of restricted access to abortion following a change in the Hungarian abortion law in 1974. Due to a change that restricted access to legal abortions, the number of induced abortions decreased from 169,650 to 102,022 between 1973 and 1974, whereas the number of live births increased from 156,224 to 186,288. We analyze the effects on the adult outcomes of the affected cohort of newborns (educational attainment, labor market participation, teen fertility). We use matched large-scale, individual-level administrative datasets of the Hungarian Central Statistical Office (population census 2011; live birth register), and we...