Structural Changes in the Hungarian Healthcare System Between 2000 and 2017.

Abstract

BACKGROUND\nThe rigid and old-fashioned structure of the Hungarian healthcare system has been discussed since the mid-1990s and is at the center of professional and policy debates. It is characterized by the too high number of acute care hospital beds in international comparison; access is regionally unequal; levels of progressive care are mixed; and there is a nonuniform emergency service system with unequal access to the emergency room, heterogeneous quality of care, and unexploited opportunities of modern health technology (eg, 1-day surgery, minimally invasive procedures, telemedicine).\n\n\nOBJECTIVES\nThe aim of this study is to analyze the indicators of ongoing structural changes of the Hungarian healthcare system between 2000 and\xa02017.\n\n\nMETHODS\nData are derived from the Organisation for Economic Co-operation and Development Heath Statistics, Hungarian National Statistical Office, National Health Insurance Fund Administration and the database of the European Structural Funds. The methods used for the analysis are descriptive statistics, trend analysis, and longitudinal data.\n\n\nRESULTS\nThe total number of hospitals beds showed a 32% reduction between 2005 and 2017. Parallel with this subsequent reduction of hospital bed capacities, we can see a moderate reduction (22.3%) in the number of discharged patients from hospitals: from 2005 to 2017, 2.55 million to 1.95 million. The average length of stay in acute hospital care has decreased from 6.3 to 5.1 days. About 25 to 27 small local hospitals lost their acute or short-term care profile (mainly intensive care units, internal medicine, surgery, and pediatric care wards) and became long-term care, chronic care, or rehabilitation profile hospitals.\n\n\nCONCLUSION\nStructural change is in progress in the Hungarian healthcare system, and some efficiency gains have been reached. Nevertheless, still there are significant potential efficiency gains in the better organization and management of health services in addition to the dissemination and better incorporation of modern healthcare technologies.