Comparative analysis of the quality of life regarding patients who underwent hip replacement in public versus private hospitals in Hungary.

The study aimed to investigate the impact of hip replacement surgery on the quality of life and to compare the outcomes by sociodemographic and surgical data in Hungarian public and private hospitals. Patients were selected at the Department of Orthopaedics (Clinical Centre, University of Pécs) and at the Da Vinci Private Clinic in Pécs. Patients completed the SF-36 and Oxford Hip Score (OHS) questionnaires before the surgery, 6 weeks and 3 months later. We also evaluated socio-demographic data, disease and surgical conditions. The research involved 128 patients, 60 patients in public, 68 patients in private hospital. Despite the different sociodemographic characteristics and surgical outcomes of public and private healthcare patients, both groups had significantly improved the quality of life 3 months after hip replacement surgery measured by OHS and SF-36 physical health scores (p < 0.001). In the mental health score, only the patients of the private health sector showed a significant improvement (p < 0.001). The extent of improvement did not differ between the two healthcare sectors according to the OHS questionnaire (p = 0.985). While the SF-36 physical health score showed a higher improvement for public patients (p = 0.027), the mental health score showed a higher improvement for private patients (p = 0.015).

Annual epidemiological and health insurance disease burden of hip osteoarthritis in Hungary based on nationwide data.

BACKGROUND: Health services utilization related to hip osteoarthritis imposes a significant burden on society and health care systems. Our aim was to analyse the epidemiological and health insurance disease burden of hip osteoarthritis in Hungary based on nationwide data. METHODS: Data were extracted from the nationwide financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary for the year 2018. The analysed data included annual patient numbers, prevalence, and age-standardized prevalence per 100,000 population in outpatient care, health insurance costs calculated for age groups and sexes for all types of care. Patients with hip osteoarthritis were identified using code M16 of the International Classification of Diseases (ICD), 10th revision. Age-standardised prevalence rates were calculated using the European Standard Population 2013 (ESP2013). RESULTS: Based on patient numbers of outpatient care, the prevalence per 100,000 among males was 1,483.7 patients (1.5%), among females 2,905.5 (2.9%), in total 2,226.2 patients (2.2%). The age-standardised prevalence was 1,734.8 (1.7%) for males and 2,594.8 (2.6%) for females per 100,000 population, for a total of 2,237.6 (2.2%). The prevalence per 100,000 population was higher for women in all age groups. In age group 30-39, 40-49, 50-59, 60-69 and 70 + the overall prevalence was 0.2%, 0.8%, 2.7%, 5.0% and 7.7%, respectively, describing a continuously increasing trend. In 2018, the NHIFA spent 42.31 million EUR on the treatment of hip osteoarthritis. Hip osteoarthritis accounts for 1% of total nationwide health insurance expenditures. 36.8% of costs were attributed to the treatment of male patients, and 63.2% to female patients. Acute inpatient care, outpatient care and chronic and rehabilitation inpatient care were the main cost drivers, accounting for 62.7%, 14.6% and 8.2% of the total health care expenditure for men, and 51.0%, 20.0% and 11.2% for women, respectively. The average annual treatment cost per patient was 3,627 EUR for men and 4,194 EUR for women. CONCLUSIONS: The prevalence of hip osteoarthritis was 1.96 times higher (the age-standardised prevalence was 1.5 times higher) in women compared to men. Acute inpatient care was the major cost driver in the treatment of hip osteoarthritis. The average annual treatment cost per patient was 15.6% higher for women compared to men.

Assessing the Implementation of the Baby-Friendly Hospital Initiative in Hungary: A Cross-Sectional Study.

