A sneak peek into the Hungarian Healthcare System and Health Status

The Hungarian healthcare system is mostly state-funded with a long-term policy aimed at sustaining the system by offering optional services through privately-operated healthcare clinics and centers. Hungary spent € 8.59 bn in 2015 on healthcare, equal to 8.18% of its GDP.

Structure

The Hungarian healthcare system functions via a comprehensive, compulsory, employment-based national health insurance scheme that provides near universal coverage in terms of both treatments and population.

Healthcare restructuring plans began in 2011 with plans for renationalizing Hungarian hospitals that were maintained by the local government. The restructuring process was completed last year with a significant delay.

Although the central government is responsible for both social welfare and health provision, other entities (e.g. the National Assembly, local governments, regional health councils, the National Health Insurance Fund Administration and the National Public Health and Medical Officer Service) are also heavily involved in this process.

There are four main functions under the Hungarian healthcare system: stewardship/ownership, service delivery, financing and public health (we will go more in depth with each of these functions in Chapter 2.5 The National Level).

Funding

The Hungarian healthcare system is funded by health insurance contributions and services are free of charge for all citizens insured under the National Health Insurance Fund or Országos Egészségpénztár Penztar (OEP).

Despite this fact, public funding is considered less than adequate and patients may be required to make a contribution to the cost of their medical expenses. Additionally, due to the low wages paid to healthcare professionals, it is not uncommon for patients to pay “gratuity fees” to both doctors and nurses after undergoing a surgical procedure or giving birth.

Another example of the less than adequate funding is the fact that there is a charge for prescriptions, despite the fact that they are subsidized.

Hungarian healthcare is financed in different ways, depending on the type of care:

  • Outpatient specialist care is financed on a fee-for-service point system
  • Acute inpatient and rehabilitation function on a DRG system
  • Chronic care works on patient-days adjusted to the complexity of the case
  • Primary care on a patient capitation system

Healthcare Status

The health status among the general population in Hungary is considered to be among the worst in Europe, with most healthcare indicator scores ranking below the European average.

Infant mortality and life expectancy

When looking at infant mortality rates, Hungary has a score of 4.8 deaths per 1000 live births. Although Hungarian infant mortality rates have decreased significantly during the last decades, the current rate is still below the European average of 3.5.

When taking a closer look at this indicator and comparing Hungary’s score with other countries in the region, only Romania had a higher infant mortality rate.

Hungary Infant Mortality rate
Hungary Infant Mortality rate

In 2014, life expectancy at birth in Hungary was 75.6 years, which is below the European average of 83.3 years. Hungary, also ranked quite low on this indicator when compared to other countries in the region, with only Romania lagging behind in terms of life expectancy at birth.

This relatively low life expectancy can be partially attributed to the fact that there are high mortality rates related to non-communicable diseases.

Non-communicable and chronic diseases

Some of the most prevalent conditions are cardiovascular disease (primarily acute myocardial infarct), cancers (especially lung cancer) and respiratory diseases.

Hungary Non-communicable and chronic diseases Mortality rate
Hungary Non-communicable and chronic diseases Mortality rate

Furthermore, life-styles that put people at risk for chronic diseases are quite common, for example:

  • Obesity is common (about 28.5%)
  • About 50% of Hungarian adults smoke (this is well above the OECD average of 20.7%)
  • Hypertension is not well controlled
  • Nutritional choices tend to be high in fat
  • Sedentary lifestyles are quite common and people are not getting enough exercise

These risk factors foreshadow further increases in the occurrence of health problems like diabetes and cardiovascular diseases, and higher healthcare costs in the future. Recent studies have shown that some of the main barriers to preventing non-communicable diseases (NCD) in Hungary include:

  • The fact that the population generally has a low level of health literacy
  • There is a “mismatch” in the healthcare system between the incentives offered and the actual requirements for effective NCD management (e.g. the current focus is on processes rather than outcomes).
  • These challenges are happening within a context of human resource shortages and a lack of standardized training in NCD management

The combination of these factors has a significant impact on service delivery.

The management of non-communicable diseases has been included as part of the current public health agenda in Hungary, which will help define national action plans on health system strengthening and NCD control and management.

In contrast to the high rates of NCD’s, incidence rates for communicable diseases or infectious diseases are quite low, reflecting an effective vaccination program. The incidence rates for measles, pertussis and hepatitis B are among the lowest in the OECD.

Coronary heart disease is the most frequent cause of death, and is almost three times as common as deceasing due to a stroke.

For further quantitative information on the Hungarian healthcare system and the macroeconomic climate, please look into our Business intelligence platform or order the TforG Deep Dive report for Hungary containing volumes of 1000 surgical procedures in 13 specialisms.