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

Health systems in transition Hungary 169
Hungary, 2006). The HISA was to supervise private and public actors within
the health care system, including new entrants to the health insurance market.
In this capacity, it was also to oversee and evaluate the outcome of health
services delivered by providers and to protect patient rights. No separate
discussion paper was presented, and no formal health impact assessments were
conducted, however, before the HISA was established and went into operation
in January 2007.
After the repeal in 2008 of the bill that would have introduced managed
competition to the health insurance system, the new authority did not play any
supervisory role with regard to the NHIFA, but rather focused on monitoring
waiting lists and the quality of services, as well as on examining patient
complaints. In February 2009 the HISA published an activity report, which
showed that only 1350 complaints had been submitted to the authority in 2009,
which is very low compared to the total number of services provided within the
health system. Most complaints were about care provided improperly and in a
manner contrary to professional standards, insufficient patient information, and
waiting lists. The HISA conducted some useful research to inform the public
and policy-makers on quality issues and access to care (HISA, 2009).
Following the elections in April 2010, the new government eliminated the
HISA (2010/10) with the stated aim of improving the efficiency of the health
system. Some functions of the HISA were preserved by the government
and distributed to other actors in the health system, such as the NHIFA
and NPHMOS.
Capacity regulation
A stated goal of the governments in power from 2002 to 2010 was to make
health care provision more equitable, increase the quality of care and improve
the efficiency of health care delivery by adjusting the capacity of providers more
precisely to the needs of patients (2006/12). In 2006 the government argued that
(a) the structure of the health care delivery system (the ratio of acute, chronic
and nursing care capacities) and its relationship with morbidity and mortality
patterns were distorted and (b) the geographical distribution of the capacities
was unequal, resulting in unfair disparities in access to care.
To address this issue, the government aimed to reshape the system so that
treatments for emergencies and common diseases would become accessible
in as many places as possible – preferably within the framework of outpatient
care – while more serious and costly interventions would be limited to facilities
where all necessary conditions were available. A new law to this effect was
approved by the National Assembly in the second half of 2006 (2006/12) and