We assessed the prevalence of the "Ten Steps to Successful Breastfeeding" in Hungary and identified possible associations of the steps with breastfeeding. Our quantitative, cross-sectional research was conducted anonymously online in Hungary with a self-administered questionnaire in 2021. Targeted sampling was used, with biological motherhood and having at least one child no older than 60 months as inclusion criteria (n = 2008). The implementation of the "Ten Steps to Successful Breastfeeding" was analyzed separately for breastfeeding and non-breastfeeding mothers. A breastfeeding mother was defined as breastfeeding for at least six months. Descriptive statistics, χ2 test, and t-test were calculated with SPSSv25 (p < 0.05). No significant differences were found between breastfeeding and non-breastfeeding mothers in terms of supplementary feeding at the advice of a health professional (p = 0.624) and in terms of assistance with breastfeeding or suggested breastfeeding positions during hospitalization (p = 0.413). Significant differences were found for receiving breastfeeding-friendly recommendations by staff (p = 0.006), valuing breastfeeding (p < 0.001), skin-to-skin contact within 1 h (p = 0.002), receiving supplementary feeding (p < 0.001), rooming-in (p < 0.001), responsive feeding, recognizing hunger signs (p < 0.001), pacifier/bottle use (p < 0.001), and availability of breastfeeding support (p = 0.005). Significant differences were observed between breastfeeding and non-breastfeeding subsamples regarding the implementation of baby-friendly steps (p < 0.001). Breastfeeding mothers experienced the implementation of more baby-friendly steps and a higher rate of breastfeeding, while there was no significant difference in the duration of exclusive (p = 0.795) and partial breastfeeding (p = 0.250) based on the results. We concluded that exposure to the Baby-Friendly Hospital Initiative may be associated with increased 6-month breastfeeding but may not influence longer durations.

The Impact of Mode of Delivery and Postpartum Conditions on Breastfeeding: A Cross-Sectional Study.

Breast milk is the optimal and essential source of nutrients for babies. Many women, however, do not breastfeed or stop early after giving birth, often due to lack of support. For newborns delivered by caesarean section, there is often a delay, or no skin-to-skin contact after birth; thus, early breastfeeding is not achieved. Separation, complementary feeding or pacifier use also limits the mother's ability to breastfeed. A quantitative, cross-sectional study was conducted. Sociodemographic data, the mode of delivery and postpartum circumstances, information on breastfeeding, and the method and duration of feeding were collected (n = 2008). Two-thirds of children born by caesarean section did not have skin-to-skin contact after birth (p < 0.001). Lack of rooming-in placement increased the incidence of more frequent complementary feeding (p < 0.001) and shortened the duration of exclusive breastfeeding (p < 0.001). The duration of breastfeeding may also be negatively affected by scheduled feeding (p = 0.007) and pacifier utilization (p < 0.001). The mode of delivery and postpartum circumstances directly affecting the mother and the newborn can affect the feasibility of breastfeeding and the duration of exclusive and partial breastfeeding. For positive breastfeeding outcomes, skin-to-skin contact immediately after birth, rooming-in and unrestricted, demand breastfeeding, as well as the avoidance of the use of pacifiers, are recommended.

[Changes of payment of physicians between 1998 and 2021 in Hungary]. / Az orvosok fizetésének alakulása 1998 és 2021 között hazánkban.

INTRODUCTION: The development of the medical career model is a priority issue from the point of view of safe patient care. OBJECTIVE: In our research, we aimed to examine the average monthly income of doctors employed in Hungary between 1998 and 2021, especially with regard to the significant increase in medical payment in 2021. DATA AND METHODS: Data were derived from the database of the National Directorate General for Hospitals. Doctors employed full-time in all public health institutions were included in our time-series analysis. In our institutional-level analysis, we considered all employed doctors of all public hospitals. Each healthcare institution was grouped according to the type of institution. RESULTS: The payment of full-time doctors in Hungary increased by 16.1 times between 1998 and 2021. In 2020, the payment of hospital doctors at the national level was 767 505 Ft (2186 €), while in 2021, as a result of the increase in medical income, it was 1 415 481 Ft (3948 €) (+84%). In 2021, this was 1 435 972 Ft (4005 €) in national institutes, 1 204 258 Ft (3359 €) in clinical centers, 1 397 181 Ft (3897 €) in capital hospitals, 1 520 821 Ft (4242 €) in county hospitals and 1 688 726 Ft (4710 €) in city hospitals. The difference between the highest and the lowest payment was 1.90 times in national institutes, 1.26 times in clinical centers, 1.93 times in capital hospitals, 1.47 times in county hospitals and 1.75 in city hospitals. CONCLUSION: In 2021, as a result of the increase in medical incomes, the average incomes increased significantly. We observed significant differences between the types of institutions. Orv Hetil. 2023; 164(29): 1146-1154.

Inequalities in premature mortality from ischaemic heart disease in the WHO European region.

