Experiences with the application of the DRG principle in Hungary

doi:10.1017/CBO9780511620003.015

14 - Experiences with the application of the DRG principle in Hungary

Published online by Cambridge University Press: 24 February 2010

Júlia Nagy ,

Csaba Dózsa and

Imre Boncz

Edited by

John Kimberly ,

Gerard de Pouvourville and

Thomas d'Aunno

Show author details

John Kimberly: Affiliation:
University of Pennsylvania
Gerard de Pouvourville: Affiliation:
Centre National de la Recherche Scientifique (CNRS), Paris
Thomas d'Aunno: Affiliation:
INSEAD, Fontainebleau, France

Book contents

Get access

Summary

A brief description of the Hungarian health care system

With the political changes in 1990, the Hungarian health care system changed from a Soviet-type health care system to the Bismarckian traditions of compulsory national health insurance similar to many other East European countries. After 1990, the responsibility for maintaining all levels of health care services was transferred from central to local government with a few exceptions (universities, national medical institutes).

Responsibility for the financing of health care services was given to the National Health Insurance Fund (NHIF), the only insurance fund in Hungary, and performance-related financing was introduced. As a general rule, NHIF finances the running costs, while coverage of capital costs is the duty of the owner of the health care institute, usually local government.

Most of the health care budget comes from contributions. Employees pay a contribution of 4 per cent of their gross income, and employers pay 11 per cent, without an income ceiling. In 1996 a “health tax” was introduced, which was a fixed, lump sum amount (currently 3,450 Ft/month/employee (approx. US$18.50); average income in Hungary is about US$600/month). This health tax is expected to be eliminated in the future. Although currently only about 38 per cent of the total Hungarian population pay health insurance contributions, the rest (pensioners, children, the unemployed, etc.) also receive health insurance coverage and are entitled to health care services.

Type: Chapter
Information: The Globalization of Managerial Innovation in Health Care , pp. 284 - 319

DOI: https://doi.org/10.1017/CBO9780511620003.015 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Boncz, I., Nagy, J., Sebestyén, A., Kőrösi, L. (2004) Financing of Health Care Services in Hungary. European Journal of Health Economics, 5(3): 252–8.CrossRef Google Scholar PubMed

Gulácsi, L., Dávid, T., Dózsa, Cs. (2002) Pricing and Reimbursement of Drugs and Medical Devices in Hungary. European Journal of Health Economics, 3: 271–8.Google Scholar PubMed

,OECD Health Data 2004. Paris: OECD.

Belicza, É., Balogh, Á., Szócska, M. (2001) Performance Indicators of Hospital Care: Evaluation of Acute Myocardial Infarction Patient Care. [In Hungarian: A kórházi ellátás minõségi indikátorai: az akut myocardialis infarctus kezelésének értékelése] Orv Hetil, 142(21): 1003–9.Google Scholar PubMed

Belicza, É., Takács, E., Boncz, I. (2004) Development of an Indicator System for Evaluating the Quality of Health Care Services. [Indikátorrendszer kialakítása az egészségügyi szolgáltatások értékelésére] Orvosi Hetilap, 145(30): 1567–72.Google Scholar PubMed

Szende, Á., Mogyorósy, Z., Muszbek, N., Nagy, J., Pallos, G., Dózsa, C. (2002) Methodological Guidelines for Conducting Economic Evaluation of Healthcare Interventions in Hungary: A Hungarian Proposal for Methodology Standards. European Journal of Health Economics, 3: 196–202.CrossRef Google Scholar

Sebestyén, A., Boncz, I., Dózsa, Cs., Nyárády, J. (2004) Cost Analysis of Peritrochanteric Fractures According to Types of Surgical Treatment and Progressive Care from the Viewpoint of Financial Providers. [In Hungarian: Trochantertáji törések ellátásának költségvizsgálata a műtéti eljárások és a progresszív ellátási szintek szerint finanszírozói szemszögből] Orv Hetil, 145(21): 1115–21.Google Scholar PubMed

