Health Systems in Transition - Hungary - World Health Organization ...

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102 Health systems in transition Hungary currently used mainly in the long-term treatment of psychiatric patients (see section 5.7). The care these hospitals provide should not be confused with same-day surgery. Table 4.1 provides simple descriptive statistics on the number of 155 inpatient care providers and their capacities. The average capacity was 470 beds, and the total number of beds operated by each provider ranged from 10 to 2166. The largest provider was Semmelweis University in Budapest, and the smallest were two hospice and chronic care providers, each of which had 10 beds. About 70% of all providers had fewer than 500 beds. Larger hospitals (that is, hospitals with more than 1000 beds) include four universities with medical faculties, four municipal hospitals, the Military Hospital in Budapest, 13 large county hospitals, and a large municipal hospital in Borsod county. Six inpatient care providers had only acute beds, whereas 45 had only chronic capacities (although 8 of these 45 also provided same-day elective surgery). The rest had a mixed profile with both acute and chronic beds. The average acute capacity was 415 beds, while the corresponding figure for chronic care was 186 beds in 2009. The largest chronic care provider in 2009 was a municipal hospital in Budapest, with 795 chronic beds. Table 4.1 Number and size of inpatient care providers in Hungary, 2009 Size of inpatient care providers (in beds ) Other providers Hospitals 80– 150– 250– 500– 1000– 1500– Type of provision Acute care 10–19 20–79 149 249 499 999 1499 1999 2000+ Number of providers 0 18 17 11 30 20 9 1 1 % of providers 0.0% 16.8% 15.9% 10.3% 28.0% 18.7% 8.4% 0.9% 0.9% Cumulative number 0 18 35 46 76 96 105 106 107 Cumulative % Chronic care 0.0% 16.8% 32.7% 43.0% 71.0% 89.7% 98.1% 99.1% 100.0% Number of providers 8 32 38 31 29 8 – – – % of providers 5.5% 21.9% 26.0% 21.2% 19.9% 5.5% – – – Cumulative number 8 40 78 109 138 146 – – – Cumulative % Total 5.5% 27.4% 53.4% 74.7% 94.5% 100.0% – – – Number of providers 7 23 13 19 44 23 13 9 1 % of providers 4.6% 15.1% 8.6% 12.5% 28.9% 15.1% 8.6% 5.9% 0.7% Cumulative number 7 30 43 62 106 129 142 151 152 Cumulative % 4.6% 19.7% 28.3% 40.8% 69.7% 84.9% 93.4% 99.3% 100.0% Source: Authors’ calculations based on NHIFA, 2010.
Health systems in transition Hungary 103 In 2009 more than 26% of inpatient care capacity was concentrated in Budapest, which had 108.8 beds per 10 000 population, or about 50% more than the nationwide average (Table 4.2). Even though there had been some excess capacity in Budapest in the early 1990s, these figures no longer represent unjustified disparities in the geographical distribution of hospital beds for two reasons: first, Budapest serves the population of the surrounding counties as well (mainly Pest county, but to a lesser extent also Komárom-Esztergom, Fejér, Nógrád and Heves counties). When Pest county is taken into account, which together with Budapest forms the region known as Central Hungary, the number of hospital beds per 10 000 population exceeded the nationwide average by only 6% in 2009. Second, Budapest accommodates the majority of care capacities at the highest level of specialization (for example, at the National Institutes of Health), and the institutions at this level have a catchment area that encompasses the entire country. At the regional level, geographic inequalities have generally decreased over the past 20 years, although this does not mean that capacity currently matches health care needs perfectly. The Southern Great Plain region showed the greatest deviation: in 2009, its capacity in terms of hospital beds was about 10% lower than the country average and the health status of its population was worse than the nationwide average. Although capacity in the Northern Great Plain region deviated less from the nationwide average, the health status of the population in this region was even worse than that in the Southern Great Plain region. It is important to note that whereas both the Northern Hungary and the Southern Transdanubia regions were above the country average in terms of hospital beds, the health status of their populations was substantially worse than the country average, which also implies regional disparities (HCSO, 2010a). Even though inpatient care capacity shows even larger disparities at the county level, this is not necessarily a source of concern, given that the utilization of health services is not confined by the geographical borders of the counties.
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Health Systems in Transition Vol. 1
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Health Systems in Transition Péter
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Contents Preface
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Preface The Health Systems in Trans
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Acknowledgements The Health System
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Health systems in transition Hungar
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Abstract Hungary has achieved a suc
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Executive summary Introduction Hung
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1. Introduction 1.1 Geography and s
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18 NATIONAL/CENTRAL LEVEL REGIONAL
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6. Principal health reforms 6.1 Ana
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8. Conclusions Since the mid-1990s,
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10. Appendices 10.1 References Ád
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The Health Systems in Transition pr
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The European Observatory on Health
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