OBJECTIVES: Ischaemic heart disease (IHD) is one of the leading causes of premature mortality. Our aim was to analyse standardised premature mortality rates from IHD by geographical groups in the age group 45-59 years. METHODS: We performed a retrospective, quantitative analysis of age-standardized mortality rates from IHD between 1990-2014 per 100,000 population in Western European (WE: N = 17), Eastern European countries (EE: N = 10), and countries of the former Soviet Union (fSU: N = 15) within the European Region of the World Health Organisation (WHO) based on data retrieved from the WHO European Mortality Database. Descriptive statistics, time series analysis and statistical tests were used for the analyses (ANOVA, Kruskal-Wallis test, Mann-Whitney test, paired t-test). RESULTS: On average, age-standardized death rates (ASDR) from IHD per 100,000 population were the lowest in WE (men 1990: 143.67, 2014: 50.29; women 1990: 29.06, 2014: 9.89), and the highest in fSU (men 1990: 358.69, 2014: 253.25; women 1990: 99.78, 2014: 57.85). Between 1990 and 2014, all three groups experienced significant decrease in ASDR both in men and women (fSU: -29.39%, -42.02%; EE: -49.41%, -50.57%; WE: -64.99%, -65.97%, respectively) (p < 0.05). Between 1990 and 2004, ASDR decreased in WE in both sexes (p < 0.001), in EE among males (p = 0.032). Between 2004 and 2014, ASDR from IHD decreased significantly in both sexes in fSU and WE, in EE only among women (p < 0.05). CONCLUSIONS: During the whole period analysed, ischaemic heart disease mortality significantly decreased in both sexes in all the groups.

Prevalence and Annual Health Insurance Cost of Endometriosis in Hungary-A Nationwide Study Based on Routinely Collected, Real-World Health Insurance Claims Data.

Endometriosis is a disease that is often diagnosed late and that may lead to significant reduction in quality of life and serious complications (e.g., infertility). We aimed to assess the prevalence and the annual, nationwide health insurance treatment cost of endometriosis in Hungary using a quantitative, descriptive, cross-sectional method, focusing on the year 2019. We used claims data obtained from the Hungarian National Health Insurance Fund Administration (NHIFA). Patient numbers, total and age-specific prevalence, annual health insurance expenditure, and the distribution of costs across age groups were determined. The NHIFA spent a total of HUF 619.95 million (EUR 1.91 million) on endometriosis treatment. The highest number of patients and prevalence (10,058 women, 197.3 per 100,000) were found in outpatient care. In acute inpatient care, prevalence was substantially lower (23.5 per 100,000). Endometriosis, regardless of its type, affects 30-39-year-olds in the highest number: 4397 women (694.96 per 100,000) in this age group were affected in 2019. The average annual health insurance expenditure per capita was EUR 189.45. In addition to early detection and diagnosis of endometriosis, it is of pivotal importance to provide adequate therapy to reduce costs and reduce the burden on the care system.

Assessing the per Capita Food Supply Trends of 38 OECD Countries between 2000 and 2019-A Joinpoint Regression Analysis.

Food supply has an impact on the prevalence of diet-related non-communicable diseases. We aimed to analyze the protein, fat (g/capita/day) and calorie (kcal/capita/day) supply from 2000 to 2019 as derived from the OECD Health Statistics database. A joinpoint regression was used to examine the number and location of breakpoints in the time series. The annual percent change (APC) was calculated using Joinpoint 4.9.0.0. The per capita daily kcal per nutrient was calculated for each country and the resulting percentage distributions were compared to the acceptable macronutrient distribution ranges. Protein, fat and calorie supplies have increased significantly between 2000 and 2019. Each started to show a much steeper, positive change between 2012 and 2014 (APCfat: 1.0; 95%CI: 0.8-1.1; APCprotein: 0.5; 95%CI: 0.3-0.6; APCkcal: 0.4; 95%CI: 0.3-0.5). In terms of the composition of the daily calorie intake per capita, the overall share of fat (+4.9%) and protein (+1.0%) increased between 2000 and 2019. We found significant differences among countries and also an increasing and optimal proportion of consumed protein per total calorie in all countries over the last two decades. We concluded that several countries have access to fat availability above the optimal level, which deserves particular attention from health policy makers in the fight against obesity and diet-related diseases.

The long-term effect of generic price competition on the Hungarian statin market.

