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

Health systems in transition Hungary 139
care under the territorial supply obligation are required to set up a hospital
supervisory council, whose members can be delegated by NGOs, providers
and local governments. This council does not have management rights but can
formulate opinions and proposals supporting the operation of the providers; it
also represents the interests of the resident population.
In 2003 the Ministry of Health, Social and Family Affairs 3 regulated some
aspects of the management structures in public hospitals (2003/11). According
to this regulation, the management of public hospitals must consist of a director
and deputy directors in a typical pyramid-shaped hierarchical structure. The
deputy directors are responsible for areas such as medical, nursing and business
operations. In addition, there is a professional management board, whose
members consist of medical and nursing directors, as well as the heads of every
professional department. This board must meet for at least two sessions per year
and can formulate recommendations to the director of the hospital. The consent
of this board is necessary for some management issues, including the strategic
professional plan of the institution and its quality management policy.
5.4.3 Day care
Day care in Hungary is defined using a 24-hour limit after hospital admission,
which means that patients who are admitted late in the day and spend the
night in hospital can also be considered day-care cases. At the same time,
minor surgical procedures that do not need any postoperative supervision and
emergency cases are not classified as day care (NHIFA, 2003). A special type
of intermediate care known as daytime hospital treatment (for example, mental
health treatment and rehabilitation services that do not require an overnight
stay) is also not considered day care (see section 5.7).
The organizational, infrastructural and human resource requirements of day
care are regulated by a ministerial decree (2002/20), whereas further regulations
to be observed by service providers are defined in a rule-book published by the
NHIFA (NHIFA, 2003). The State Secretariat for Healthcare also has a protocol
on outpatient surgery, which was developed by the Professional College of
Surgery and the Society of Multidisciplinary One-Day Surgery. Although
the ministerial decree has opened up the provision of day-care services to
polyclinics, the requirements are stricter than those for inpatient care. For
example, physicians must have at least five years of experience providing
3 As of 2010 called the State Secretariat for Healthcare within the Ministry of National Resources.