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

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Health systems in transition Hungary
therapy must visit their specialist at least once every six months.
Unfortunately, there is no seamless national information system for
medical documentation accessible to providers at every level of care;
family doctors can only obtain secondary care treatment documents that
are handed over to them by the patient..
All the services mentioned above, with the exception of the free choice of
hospital and physician and any outpatient medication, are currently covered by
the HIF and are therefore free of charge. Certain outpatient specialist services
do not require a referral from a family doctor (see section 5.3).
5.3 Primary care
In Hungary, municipalities are responsible for ensuring the provision of primary
care to the local population (1990/3), including family doctor services (through
family physicians and family paediatricians), dental care, out-of-hours services,
MCH nurse services and school health services (1997/20).
Family doctor services, at least in larger municipalities, are provided to
adults by family physicians and to children by family paediatricians. In smaller
municipalities, family physicians care both for adults and children in so-called
mixed practices. Family doctors are required to have a qualification in the
specialization of family medicine, which was introduced in 1992.
Local governments are responsible for ensuring that family doctor services
are available to their population. They have the right to designate the primary
care districts for family doctor services within their territory. To be eligible for
HIF financing, family physician practices must care for at least 1200 residents
over the age of 14 years and family paediatrician practices must care for at least
600 children aged 14 year or younger (1999/1). Primary care districts, which
must cover the entire territory within the local government’s jurisdiction (for
example, a municipality), serve as the basis of the territorial supply obligation.
People do not have to register with a provider in their primary care district.
Since 1992 people have been allowed to choose their family doctor freely, but
may only switch to a new family doctor once a year. Family doctors are not
allowed to refuse patients who live in their primary care district, but may refuse
applicants from other districts (1992/3). Municipalities can decide whether to
deliver family doctor services themselves (by hiring family doctors as public
employees) or to contract with family doctors working as private entrepreneurs.
The latter is the most common arrangement in primary care and is known as