BACKGROUND: Generic competition is a vital health policy tool used in regulating the pharmaceutical market. Drug group HMG-CoA reductase (3-hydroxy-3-methyl-glutaryl-coenzyme-A reductase) inhibitors, widely known as "statins," was the first drug group in Hungary in which generic prescriptions became mandatory. Our aim is to analyze the changes in the retail and wholesale margins through the generic competition regarding "statins". METHODS: Data was derived from the nationwide pharmaceutical database of the Hungarian National Health Insurance Fund Administration, the only health care financing agency in Hungary. We observed the turnover data regarding the HMG-CoA-reductase inhibitor "statins" from 2010 through 2019. As the drugs under review have a fixed price point in Hungary, we effectively calculated the margins. RESULTS: In 2010, the consumer expenditure of statins was 30.7 billion HUF ($148 million), which decreased by 59%, to 12.5 billion HUF ($42.9 million) in 2019. In 2010, the annual health insurance reimbursement of statins was 23.7 billion HUF ($114 million), which underwent a 63% decrease to 8.6 billion HUF ($29.7 million) in 2019. In 2010, the DOT turnover was 287 million days, and it increased to above 346 million days for 2019, which reflects a 20% increase over the past nine years. The monthly retail margins decreased from 334 million HUF ($1.6 million), (January, 2010) to 176 million HUF ($0.61 million), (December, 2019). The monthly wholesale margins decreased from 96.3 million HUF ($0.46 million), (January, 2010) to 41.4 million HUF ($0.14 million), (December, 2019). The most significant downturn in margins was due to the introduction of the first two blind bids. The combined DOT turnover in reference to the examined 43 products consistently increased. CONCLUSIONS: The decline in retail and wholesale margin and in health insurance expenditures was largely due to a reduction in the consumer price of generic medicines. DOT turnover of statins also increased significantly.

Assessing the impact of Hungary's public health product tax: an interrupted time series analysis.

OBJECTIVES: Imposing taxes on unhealthy goods can generate income, raise people's health awareness, and eventually decrease the prevalence of chronic diseases. Our aim was to assess the impact of Hungary's public health product tax (PHPT) since its implementation in September 2011. Differences in purchasing habits between households with different income statuses were also compared. METHODS: A retrospective, descriptive analysis of tax bases and income was carried out, and an interrupted time series analysis using the generalised least squares method was performed to examine the changes in trends regarding the purchase of taxable products before and after the implementation of the tax. The amount of tax base (in kilograms or litres), income (in HUF and EUR), and annual purchased quantity of food and beverage groups per household were assessed. Data were derived from the National Tax and Customs Administration of Hungary and the Hungarian Household Budget and Living Conditions Surveys. The study sample was composed of households who participated in the surveys (mean = 8,359, SD = 1,146) between 2006 and 2018. RESULTS: The households' tax bases and incomes increased constantly (with a few exceptions). The total revenue was 19.49 billion HUF (67.37 million EUR) in 2012 and 59.19 billion HUF (168.55 million EUR) in 2020. However, the households' purchasing habits did not change as expected. A significant short-term decrease (between 2012 and 2013) in purchasing unhealthy goods was observed for three groups: soft drinks (p = 0.009), jams (p = 0.047), and fruit juices (p = 0.038). Only soft drinks showed a significant decreasing trend in the post-intervention period between 2012 and 2018 (p < 0.001). CONCLUSIONS: We concluded that the PHPT did not decrease households' unhealthy food purchasing trend, although it has a positive effect as it can create revenue for health care and health-promoting programmes.

[Participation indicators of organized cervical cancer screening in Hungary]. / A szervezett lakossági méhnyakszurés részvételi mutatói Magyarországon.

The aim of this study was to determine the percentage of women in Hungary who underwent gynecological cytological examinations either as part of a screening test or diagnostic examinations. Data derived from the nationwide financing database of the Hungarian National Health Insurance Fund Management and covered the period 2008-2021. We analyzed both diagnostic and screening cytological tests. The number of diagnostic tests has decreased. The number of patients per 10,000 female inhabitants in 2021 was a national average of 840. The highest rate was observed in the counties of Hajdú-Bihar (1464/10,000 female inhabitants), Tolna (1443) and Baranya (1254). In screening, the number of cytological tests is lower compared to smearing. The annual participation rate decreased from 28% to 17%. The number of patients and the participation rate of diagnostic cytology examinations decreased during the examined period. The added value of screening cytology is moderate, the willingness to participate is low, falling short of the expected value.

[Participation indicators of organized mammography screening in Hungary between 2012-2021]. / A szervezett lakossági mammográfiás emloszurés részvételi mutatói 2012­2021 között Magyarországon.

