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

Health systems in transition Hungary 161
accommodation for 8–14 people with physical or mental disabilities who are at
least partially able to care for themselves, with the aim of reintegrating them
into the community.
Just as for health care, the responsibility for provision does not imply that
local governments have to deliver the services themselves and contracting out
services is even more prevalent in the social sector than in the health care sector.
In 2007, residential social care was provided by 999 institutions, 35.7% of which
were NGOs. Total capacity was 88 525 beds (88.1 beds per 10 000 inhabitants),
59.7% of which were in homes for elderly people, 19% in homes for people with
disabilities, 9.5% in homes for psychiatric patients, 2.6% in homes for addicts
and 9.2% in homes for homeless persons. The number of residents was 85.0 per
10 000 population (Mester, 2010). The outsourcing of the delivery of primary
social care services is not so widespread. In 2007, social catering was provided
by NGOs to less than 5% of recipients (Mester, 2010).
There is a shortage of places in residential homes. In 2000 a total of 20
people per 10 000 population were on waiting lists, half of them for more than
a year, the problem being most pressing in residential homes for elderly people
(HCSO, 2001). Unfortunately, no statistics on waiting lists have been published
since 2000, and although occupancy rates have slightly dropped in the past
decade (Mester, 2010), various studies claim that the shortage of capacity has
not been relieved (European Commission, 2009; State Audit Office, 2008b).
The absolute and relative shortage of places, the geographic disparities,
insufficient coordination between health and social care, and contradictory
financial incentives (high user charges in social care as opposed to low or
no user charges in health care) have led to the abuse of acute inpatient
care capacities by chronic and social care cases – otherwise known as the
medicalization of social problems (European Commission, 2009). This is a
fundamental performance issue, and addressing it is key to a successful health
care reform. In addition, there is a lack of comprehensive quality assurance and
accreditation mechanisms in social care and of proper coordination mechanisms
between social care and health care (State Audit Office, 2008b).
5.9 Services for informal carers
Having recognized the value of informal carers in home-based care, the
Hungarian social care system provides financial assistance for this category
of caregivers. Relatives of patients requiring long-term care are eligible for a