ABSTRACT
BACKGROUND – High-value medical imaging diagnostic procedures are key elements of the diagnostic process of patients with suspected oncological disease and in determining the effectiveness of the initiated therapy. In Hungary, due to the high diagnostic demands, diagnostic waiting lists for computed tomography (CT) or magnetic resonance imaging (MR) are usually long and result in less transparent reporting times, even in the case of individuals who are potentially suspected of having a malignant disease, or in the case of the follow-up of effectiveness of treatment of diagnosed cancer patients. THE AIM OF THE PRESENT STUDY – Midterm analysis of the onco-diagnostic Program in Budapest implemented within the framework of the Healthy Budapest Program (HBP), gain experiences and presentation of underlying health policy processes. RESULTS – From November 2020 till 31st of December 2022 within the framework of the Program, the Municipality of Budapest has reimbursed 5437 contrast-enhanced CT and 2948 MR examinations with "C” or "D” disease diagnosis. Examinations has been financed in a sector-neutral manner to public and private healthcare providers in the so-called ‘BP' reimbursement category. The report undertaken by Semmelweis University has found, that in Budapest Municipality funded patients, radiological examinations were performed on average 15.2 days sooner (16.1 vs. 31.1 days), than in the case of the National Health Insurance Fund funded patients, the mean waiting time for CT/MR examination was shortened by 13.0 days (4.2 vs. 17.2 days, respectively). In 86% of cases, patients used the Program once, in 14% twice or more. Utilization of the Program shows a significant difference by the different districts of the Capital: the number of cases – originally planned based on demographic, prevalence and incidence data, broken down by district – was utilized between 3-45% for CT, and 8-37% for MR cases, respectively, by district residents mainly referred by district outpatient clinic specialists, between the period of November 2020 and August 2022. CONCLUSION – The Program has been utilised in a smaller scale, than it was originally planned before COVID, in terms of its cases. The program has achieved its aim through the reduction of CT and MR diagnostic waiting times and waiting lists, and it has an indirect effect in generally reducing waiting times at medical imaging. However, this is not sufficient to speed up and provide more efficient service for the entire oncology diagnostic process. Therefore, we wish to further develop the Program in the direction of adding additional diagnostic examinations and developing a patient pathway management module. © 2023 Literatura Medica Publishing House. All rights reserved.
ABSTRACT
BACKGROUND – High-value medical imaging diagnostic procedures are key elements of the diagnostic process of patients with suspected oncological disease and in determining the effectiveness of the initiated therapy. In Hungary, due to the high diagnostic demands, diagnostic waiting lists for computed tomography (CT) or magnetic resonance imaging (MR) are usually long and result in less transparent reporting times, even in the case of individuals who are potentially suspected of having a malignant disease, or in the case of the follow-up of effectiveness of treatment of diagnosed cancer patients. THE AIM OF THE PRESENT STUDY – Midterm analysis of the onco-diagnostic Program in Budapest implemented within the framework of the Healthy Budapest Program (HBP), gain experiences and presentation of underlying health policy processes. RESULTS – From November 2020 till 31st of December 2022 within the framework of the Program, the Municipality of Budapest has reimbursed 5437 contrast-enhanced CT and 2948 MR examinations with "C” or "D” disease diagnosis. Examinations has been financed in a sector-neutral manner to public and private healthcare providers in the so-called ‘BP' reimbursement category. The report undertaken by Semmelweis University has found, that in Budapest Municipality funded patients, radiological examinations were performed on average 15.2 days sooner (16.1 vs. 31.1 days), than in the case of the National Health Insurance Fund funded patients, the mean waiting time for CT/MR examination was shortened by 13.0 days (4.2 vs. 17.2 days, respectively). In 86% of cases, patients used the Program once, in 14% twice or more. Utilization of the Program shows a significant difference by the different districts of the Capital: the number of cases – originally planned based on demographic, prevalence and incidence data, broken down by district – was utilized between 3-45% for CT, and 8-37% for MR cases, respectively, by district residents mainly referred by district outpatient clinic specialists, between the period of November 2020 and August 2022. CONCLUSION – The Program has been utilised in a smaller scale, than it was originally planned before COVID, in terms of its cases. The program has achieved its aim through the reduction of CT and MR diagnostic waiting times and waiting lists, and it has an indirect effect in generally reducing waiting times at medical imaging. However, this is not sufficient to speed up and provide more efficient service for the entire oncology diagnostic process. Therefore, we wish to further develop the Program in the direction of adding additional diagnostic examinations and developing a patient pathway management module. © 2023 Literatura Medica Publishing House. All rights reserved.