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

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8 Health systems in transition Hungary increase has been attributed to a decrease in cardiovascular mortality over the same period. Indeed, after three decades of decline in population health status due to non-communicable diseases, this turnaround was interpreted as the beginning of a new era in population health (Józan, 2009). Some researchers are sceptical of this view and have pointed out that the gap in life expectancy at birth between Hungary and neighbouring Austria, the other Visegrád Group countries and the EU15 average has remained essentially unchanged for women and narrowed only somewhat for men over this period (Széles et al., 2005). Moreover, since the mid-1990s, mortality due to ischaemic heart disease in individuals younger than 65 years in Hungary has actually increased relative to the EU15 and Visegrád Group averages (Széles et al., 2005). Finally, compared to the EU15 average, the relative risk of mortality from cardiovascular disease, malignant neoplasms and respiratory disease among both women and men of all ages has continued to rise (Ádány, 2008). Table 1.3 Mortality and health indicators, 1970 –2009 (selected years) 1970 1980 1990 1995 2000 2005 2009 Life expectancy at birth, total (years) 69.3 69.1 69.5 70.1 71.9 73.0 74.5 Life expectancy at birth, male (years) 66.4 65.5 65.2 65.5 67.6 68.8 70.3 Life expectancy at birth, female (years) 72.2 72.8 73.9 74.8 76.3 77.2 78.5 Crude death rate per 1 000 population, total 11.6 13.6 14.0 14.1 13.3 13.5 13.0 Crude death rate per 1 000 population, male 12.5 14.8 15.4 15.7 14.5 14.6 13.9 Crude death rate per 1 000 population, female 10.8 12.4 12.8 12.6 12.2 12.5 12.1 Source: WHO Regional Office for Europe, 2010. In short, Hungary still ranks among the lowest in Europe with regard to life expectancy at birth, trailing the EU27 average by 5.1 years and the EU15 average by 6.3 years in 2009. When taking the overall disease burden into account, this gap persists, with disability-adjusted life expectancy (DALE) in Hungary reaching 65.8 years in 2007 (Table 1.4) compared to 73.0 years in the EU15, 71.7 years in the EU27, 71.3 years in Slovenia, 69.9 years in the Czech Republic, and 67.1 years in Poland (WHO Regional Office for Europe, 2010).
Health systems in transition Hungary 9 Table 1.4 DALE in years, 2000 –2007 (selected years) 2000 2001 2002 2007 Male 57.9 58.0 61.5 62.3 Female 65.4 65.5 68.2 69.3 Total 61.6 61.8 64.9 65.8 Source: WHO Regional Office for Europe, 2010. As can be seen in Table 1.5, the main causes of death in Hungary are diseases of the circulatory system, malignant neoplasms, diseases of the digestive system (including liver disease) and external causes (including suicide). This pattern has remained essentially unchanged since 2000, and mortality from each of these causes continues to be higher than for the EU27 and, in the case of malignant neoplasms and digestive system disease, the EU12 and WHO European Region averages (WHO Regional Office for Europe, 2010). Table 1.5 Main causes of death (SDR, all ages, per 100 000), 1980 –2009 (selected years) 1980 1990 1995 2000 2005 2009 Communicable diseases Infectious and parasitic disease 13.4 8.5 7.2 5.6 4.1 3.8 Tuberculosis 10.9 6.1 5.5 3.3 2.1 1.4 HIV/AIDS a Noncommunicable diseases n/a n/a 0.1 0.2 0.1 0.1 Diseases of circulatory system 688.7 643.9 592.0 521.0 502.4 421.2 Ischaemic heart disease 229.4 239.7 248.7 226.9 261.3 214.8 Cerebrovascular disease 218.0 177.2 158.6 141.7 108.2 90.8 Malignant neoplasms 239.9 266.7 276.2 268.2 237.4 243.2 Trachea/bronchus/lung cancer 44.5 61.2 65.0 65.0 60.8 65.9 Breast cancer (female) 29.0 32.2 32.7 32.5 27.4 28.1 Cervical cancer 11.0 9.6 8.4 7.3 6.5 5.9 Diseases of the digestive system 62.9 81.4 106.4 87.0 70.6 65.6 Chronic liver disease and cirrhosis 27.4 50.6 79.0 60.1 44.5 41.3 Diseases of the respiratory system 89.4 57.1 52.5 40.3 47.7 44.3 Mental disorders and diseases of the nervous system and sensory organs 12.1 19.4 25.5 22.2 22.3 29.6 Diabetes External causes 16.9 16.2 14.8 17.3 25.6 17.9 External cause injury and poison 114.3 121.1 100.9 82.2 67.9 59.0 Suicide and self-inflicted injury 44.4 38.1 30.5 29.2 23.2 21.8 Motor vehicle traffic accidents 15.8 24.4 16.2 12.0 12.1 8.5 Sources: WHO Regional Office for Europe, 2010; a European Commission, 2011. Notes: SDR: Standardized death rate; n/a: Not available.
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Page 3 and 4: Health Systems in Transition Péter
Page 5 and 6: Contents Preface
Page 7 and 8: Preface The Health Systems in Trans
Page 9 and 10: Acknowledgements The Health System
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Page 19 and 20: Abstract Hungary has achieved a suc
Page 21 and 22: Executive summary Introduction Hung
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3. Financing 3.1 Health expenditure
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Health systems in transition Hungar
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8. Conclusions Since the mid-1990s,
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The Health Systems in Transition pr
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The European Observatory on Health
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