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

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Health systems in transition Hungary
deviate from their provisions in order to ensure the best medical outcome for
individual patients. Several measures have been implemented endorsing quality
control and improvement in Hungary (see section 7.4.2).
Efficient provision of services
Several measures have been taken over time to improve service provision and
increase the efficiency of the system. Although the overall public expenditure
on health seems to have been contained successfully, this does not necessarily
mean that resource allocation has been efficient within the health sector (see
section 7.5.1). Improving technical (production) efficiency has been strived for
over almost two decades: introducing HDGs in 1993 was seen as a means to
increase productivity and efficiency and promote cost-consciousness among
hospital management. Several mechanisms to prevent the abuse of the system
and ensure quality of care for patients are also in place and technical efficiency
seems to have increased over the past few years (see section 7.5.2).
Cost-containment
Even though it cannot be classified as an objective of the health system per
se, one of the most important policy goals over the past 20 years has been the
containment of health expenditures. The actions of successive governments
and resulting health care budget cuts leave no doubt that these have been under
tight central control: between 1990 and 2000, health expenditures dropped
by nearly 30% in real terms (see also section 3.1). Given that the government
is obliged to cover the deficit of the HIF, rising health expenditures have
increasingly been seen as a potential threat to fiscal balance (see section 3.3.2).
While the overall cost-containment policy was successfully implemented, no
explicit priorities were set for the use of resources within this reduced budget.
Further, not enough attention has been paid to the potential negative impact of
these measures on population health status and the quality, accessibility and
long-term sustainability of health care.
7.2 Financial protection and equity in financing
7.2.1 Financial protection
The magnitude of private expenditure on health in Hungary – most of which is
attributable to OOP spending – is still unclear, not least because of divergent
estimates on the extent of informal payments (see section 3.4.3 as well as
section 3.1). OECD data indicate that after an increase from about 11% in 1991
to a peak of 31% in 2001, private expenditure as a share of total expenditure on