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

Health systems in transition Hungary 209
Fig. 7.11
Variation in 30-day mortality (%) in patients with acute myocardial infarction
according to county of the hospital of first admission, 2008
Vas
Zala
Source: Belicza, 2008.
Gyor-M-S
Veszprém
Somogy
Komárom-E
Baranya
Fejér
Tolna
Budapest
Nógrád
Pest
Bács-Kiskun
Csongrád
Borsod-A-Z
During the late 1990s and the 2000s, there were a few attempts to address
these problems comprehensively by entrusting one actor with the coordination
of care. The earliest of these initiatives was the CCS, which was launched as
a pilot programme in 1999 and eventually eliminated in 2008 (2008/9). The
CCS assigned the care coordination function to health care providers on the
basis of financial incentives and covered more than 20% of the population of
the country (about 2.2 million inhabitants) in 2005. The project was criticized
mainly for lack of transparency as well as inequitable distribution (State Audit
Office, 2008a) (see also subsection Coordination in health care in section 6.1.1).
One of the most important issues identified by the CCS is the manifestation
of previously unmet need due to the improvement of care activities by the
care coordinators. Relevant findings suggest that the early identification and
proper care of patients with chronic diseases does not generate savings in the
short term (Fig. 7.12). Although the cost of care for cardiovascular patients
identified by screening programmes was lower on average, the total cost
was higher, because these patients accessed high-cost interventions (such as
Percutaneous Coronary Intervention [PCI]) on time. Undiagnosed and not
properly cared for patients, on the other hand, did not, either because they
succumbed to their condition or because they were past the critical time period
indicated for the intervention. This finding also suggests that the sustainability
Heves
J-N-Szolnok
Békés
Hajdú-Bihar
Szabolcs-Sz-B
23.7 to 26.7 (5)
20.9 to 23.7 (5)
18.1 to 20.9 (3)
15.3 to 18.1 (3)
12.5 to 15.3 (4)