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

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Health systems in transition Hungary
The characteristics and extent of health inequities in Hungary since the
mid-1980s have been thematized in scientific literature (Kósa, 2009; Kósa et al.,
2007). The NPHP intended to address primarily the marginalized sections of
society, such as Roma minorities, disabled people and the homeless, especially
with regard to improving their access to health services. Planned interventions
to deal with health inequities within the wider framework of social determinants
of health have been lacking, however (Kósa, 2009).
The regulatory framework for health impact assessments was incorporated
into the legal framework of environmental assessment. According to this, the
government defines those activities where environmental assessment is either
obligatory or optional (1995/7). In 2005, the government refined the regulation
of health aspects more in detail (2005/10). There is a tendency towards the
increased use of health impact assessments at the local level, but health impact
assessment is often overlooked in the political decision-making process since
there is no effective approach to involve the political stakeholders, such as the
Health Committee of the National Assembly, more deeply in the procedure.
2.7 Health information management
2.7.1 Information systems
A transparent and consistent strategy for information and communications
technology in the Hungarian health system is still lacking. Based on a national
IT centre created as part of the first government IT programme at beginning
of the 1970s, the Information Centre for Health Care was founded in 1987.
That year, the centre began a pilot project to collect cost data in hospitals to be
used in the HDG system (1987/1). The Centre played a key role in running the
financing reporting system of the providers and in preparing policy decisions,
especially with data collection. Since 2004 it has continued its work within the
organizational framework of the NHIFA. In addition, the NISHR was assigned
to take part in developing eHealth policy proposals by establishing a special
management unit (WHO, 2006).
With regard to all contracted and financed services of the NHIFA, the data
collection and reporting obligations of the providers are clearly linked to health
financing. Even family doctors must send itemized performance reports to
the NHIFA despite their being paid, for the most part, through capitation. The
structure and content of the reports are strictly regulated by the government
(1999/1). Despite the high priority placed on information and communications