[Results of monitoring the year 2002 of the Hungarian breast cancer screening program]. / A 2002. évi szervezett lakossági emlôszûrés monitorozásának eredményei.

AIM: The aim of the study is to analyse the regional and time range characteristics of the breast cancer screening programme and the utilization of health services related to the programme. METHODS: The data derive from the database of the National Health Insurance Fund Administration containing routinely collected financial data. The patients include all the women having mammography screening in the year of 2002 (N=314,395). In the time range analysis the starting point (T0) was the time of the mammography screening identified with the outpatient code "42400 mammography screening". We calculated the average delay between the time of mammography screening (time=T0), further diagnostic (time=T1) and therapeutic (time=T2) procedures. For the calculation of the average period spent from the time of mammography screening we used the median value instead of arithmetic mean. RESULTS: According to our data 17,303 women had ultrasound examination in axilla (T1 median value: 20 days) and 23,249 women had ultrasound examination in breast (T1 median value: 26 days). Among the women having mammography examination in 2002, 906 had chemotherapy (T2 median value: 83 days), while 1364 patients had radiotherapy (T2 median value: 136 days). The T2 median value of subtotal and total mastectomy was 43-47 days and 50-53 days respectively, while the T2 median value of breast operations because of non-malignant causes was 57 days after mammography screening. The total annual cost of organised breast cancer screening programme, including the cost of mammography examination, the cost of further diagnostic examination and surgical, radio- and chemotherapy treatment of recalled women, was 2,242 billion Hungarian forints (8,968 million euros) in 2002. CONCLUSION: We observed significant regional differences, which result in large discrepancies in the equity. We can assume that these differences can be reduced by better organisation and the more consistent application of professional guidelines.

[The incidence and cost of severe sepsis in intensive care units]. / A súlyos szepszis gyakorisága es kezelésének költsége intenzív osztályon.

OBJECTIVES: The aim of the study was to determine the incidence and mortality of sepsis and to analyse the direct costs of severe sepsis treated in intensive care unit in Hungary. METHOD: National data on sepsis demography, incidence and mortality were collected using the database of Hungarian Health Fund, Year 2001. The cost of treating severe sepsis was calculated by retrospective data collection of resource use in 6 ICUs. Personnel costs were calculated from annual salary report and the indirect costs were estimated by the financial director of each participating hospital. To validate retrospective data, the ICUs organised a prospective cost-analysis during one month period. RESULTS: There were 2659 patients reported with septic DRG code in Hungary. The mortality of sepsis is 42.7%, the average length of stay is 14.5 days (SD-17.4). Patients discharged from ICU after sepsis remained in hospital for further 18.1 days (SD-18). The mortality of severe sepsis in the pilot sample (n = 70) was found to be 64.2%, with average length of stay 15.5 (SD-10.2). The average daily ICU cost of severe sepsis is HUF 107 200 (429 Euro). Consumables account for 68% of total cost, the personnel 26.3% and clinical support 5.7%. CONCLUSION: The mortality of severe sepsis is high and the cost of treating severe sepsis is four times more then the average ICU daily cost. To take into account the much longer length of stay (15.5 vs. 5 day), annual cost of septic patients is HUF 4.4 billions (1 140000 Euro) in Hungary.