{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T11:27:04Z","timestamp":1780572424911,"version":"3.54.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Spatially segregated, socio-economically deprived communities often face significant health disparities. This paper evaluates the impact of COVID-19 on healthcare delivery and reimbursement disparities in Hungary, particularly focusing on segregated populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To examine healthcare utilization and reimbursement patterns among patients in segregated areas (SA) and non-segregated or complementary areas (CA) during the first year of the COVID-19 pandemic, compared to pre-pandemic levels, and to understand how these patterns influenced overall health outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional study using 2019 and 2020 healthcare data from all Hungarian general medical practices (GMPs) was conducted. Segregated areas were identified based on governmental criteria, and healthcare indicators were standardized by age, sex, and socioeconomic status. Key indicators included General Practitioner (GP) visits, outpatient services, Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) usage, hospitalizations, healthcare reimbursement, and premature mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 2020, there was a notable reduction in healthcare services utilization due to COVID-19 restrictions, with GP visits declining by 10.43% in SAs and 4.13% in CAs. Outpatient services decreased by 19.16% in SAs and 12.45% in CAs, while hospitalizations dropped by over 23.52%. Despite these reductions, the relative risk (RR) of healthcare service use remained higher in SAs compared to CAs (RR\u202f=\u202f1.22, 95% CI: 1.219;1.223). Healthcare reimbursement was significantly lower in SAs (RR\u202f=\u202f0.940, 95% CI: 0.929;0.951), and premature mortality was higher (RR\u202f=\u202f1.184, 95% CI: 1.087;1.289).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The COVID-19 pandemic led to a significant reduction in healthcare utilization across Hungary. However, segregated populations in 2020 continued to have higher healthcare service use but received lower reimbursement, indicating persistent healthcare disparities. The consistently higher premature mortality rate in SAs underscores the need for targeted interventions and improved healthcare access and quality for vulnerable communities. Future policies should be built on data from comprehensive monitoring systems to address and mitigate these disparities, ensuring equitable healthcare access in and out of health crises.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1481814","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T05:30:04Z","timestamp":1747114204000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["COVID-19\u2019s effect on healthcare disparities: delivery, reimbursement, and premature mortality in residentially segregated populations"],"prefix":"10.3389","volume":"13","author":[{"given":"Kasabji","family":"Feras","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferenc","family":"Vincze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinga","family":"Lakatos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"P\u00e1link\u00e1s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e1szl\u00f3","family":"K\u0151r\u00f6si","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e1szl\u00f3","family":"Ulicska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"K\u00f3sa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e1nos","family":"S\u00e1ndor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e0264363","DOI":"10.1371\/journal.pone.0264363","article-title":"{COVID}-19 vaccination coverage in deprived populations living in segregated colonies: {a} nationwide cross-sectional study in {Hungary}","volume":"17","author":"S\u00e1ndor","year":"2022","journal-title":"PLoS One"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1053\/j.semvascsurg.2021.08.002","article-title":"Health care disparities during the COVID-19 pandemic","volume":"34","author":"Andraska","year":"2021","journal-title":"Semin Vasc Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1038\/s41390-019-0513-6","article-title":"The color of health: how racism, segregation, and inequality affect the health and well-being of preterm infants and their families","volume":"87","author":"Beck","year":"2020","journal-title":"Pediatr Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1093\/epirev\/mxp001","article-title":"Is {segregation} {bad} for {your} {health}?","volume":"31","author":"Kramer","year":"2009","journal-title":"Epidemiol Rev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2334","DOI":"10.1007\/s40615-021-01170-w","article-title":"Disproportionate impact of COVID-19 on racial and ethnic minority groups in the United States: a 2021 update","volume":"9","author":"Tai","year":"2022","journal-title":"J Racial Ethn Health Disparities"},{"key":"ref6","unstructured":"Health equity considerations and racial and ethnic minority groups\n          \n          2020"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1684","DOI":"10.1016\/S0140-6736(21)00949-1","article-title":"COVID-19 and disparities affecting ethnic minorities","volume":"397","author":"Morales","year":"2021","journal-title":"Lancet"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1186\/s12889-023-15223-8","article-title":"Ethnic disparities in COVID-19 outcomes: a multinational cohort study of 20 million individuals from England and Canada","volume":"23","author":"Zaccardi","year":"2023","journal-title":"BMC Public Health"},{"key":"ref9","unstructured":"Ensuring equitable access to COVID-19 health services and support\n          \n          2020"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.puhe.2023.10.023","article-title":"Impact of sociodemographic and economic determinants of health on COVID-19 infection: incidence variation between reference periods","volume":"225","author":"Ramalho","year":"2023","journal-title":"Public Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1093\/eurpub\/ckad224","article-title":"Primary care indicators for disease burden, monitoring and surveillance of COVID-19 in 31 European countries: Eurodata study","volume":"34","author":"Ares-Blanco","year":"2024","journal-title":"Eur J Pub Health"},{"key":"ref12","unstructured":"Policies EO on HS and Hungary: country health profile 2021\n          \n          2021"},{"key":"ref13","unstructured":"COVID-19 pandemic - 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