Country’s healthcare system in a nutshell

The Hungarian health system operates under a single health insurance fund, covering nearly all residents, though its service range 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 managed by the National Institute of Health Insurance Fund Management (NEAK), which is supervised by the Ministry of Human Capacities. Funding comes 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. This coverage encompasses both those who are members of health insurance schemes and those who have free access to state-provided healthcare services (Our World in Data, n.p.).

Public vs private

Open

Source: The World Bank.
The pink column refers to the public expenditure as a % of the country’s total healthcare expenditure. The blue dot is the country’s expenditure on health per capita, expressed in international dollars at purchasing power parity.

The national PHR

History

The National eHealth Infrastructure and its specialised modules were established within the framework of 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, with a total investment of 4.87 billion Hungarian forints. Continuous development of the system is ensured by forms close cooperation of the Hungarian State and the European Union such as project no. 1.9.6 of the Human Resource Development Operating Programme / EFOP of Hungary.

Establishing the EESZT infrastructure was a significant milestone in the history of Hungary’s e-healthcare.

The core principle of the system is to interconnect the earlier fragmented healthcare data systems in all of Hungary, and - taking into account foreign examples - collect all data in a central system, thus the operating services of the Infrastructure would allow the various treatment locations to access the necessary information. Another important objective was to provide modern central services such as subsystems for issuing electronic receipts, electronic referrals, and medical documents, or the eProfile, which facilitates the widespread adoption of modern health care.

The use of EESZT has been mandatory since November 2017 for publicly funded healthcare providers and pharmacies. For non-publicly funded healthcare providers – in the case of private providers who are obligated to provide data to the central implant registry and the prosthesis registry – as well as for the National Ambulance Service, it is mandatory from November 1, 2018. Thus, data will only be entered into the Space after joining, and previous patient data is not yet visible in EESZT. Private providers who have a valid operating license and perform outpatient medical or dental activities have a data reporting obligation to EESZT from 06.01.2020.

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

Open

Source:https://e-egeszsegugy.gov.hu/web/eeszt-information-portal/history-of-eeszt

Features

The National eHealth Infrastructure (EESZT) is a central IT system that has set the foundations for ensuring communication between healthcare service providers.

According to the EESZT official website, most hospitals' systems in Hungary are integrated with the EESZT system and therefore data that are added to the patients' records in the hospital EHR are automatically added also to the national infrastructure.

The EESZT system transfers the health data of every patient to a central database which the various health professionals can consult through the corresponding hospital, general practitioner, or pharmacy systems with the appropriate authorisation (e.g. pharmacists can only see prescriptions).

As well as professionals, also patients can access their personal medical data, through the citizen portal and also a mobile application which is constantly being developed and updated.

The platform provides patients with a variety of features. Patients can view:

• their prescriptions and dispensed medications and medical aids

• referrals

• health documents

• COVID-related data: vaccination certificate, test certificate, health certificate. Patients can also book COVID vaccinations

• outpatient appointments notes

• admissions and discharges documents

• test results

• eProfile: this includes allergies, pregnancy status and implants. This is the never or rarely-changing health data uploaded by the GP, which could be life-saving in case the patient’s record is accessed during emergency care.

• All events when patients used healthcare in outpatient and inpatient specialist care facilities or at family doctor services appear in the ‘Event Catalog’. The data is uploaded by the institutions;

• Patients can continuously monitor who has requested access to their data (the GP and treating clinicians have access), and they can set which EESZT event they request an e-mail notification from the system. The data displayed for treating physicians depends on the settings, permissions, and restrictions made during self-determination. More info here

( EESZT, n.d. )

Challenges and areas for improvement

The main weaknesses of the platform are:

• ability for patients to input data manually is limited to some specific measurements. Patients can’t add other medical data manually (such as allergies, files etc)

• There’s no ability for patients and professionals to communicate with each other via the platform.

• there is no device integrations, i.e. patients can contribute to the record data from their device by uploading a file which contains the data extract from the device, but there is no possibility to connect the device to the record.

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 practicioners, 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: . (Accessed 13 September 2023)

World Health Organization, 2023. Hungary: Country Overview. [online] Available at: (Accessed 13 September 2023)