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

Health systems in transition Hungary 45
inhabitants, while the municipality remains responsible for capital costs
according to the principle of maintenance obligation. This scheme is
known as “functional privatization”.
3) Family doctors can work as independent private providers with no
municipal contract and no territorial supply obligation, if patients choose
them, but they are only entitled to capitation payment from the HIF if
they have a minimum of 200 registered patients. It is worth noting that
the system of “practice rights” established in 2000, does not apply to this
group of practitioners.
4) Employment options were widened in 2001 and 2003 through the
introduction of the so-called freelance medical doctor status (2001/12 and
2003/19), which removes doctors from public employee regulations, but
does not make them self-employed private entrepreneurs. Physicians who
opt for a freelance status contract with the health care provider and are
free to negotiate fees; they are also allowed to form group practices.
Health service provision is supervised by the NPHMOS. Monitoring of
providers is regular and includes checking personnel and material minimum
standards, and the quality of services delivered. The system consists of
supervisory chief medical doctors at the municipal, county and in some
cases regional level for various medical specialties, and there is one national
supervisory chief medical doctor for 54 specialty areas. The National Centre for
Healthcare Audit and Inspection is responsible for appointing these supervisory
chief medical doctors upon the approval of the national and regional chief
medical officers and in collaboration with the professional colleges and the
National Institutes of Health.
Reimbursement prices and utilization, including the scope of benefits,
referrals and waiting lists are also regulated within the health insurance system.
To ensure the quality of training and minimum standards of service provision,
all health workers are expected to improve their professional knowledge, and
medical doctors must achieve a minimum of 250 credit points on accredited
courses in a five-year continuing education cycle.
To ensure the quality of care provided, the government decided to develop
a national accreditation system and create a system of quality assurance in
1994 (1994/7), requiring the professional colleges to take part in elaborating
the standards of the quality assurance system (1995/4). In 1996 the government
established the National Quality Award, for which the providers can apply
based on the European Foundation for Quality Management model. But it was