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

Health systems in transition Hungary 195
One of the concepts for assessing health system performance is that of
avoidable mortality. 4 A recent study shows that Hungary’s avoidable mortality
rate ranked very high among OECD countries in 2005, both overall and
disaggregated by gender. Even though this was not the case for all individual
causes of disease (Hungary had a relatively low rate of avoidable mortality
for infectious diseases), the rate for non-transmittable diseases was among the
highest. Between 1997 and 2005 there was a relatively low decline in overall
avoidable mortality rates and, in conjunction with the fact that the rate itself
remained high, the conclusion could be drawn that more progress could be
achieved within the health system (Gay et al., 2011).
At present, the only compulsory screening programmes in Hungary are
those for infants and children, including screening for congenital disorders
and examinations of the sensory organs and blood pressure on an annual basis
(1997/17). Even though screening programmes for both breast and cervical
cancer have been in place since 2002 and 2003, respectively, participation
remains low and there is no recent assessment of the programmes’ impact.
The EU-SILC survey regularly assesses the self-reported health status of the
population in the EU. In 2008, 19.2% of respondents in Hungary reported that
their health status was “bad” or “very bad”, compared to 9.5% in the EU27 as
a whole. Conversely, the share of respondents reporting that their health status
was “good” or “very good” was 55.2% in Hungary versus 68% in the EU27 (see
also section 1.4) (European Commission, 2011).
7.4.2 Health service outcomes and quality of care
Despite the fact that Hungary has a relatively low life expectancy at birth and a
considerably high avoidable mortality rate (see section 7.4.1), there are quality
measures that paint a more positive picture. For example, the vaccination system
is well organized and serves the public health needs of the population. Among
children, measles immunization coverage was 99.8%, in 2009, which is an
outstanding result among all OECD countries and also in the WHO European
Region. Coverage for immunization against diphtheria, pertussis and tetanus
is equally high (WHO Regional Office for Europe, 2011).
Several measures have been implemented endorsing quality control and
improvement, such as the formulation of registration and licensing regulations;
the definition of minimum standards for the provision of various health services;
the establishment of internal and external quality-control systems for health
4 The term “avoidable mortality” is used throughout this review to designate deaths caused by conditions considered
treatable or preventable by health care services. This concept has been variably described as “avoidable”,
“amenable”, “treatable” or “preventable” mortality. For a terminological discussion see, for example, Nolte and
McKee (2004) and Gay et al. (2011).