Country’s healthcare system in a nutshell

Hungary’s healthcare system operates under a single health insurance fund that covers nearly all residents, although its range of services is more limited compared to other EU countries.

Since 2011, reforms have centralised the system, with the national government overseeing strategic direction, financing, regulations, and most specialist and inpatient care. The Ministry of Human Capacities manages the system through the National Healthcare Service Centre (ÁEEK), which coordinates care, plans hospitals, and oversees licensing. In 2012, the central government took control of local hospitals from county and municipal authorities, with ÁEEK managing these state-owned facilities.

The single health insurance fund is administered by the National Institute of Health Insurance Fund Management (NEAK), which is supervised by the Ministry of Human Capacities. Funding is derived from payroll contributions and government transfers.

Healthcare delivery is predominantly hospital-based, with the national government directly managing hospitals and providing most inpatient and outpatient services, though some local governments still operate polyclinics.

(World Health Organization, 2023)

According to the most recent data from 2010, health insurance covered the entire population of Hungary, including both members of health insurance schemes and those with free access to state-provided healthcare services (Our World in Data, n.p.).

Public vs private

The national PHR

History

The National eHealth Infrastructure and its specialised modules were established (through projects no. TIOP-2.3.2-12/1-2013-0001 and TIOP-2.3.1-13/1-2013-0001) under the Social Infrastructure Operating Programme, with support from the European Union and co-funding by the Hungarian State. The total investment amounted to 4.87 billion Hungarian forints (approximately 13.15 million USD). Continuous development of the system is ensured through close cooperation between the Hungarian State and the European Union, such as project no. 1.9.6 of the Human Resource Development Operating Programme, focused on establishing the Electronic Health Service and Data Integration System, known as EESZT.

The core principle behind the system was to interconnect the previously fragmented healthcare data systems across the country and, drawing on international examples, collect all data into a central system. This would enable treatment locations to access the necessary information seamlessly. Another key objective was to provide modern centralised services, such as subsystems for issuing electronic prescriptions, electronic referrals, and medical documents, as well as the eProfile, promoting the widespread adoption of modern healthcare practices.

The use of the EESZT system has been mandatory since November 2017 for publicly funded healthcare providers and pharmacies. For non-publicly funded providers, including private practitioners required to provide data to the central implant and prosthesis registries, and for the National Ambulance Service, it became mandatory from 1 November 2018. Only data entered after joining the system is visible in the EESZT, as historical patient data has not yet been incorporated. Since 1 June 2020, private providers with valid operating licences, performing outpatient medical or dental activities, have also been required to report data to the EESZT.

(EESZT, n.d.-a; EESZT, n.d.-b)

Features

The National eHealth Infrastructure (EESZT) is a centralised IT system designed to enable seamless communication between healthcare service providers in Hungary.

According to the EESZT official website, most hospitals in Hungary have their systems integrated with EESZT. This integration ensures that data added to patient records in a hospital's electronic health record (EHR) system is automatically uploaded to the national infrastructure. EESZT transfers each patient's health data to a central database, which authorised health professionals—such as hospital staff, general practitioners, or pharmacists—can access through their respective systems. Access is role-based; for example, pharmacists can only view prescription information.

In addition to healthcare professionals, patients can access their medical data through the EESZT citizen portal and a mobile app that is continuously being updated. The platform offers patients a wide range of features, allowing them to view:

• Prescriptions and dispensed medications, including medical aids

• Referrals for specialist consultations

• Health documents such as outpatient appointment reports and notes, admission, and discharge documents

• COVID-related data, including vaccination certificates, test results, and health certificates. Patients can also book COVID vaccinations.

• Test results

• eProfile, which includes critical health information such as allergies, pregnancy status, and implants. This profile contains health data rarely subject to change, uploaded by the GP, and could be life-saving if accessed during emergency care.

Additionally, patients can access an Event Catalogue, which logs all instances when healthcare services were used, whether in outpatient or inpatient facilities or at family doctor services. The institutions providing care upload this information.

Patients can also monitor who has accessed their data, with general practitioners and treating clinicians having authorised access. They can further customise their settings to receive email notifications about specific EESZT events, controlling what data is displayed to physicians based on their permissions and preferences.

( EESZT, n.d. )

Challenges and areas for improvement

While the National eHealth Infrastructure (EESZT) has made significant strides in modernising healthcare data management, it still faces several limitations that hinder its full potential. Key areas for improvement include:

1. Limited Patient Input Capabilities: The platform currently allows patients to input only specific types of health measurements. However, they are unable to manually add other essential medical data, such as allergies, detailed medical histories, or additional health documents (e.g. files or reports).

2. Lack of Direct Communication Between Patients and Professionals: EESZT does not allow direct communication between patients and healthcare professionals. This missing feature means that patients cannot use the platform to consult or follow up with doctors.

3. No Device Integration: While patients can upload data extracts from external health devices (e.g., wearable fitness trackers), there is no direct integration between these devices and the EESZT system.

Published outcomes - statistics

The latest statistics are from the 19th of April 2021 and are available at https://web.archive.org/web/20210419151255/https://e-egeszsegugy.gov.hu/web/eeszt-information-portal/the-role-of-the-eeszt-in-hungarian-healthcare

“Today, more than 26 thousand health professionals and 13 thousand pharmacy staff uses the system in Hungary. Starting from 2020, more than 22,000 institutions have access to the EESZT infrastructure, including private service providers.

This number breaks down as follows:

• There are more than 6000 active general medical practitioners, as well as:

  • more than 300 outpatient institutions

  • more than 100 inpatient institutions

  • more than 3000 pharmacies

  • more than 8800 private healthcare institutions

• The details of more than 600 million receipts have been entered into the EESZT.

• An average of 800,000 new electronic prescriptions (ePrescription) are ordered daily.

• By June 2020, there was a 90% increase in the monthly prescription of electronic prescriptions.

• Annually, 75 million medical documents (e.g. medical records, outpatient data sheets, discharge summaries) and approximately 180 million doctor-patient appointments are recorded online in the EESZT system in Hungary. This amounts to a daily average of 300,000 medical documents recorded in the Infrastructure.”
  (EESZT Information portal, 2021)

Screenshots

Login

• UGYFELKAPU which is the Citizen Portal for Hungarians

• Electronic National ID

• Citizen Portal+

• via Phone

• Face-to-face

Carer functionality

Patient history: documents by private professionals, GPs, hospitals, etc.

e-Referrals

e-Profile

Prescriptions

eGYSE

~Codings

Mobile application help page

Covid-related pages

Telemedicine / Measurements:

Devices menu:

Folders menu:

Bibliography

EESZT. (n.d). The Role of the EESZT in Hungarian Healthcare. Available at: https://e-egeszsegugy.gov.hu/web/eeszt-information-portal/the-role-of-the-eeszt-in-hungarian-healthcare. (Accessed 13 September 2023)

EESZT. (n.d). Citizen Portal - Main Page. Available at: https://www.eeszt.gov.hu/hu/nyito-oldal. (Accessed 13 September 2023)

EESZT. (n.d). EESZT Information Portal - The History of EESZT. Available at: https://e-egeszsegugy.gov.hu/web/eeszt-information-portal/history-of-eeszt. (Accessed 13 September 2023)

World Health Organization, 2023. Hungary: Country Overview. [online] Available at: https://eurohealthobservatory.who.int/countries/hungary (Accessed 13 September 2023)