Boncz, I., Sebestyén, A., Pál, M., Sándor, J., Ember, I. (2003) Health-economic Analysis of Cervical Cancer Screening. [In Hungarian: A méhnyakrák szűrések egészség-gazdaságtani elemzése] Orv Hetil, 144(15): 713–17.Google Scholar PubMed

Csomós, Á., Hoffer, G., Fülesdi, B., Ludwig, E. (2005) The Incidence and Cost of Severe Sepsis in Intensive Care Units. [In Hungarian: A súlyos szepszis gyakorisága és kezelésének költsége intenzív osztályon] Orv Hetil, 146(29): 1543–7.Google Scholar PubMed

Boncz, I., Sebestyén, A., Börzsei, L., Nyárády, J. (2005) Market Share and Progressivity in Surgery According to the System of Diagnosis Related Groups (DRGs). Eur Surg Res, 37(S1): 19.Google Scholar

Sebestyén, A., Boncz, I., Börzsei, L., Nyárády, J. (2005) DRG-based Cost Analysis of Femur Neck Fractures in Patients with and without Complications using the Hungarian HBCS System. Eur Surg Res, 37(S1): 18.Google Scholar

Boncz, I., Sebestyén, A., Hoffer, G., Ember, I. (2004) First Results of the Hungarian Nation-wide Organized Breast Cancer Screening Program. Anticancer Research, 24(5D): 3440.Google Scholar

Boncz, I., Sebestyén, A., Dózsa, Cs., Pál, M., Nyárády, J. (2004) The Effect of the Implementation of Diagnosis Related Groups (DRGs) on Trauma Care in Hungary. European Journal of Trauma, 30(S1): 180–1.Google Scholar

Jávor, A., Bordás, I., Nagy, J. (1990) Introduction of the DRG System to Hungary. In: Lecture Notes in Medical Informatics, Budapest.Google Scholar

Bordás, I., Nagy, J. (1991) Measurement of Hospital Performance based on DRGs. [In Hungarian] Egészségügyi Gazdasági Szemle, 29: 37–49.Google Scholar

Nagy, J., Bordás, I., Weltner, J., Illés, S. (1997) Refinement of HBCS and the Results of New Versions Considering Homogeneity and Redistribution of Resources. 13th International PCS Europe Working Conference, Florence, Italy.

Kiss, Zs., Molnár, A., Dublinszki, P. (2005) Experiences with the Activity-Volume Controlled Financing System. [In Hungarian: A teljesítmény-volumen korláton alapuló finanszírozás tapasztalatai.] Egészségügyi Gazdasági Szemle, 43(1):Google Scholar

Fábián, T., Kincses, G. (1993) Critical Review of the Financing System of Prospective Payment / Diagnosis-Related Groups, based on experiences in the United States of America. [In Hungarian] Orv Hetil, 134(10): 523–6.Google Scholar

Kroneman, M., Nagy, J. (2001) Introducing DRG-based Financing in Hungary: A Study into the Relationship between Supply of Hospital Beds and Use of these Beds under Changing Institutional Circumstances. Health Policy, 55: 19–36.CrossRef Google Scholar PubMed

Darago, L.Improving the DRG system in Hungary. Stud Health Technol Inform, 95: 818–23.

Darago, L. (2004) Caseview_HUN: Easy DRG Overview. Stud Health Technol Inform, 105: 182–9.Google Scholar PubMed

Boncz, I., Nagy, J. (2003) Ten Years of Experiences with the Adoption of the DRG Principle From a Financial Point of View [In Hungarian: A Homogén Betegségcsoportok (HBCS) rendszerének 10 éves tapasztalatai finanszírozói oldalról] Egészségügyi Menedzsment, 5(2): 21–7.Google Scholar

Dózsa, Cs. (2004) “Aggressive” DRG Policy in Hungary: Questions and Answers about the Function and Future of the DRG System [In Hungarian: “Agresszív” HBCS politika Magyarországon: kérdések és válaszok a HBCS rendszer működésével és jövőjével kapcsolatban]. Informatika és Menedzsment az Egészségügyben (IME), 3(4): 14–20.Google Scholar