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

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Health systems in transition Hungary
time, given that a substantial part of patient–doctor encounters in primary care
take place for the purpose of obtaining a referral, the government rationalized
prescribing regulations in order to reduce family doctors’ workload. Moreover,
the requirement that family doctors prescribe only one month’s worth of
medication at a time for patients with chronic disease was changed so that
three months’ worth of medication could be prescribed. As a result of these
measures, the number of consultations decreased by 15% from 2006 to 2007.
After user charges were eliminated in April 2008 (see section 6.1.1), the number
of consultations increased by 5% that year and by more than 8% in 2009 (HCSO,
2010f).
In addition to family doctor services, municipalities are also obliged to
provide MCH and school health services. The District MCH Service is staffed
by highly qualified nurses, trained at higher education level. They provide
preventive care and health education to pregnant women, women in childbed
and children under the age of 6 in geographic areas that are determined by the
local government and cover no more than 250 persons in need of care (2004/6).
MCH nurses are employed by the local government and work autonomously in
the facilities provided by it, or they make on-site visits to families and schools.
The work of district MCH nurses is coordinated and supervised by senior MCH
nurse officers at the county level and by the chief MCH nurse at the national
level (see section 5.1). MCH nurses also provide school health services together
with physicians as a preventive service for children between 3 and 18 years of
age. Based on the number of pupils to be cared for, school health services can be
provided on a part-time or full-time basis. Finally, as their name implies, school
MCH nurses and physicians are employed directly by a given school (1995/11).
Emergency care (out-of-hours services) and primary dental care services are
also provided in the primary care setting (see sections 5.5 and 5.12).
5.4 Specialized ambulatory care/inpatient care
The provision of secondary and tertiary care is shared among municipalities,
counties, central government and, to a minor extent, private providers. The
various providers perform a wide range of activities depending on the level of
care (secondary or tertiary), the number of specialties covered (single or multiple
specialties) and the type of care (chronic or acute, inpatient or outpatient).