Our study offers nationwide epidemiological data on fractures in Hungary. The incidence of fractures increased by age, regardless of the type of fracture. Incidence of hip fractures in Hungary fits in the previously established geographic trends in Europe. Our results fulfil a need for fracture data from Central Europe.
In this paper we give a practical overview of the changes in the financing of health care in Hungary. We describe the financing system of general practitioners, home care (nursing), out-patient care and the acute and chronic care of hospitals. We show how the financial system has changed after the political changes of 1990. The global budget approach of the 1980s was replaced by performance-related financing methods including the ICPM (International Classification of Procedures in Medicine) code system of the WHO (World Health Organization) in out-patient care and the introduction of HBCS (Homogen Betegsegcsoportok, "Homogeneous Disease Groups") in in-patient care. We underline that the efforts made towards reforming health care financing resulted in an activity-related financing system.
The aim of this study was to investigate the relationship between the delay between surgical treatment and mortality occurring within 30 days post-injury in patients aged 60 or older with femoral neck fracture. Data derive from the nationwide database of the National Health Insurance Fund Administration. Logistic regression analysis was performed to analyse the relationship between 30-day mortality and surgical delay in four groups of patients operated on within 12 h, between 12-24 h, 24-48 h or over 48 h post-injury. There were 3,777 patients involved in the study. Mortality rates in the four groups were 7.7%, 10.5%, 10.5% and 9.4%, respectively. Univariate logistic regression analysis revealed a statistically significant increase in the mortality risk in the 12-24-h treatment group compared to the group treated within 12 h (odds ratio, OR 12-24h =1.413, confidence interval, CI 12-24h : 1.032-1.935; p =0.031).According to multiple regression analysis, all three groups (12-24 h, 24-48 h and over 48 h) showed a trend to increased mortality risks, but this was not statistically significant p= 0.106; : 0.932-2.056, p=0.108; OR >48h =1.246, CI >48h : 0.950-1.635, p=0.113). We can conclude that sex, age and accompanying diseases significantly influenced early mortality, while early post-operative complications did not have a significant impact on the mortality risks.
The health status of the CEE population has improved since 1990. However, only a few countries have closed the gap with the EU-15 countries. Inflammatory conditions might represent a significant disease burden in CEE countries; however, a thorough analysis and comparison to the EU-15 is difficult because of a shortage of good-quality data.
There is therefore an urgent need to closely monitor performance and to review programme policies and procedures with the aim of increasing both the participation rate and the proportion of women eligible to attend screening.
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