The aim of our study is to analyze the participation indicators of screening rounds Nr. 6-10 (2012-2021) of the organized nationwide mammography screening program. Data derived from the nationwide financing database of the Hungarian National Health Insurance Fund Management and covered the period 2012-2021. We analyzed both diagnostic and screening mammography examinations. Between 2012 and 2019 the coverage (screening and diagnostic mammography) varied between 48.1-51.5, which decreased to 31.8% in 2020-2021. Within total coverage, the organized screening rate declined from 30.3-31.2 to 20.0, while the diagnostic mammography rate decreased from 17.7-20.7% to 11.8%. We can conclude that the number of both the diagnostic and screening mammography declined. In order to reduce the mortality of breast cancer, participation rate of mammography screening program should be increased.

[Participation indicators of colorectal screenings in Hungary between 2008-2021]. / A kolorektális szurések részvételi mutatói Magyarországon 2008­2021 között.

The aim of our study is to analyse the participation indicators of colorectal cancer screening between 2008-2021. Data derived from the nationwide financing database of the Hungarian National Health Insurance Fund Management. We analysed both diagnostic and screening examinations. According to our results, the screening rate was low, varying between 5.1-6.8% in the years examined. Between 2008 and 2019, the number of participating patients increased slightly. The highest number of patients can be observed in 2019 (178,568 people). In 2020 and 2021, we see a significant decrease, which is a consequence of the COVID-19 pandemic. In the number of patients of the entire examined period (2,233,963 people, 938,223 men, 1,295,740 women), the largest proportion was fecal blood detection by immunochemical method (OENO code: 22631). In 2021, at the county level, the highest number of patients can be seen in Csongrád-Csanád county (994 patients/10,000 people), and the least in Békés county (218 patients/10,000 people). The participation rate of women is higher than that of men in all counties. Participation in colorectal screening is very low. In order to prevent colorectal cancer death, it is necessary to increase the participation rate.

Changes in the number of healthcare professionals in European healthcare systems between 2000 and 2018 / Az egészségügyi szakdolgozók létszámváltozása az európai egészségügyi rendszerekben 2000 és 2018 között

Introduction: Ensuring the supply of healthcare professionals is an important health policy issue nowadays. Objective: The aim of our research is to provide a comprehensive picture of the health workforce situation in the European OECD countries. Data and methods: Indicators analyzed regarding the numbers of practising midwives, nurses, physiotherapists and total hospital beds were derived from the "OECD Health Statistics 2021" database for the period 2000­2018. 24 European OECD countries were grouped according to the type of healthcare system and geographical location. Data were subsequently compared by parametric and nonparametric tests, focusing especially on years 2000, 2010, 2018. Results: Between 2000 and 2018, there was a 14% increase in the average number of midwives, a 30% increase in the average number of nurses, and a 41% increase in the average number of physiotherapists per 100,000 population in the OECD countries examined. Per 100 hospital beds, the average number of midwives increased by 72%, the number of nurses by 86%, and the number of physiotherapists by 97%. Significant results for all three years analyzed were obtained in the number of physiotherapists per 100 hospital beds (p = 0.014; p<0.001; p = 0.002) when comparing the Western and Eastern European countries examined. As for the healthcare systems, significant results were obtained only in the number of nurses per 100 hospital beds for the year 2010 (p = 0.048). Conclusion: Among healthcare professional groups, the number of physiotherapists increased the most in Europe. The numbers of healthcare professionals per 100 beds are significantly higher in Western European countries analyzed compared to Eastern European countries.

Changes in the Number of Physicians and Hospital Bed Capacity in Europe.

