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

Health systems in transition Hungary 159
for people with disabilities) in the primary social care category, while daytime
social care was shifted from the special social care category to primary social
care.
According to the new classification, primary social care includes four
community care services, daytime social care in institutions and five basic
services: (1) village and homestead caretaker service ensures access to basic
public services and meets the most important personal and community needs
in villages with less than 600 inhabitants (village caretaker) or less than 400
with at least 70 people living in the outskirts (homestead caretaker); (2) social
catering provides at least one hot meal per day for social service beneficiaries;
(3) domestic help assists people in need in daily housekeeping and personal
administration activities; (4) alarm-system-based domestic help, introduced
in 2003, works as a stand-alone service or as a complementary service to
domestic help; and (5) family assistance service helps to deal with crisis
situations in families (particularly concerning social issues or mental illness).
According to Act III of 1993 (1993/1), every settlement is obliged to provide
social catering and domestic assistance, while family assistance is compulsory
only in settlements with more than 2000 inhabitants. The target group of the
alarm-system-based domestic help includes elderly people, people with severe
disabilities or psychiatric patients living alone or in two-person households
(Article 63).
In 2007 the number of persons utilizing the family assistance service was
455 per 10 000 inhabitants, and there were 692 village and 242 homestead
caretaker services in operation. There were 101.4 recipients of social catering
per 10 000 inhabitants, with 464.4 recipients per 10 000 in the population
over 60 years of age. Only 75% of municipalities provided the service, with
smaller villages typically being the exception (Mester, 2010). Domestic help
was utilized by 45.8 recipients per 10 000 population, or 209.6 persons per
10 000 population aged over 60 years. Here, regional inequalities in access to
care have been aggravated further by a decrease (of 1606 between 2002 and
2007) in the number of workers. Consequently, the number of care recipients
increased from 5.5 per nurse to 7.3 per nurse (Mester, 2010).
Domestic assistance is of special relevance for specialist home care: it is
meant to serve as the interface between social care and health care, since social
nurses are expected to realize when their clients are in need of health care
services and to notify home care services accordingly (1993/1, Article 63).