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

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136 Health systems in transition Hungary and hospitals owned by churches or charities; these private non-profit providers are integrated into the main system of financing and service delivery (NHIFA, 2010). As part of the government’s plan to rationalize the service delivery structure, the NHIFA has contracted with private profit-making providers for the provision of same-day surgery as well (see also section 5.4.1). 5.4.1 Outpatient specialist services According to the aforementioned provider typology, outpatient specialist services are provided by polyclinics, dispensaries, municipal hospitals, county hospitals, clinical departments of universities, National Institutes and health care institutions of other ministries (for example, the Military Hospital – State Health Centre under the Ministry of Defence). Initially, polyclinics employed specialists who worked exclusively in outpatient care. In the early reform phase in the 1990s, the objective was to integrate polyclinics partly into hospitals and partly into primary care. Instead of the three-pronged organization of the Semashko-style health care system during the communist era, integration would have made a two-pronged system of primary care and specialist care. The integration policy did not work, however, leaving several polyclinics that are still organizationally independent. Dispensaries were established during the communist regime. They provide outpatient care to chronically ill patients with pulmonary, dermatological and sexually transmitted diseases, people with alcohol and drug addiction, and patients with psychiatric disorders. In addition to this chronic outpatient specialist care, dispensaries implement screening programmes in their respective specialties and, additionally, for hypertension, diabetes, cancer and kidney diseases. In 2008 there were 170 dispensaries in Hungary for pulmonary disease, 125 for dermatological and venereal diseases, 135 for psychiatric disorders and 66 for addiction treatment (HCSO, 2010f). As can be seen in Fig. 5.1, each person in Hungary had an average of 11.95 outpatient contacts in 2009, which was third among the countries of central and south-eastern Europe after Slovakia (13.03) and the Czech Republic (13.00), and almost twice the EU27 average. High utilization rates in the outpatient specialist sector would not be undesirable if unnecessary hospitalization was avoided as a result. However, acute hospital admission rates in Hungary are also high (17.94 per 100 inhabitants compared to 15.66 for the EU27 average in 2008), albeit following a decreasing trend after the output of hospitals and outpatient specialist providers was limited by the government in 2006 (WHO Regional Office for Europe, 2011) (2006/5).
Health systems in transition Hungary 137 Fig. 5.1 Outpatient contacts per person per year in the WHO European Region, 2009 (or latest available year) Western Europe Switzerland (1992) Spain (2003) Germany (2008) Belgium Austria Ireland (1988) France (1996) Israel Italy (1999) Netherlands Turkey Greece (1982) Portugal (2008) Iceland (2005) Finland (2006) Denmark (2007) Norway (1991) Luxembourg (1998) Sweden (2006) Malta Cyprus (2008) United Kingdom Central and South-Eastern Europe Slovakia Czech Republic Hungary Estonia Lithuania Slovenia Poland (2006) Croatia The former Yugoslav Republic of Macedonia (2006) Latvia Bulgaria (1999) Romania Bosnia and Herzegovina Albania CIS Belarus Ukraine (2006) Uzbekistan Russian Federation (2006) Kazakhstan Republic of Moldova Azerbaijan Tajikistan (2006) Turkmenistan Kyrgyzstan (2008) Georgia Averages European Region (2006) EU12 EU27 EU15 (2006) Source: WHO Regional Office for Europe, 2011. 0.40 2.80 2.80 2.46 2.10 1.79 2.00 3.80 4.50 4.40 4.20 4.15 6.20 5.80 5.40 5.30 6.00 5.60 5.40 4.70 4.19 4.60 4.20 3.60 3.50 5.71 6.60 6.50 7.00 6.90 7.10 6.85 6.62 6.40 6.36 6.00 6.70 6.30 6.20 0 3 6 9 12 15 7.80 7.85 7.65 8.61 9.00 9.00 9.50 11.00 10.70 13.03 13.00 11.95 13.10
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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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3. Financing 3.1 Health expenditure
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8. Conclusions Since the mid-1990s,
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The Health Systems in Transition pr
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The European Observatory on Health
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