OBJECTIVES: Our aim was to examine the numbers of practicing physicians and total numbers of hospital beds in European Organisation for Economic Co-operation and Development countries. METHODS: Data analyzed were derived from the "Organisation for Economic Co-operation and Development Health Statistics 2020" database between 1980 and 2018. The selected countries were compared according to the type of healthcare system and geographical location by parametric and nonparametric tests. RESULTS: In 1980, Bismarck-type systems showed an average number of physicians of 2.3 persons/1000 population; in Beveridge-type systems, it was 1.7 persons. By 2018, it leveled out reaching 3.9 persons in both healthcare system types. In 1980, average physician number/1000 was 2.5 persons in Eastern Europe; in Western Europe, it was 1.9 persons. By 2018 this proportion changed with Western Europe having the higher number (3.7 persons; 3.9 persons). In 1980, average number of hospital beds/1000 population was 9.6 in Bismarck-type systems whereas in Beveridge-type systems it was 8.8. By 2018, it decreased to 5.6 in Bismarck-type systems (-42%) and to 3.1 in Beveridge-type systems (-65%). In 1980, the average number of hospital beds/1000 population in Eastern Europe was 10.3; in Western Europe, it was 8.5. By 2018, the difference between the 2 regions did not change. CONCLUSIONS: Although the number of physicians was 33% higher in 1980 in Eastern Europe than in Western Europe, by 2018 the number of physicians was 5% higher in Western Europe. In general, regardless of the healthcare system and geographical location, the proportion of physicians per 1000 population has improved due to a larger decrease in the number of hospital beds.

Epidemiological disease burden and annual health insurance treatment cost of colorectal cancer in Hungary / A vastag- és végbéldaganat okozta országos epidemiológiai és egészségbiztosítási betegségteher Magyarországon.

Összefoglaló. Bevezetés: Magyarországon a vastag- és a végbéldaganat mindkét nem esetében a harmadik leggyakoribb daganatos megbetegedés és a második leggyakoribb halálok. Célkituzés: Elemzésünk célja volt a vastag- és végbéldaganat okozta éves epidemiológiai és egészségbiztosítási betegségteher meghatározása Magyarországon. Adatok és módszerek: Az adatok a Nemzeti Egészségbiztosítási Alapkezelo (NEAK) finanszírozási adatbázisából származnak, és a 2018. évet fedik le. A daganat típusait a Betegségek Nemzetközi Osztályozása (BNO, 10. revízió) szerinti C18-as, C19-es, C20-as, C21-es, D010-D014-es és D12-es kóddal azonosítottuk. Meghatároztuk az éves betegszámokat korcsoportos és nemek szerinti bontásban, a prevalenciát 100 000 lakosra, az éves egészségbiztosítási kiadásokat valamennyi ellátási formára és daganattípusra vonatkozóan. Eredmények: A vastag- és végbéldaganatok kezelésére a NEAK 21,7 milliárd Ft-ot (80,2 millió USD; 68,0 millió EUR) költött 2018-ban. A költségek 58,0%-át az aktívfekvobeteg-szakellátás költségei teszik ki. Az összköltségek megoszlása szerint a legmagasabb költségek a férfiaknál (4,98 milliárd Ft) és a noknél (3,25 milliárd Ft) is a 65-74 éves korcsoportban figyelhetok meg. A legnagyobb betegszámot a járóbeteg-szakellátás esetében találtuk: 88 134 fo, ezt a háziorvosi ellátás (55 324 fo) és a CT, MRI (28 426 fo) követte. A vastagbél rosszindulatú daganata esetében az egy betegre jutó aktívfekvobeteg-kassza alapján az éves egészségbiztosítási kiadás 1,206 millió Ft (4463 USD/3782 EUR) volt a férfiak és 1,260 millió Ft (4661 USD/3950 EUR) a nok esetében. Következtetés: Hazánkban az aktívfekvobeteg-szakellátás bizonyult a fo költségtényezonek, mely magában foglalja az onkoterápiás gyógyszeres költségeket is. Orv Hetil. 2021; 162(Suppl 1): 14-21. INTRODUCTION: Colorectal cancer is the third most common type of cancer and the second most common cause of mortality in Hungary in both sexes. OBJECTIVE: The aim of our study was to determine the annual epidemiological disease burden and health insurance cost of colorectal cancer in Hungary. DATA AND METHODS: Data were derived from the financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary for the year 2018. Types of cancer were identified with the following codes of the International Classification of Diseases, 10th revision: C18, C19, C20, C21, D010-D014, D12. The data analysed included annual patient numbers according to age groups and sex, prevalence of care utilisation per 100 000 population, and annual health insurance costs for all types of care and all cancer types. RESULTS: In 2018, NHIFA spent 21.7 billion HUF (80.2 million USD, 68.0 million EUR) on the treatment of colorectal cancer. 58.0% of the costs was spent on acute inpatient care. Regarding total costs, the highest costs were found in the 65-74 age group in both men (4.98 billion HUF) and women (3.25 billion HUF). The highest patient numbers were in outpatient care: 88 134 patients, general practice care (55 324 patients) and CT, MRI (28 426 patients). The annual health care treatment cost per patient was 1.206 million HUF (4463 USD/3782 EUR) in men and 1.260 million HUF (4661 USD/3950 EUR) in women. CONCLUSION: Acute inpatient care, including the costs of oncotherapeutic pharmaceuticals, was found to be the major cost driver in Hungary. Orv Hetil. 2021; 162(Suppl 1): 14-21.

Annual epidemiological and health insurance burden of cervical cancer in Hungary / A méhnyakrák okozta éves epidemiológiai és egészségbiztosítási betegségteher Magyarországon.

Összefoglaló. Bevezetés: A méhnyakdaganatok kérdése kiemelten fontos, megoldatlan népegészségügyi probléma. A betegség terhe magas, ami elsosorban az alacsony és közepes jövedelmu országokban éloknél jelentkezik. Célkituzés: Elemzésünk célja volt meghatározni a méhnyakdaganatok epidemiológiai és egészségbiztosítási betegségterhét Magyarországon a 2018-as évre vonatkoztatva. Adatok és módszerek: Elemzésünket a Nemzeti Egészségbiztosítási Alapkezelo (NEAK) finanszírozási adatbázisának 2018. évi adatai alapján végeztük az in situ (D06), a jóindulatú (D26.0) és a malignus (C53) méhnyakdaganatokra vonatkozóan. Az elemzés a NEAK által finanszírozott összes szolgáltatóra és ellátási formára kiterjed. Meghatároztuk az éves betegszámokat, a prevalenciát 100 000 lakosra, továbbá az éves egészségbiztosítási kiadásokat betegségcsoportonként és korcsoportos bontásban, valamennyi egészségbiztosítási ellátás tekintetében. Eredmények: A NEAK 2018-ban 1,276 milliárd Ft-ot (4,7 millió USD; 4,0 millió EUR) költött a méhnyakdaganatok kezelésére. A betegek és a finanszírozás dönto többsége a méhnyak rosszindulatú daganatához kapcsolható. A finanszírozásból a malignus méhnyakdaganatok részesedése 97%. Ellátási típusonként vizsgálva a legnagyobb kiadási tétel az aktívfekvobeteg-szakellátásban jelenik meg, éves szinten 763,9 millió Ft, ami az összköltség 59,9%-a. A 100 000 lakosra jutó prevalencia az aktívfekvobeteg-szakellátás igénybevételi adatai alapján 26/100 000 lakos. Következtetés: A méhnyakdaganatok kezelésének meghatározó költségeleme az aktívfekvobeteg-szakellátás. Hazánkban a szervezett méhnyakszurés korszerusítéseként az új szurési stratégiát megfelelo finanszírozási támogatással célszeru bevezetni, a szurovizsgálatoknak, a hozzájuk kapcsolódó további diagnosztikus kivizsgálásnak és terápiának a teljesítményvolumen-korlát alóli mentesítésével. Orv Hetil. 2021; 162(Suppl 1): 22-29. INTRODUCTION: Cervical cancer is a particularly important, unresolved public health problem. The burden of the disease is high, primarily in those living in low- and middle-income countries. OBJECTIVE: Our aim was to determine the annual epidemiological disease burden and health insurance cost of cervical cancer in Hungary in 2018. DATA AND METHODS: Our analysis was made according to the financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary for the year 2018, which covers all service providers and maintenance forms financed by NHIFA. We analysed the in situ (D06), the benignant (D26.0) and the malignant (C53) cervical tumours. The data analysed included annual patient numbers and prevalence of care utilisation per 100 000 population furthermore annual health insurance costs calculated for disease and age groups. RESULTS: In 2018, NHIFA spent 1.276 billion HUF (4.7 million USD, 4.0 million EUR) on the treatment of patients with cervical cancer. The majority of patients and funding can be linked to malignant cervical cancer (97%). Acute inpatient care was the major cost driver: 763.9 million HUF (59.9% of the total health insurance expenditures) annually. The prevalence is 26 per 100 000 population based on acute inpatient care data. CONCLUSION: Acute inpatient care was the major cost driver. In Hungary, as a modernization of organized cervical screening, it is appropriate to introduce a new screening strategy with appropriate financial support, by exempting screening tests, associated additional diagnostic testing, and therapy from the performance volume limit. Orv Hetil. 2021; 162(Suppl 1): 22-29.