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In the past decades, topics related to socio-economic impacts of climate change and to mapping of potential natural risks caused by extreme climatic situations have been put high on the researchers’ agenda. Extreme weather conditions increase the vulnerability of local communities, who are in need of proper climate adaptation and mitigating strategies. There have been a number of transnational projects in the Carpathian Basin financed by different EU funding schemes, which examined the causes and impacts of climate change from various perspectives (e.g. CARPATH CC, earlier ADAM, CECILIA, ENSEMBLES, PRUDENCE, etc.).SEERISK, including nine Central and South-East European countries, is a SEE (South East Europe Transnational Cooperation Programme) funded project, commenced in 2012. The project objectives were elaborating, testing and sharing uniform methodologies for mapping risks related to climate change, examining the social consequences, and formulating recommendations for community strategy building which are applicable across the Danube region. The project also aimed to share experience and prepare local communities for extreme weather situations and for managing natural disaster situations using adaptable innovative methods.The present study aims at presenting the major outcomes of the SEERISK project. The main ambition of the paper is to present the applicability of the methodologies used in social sciences for the problem field of climate change and also the way these methods can be combined with natural science and GIS methods in order to formulate an integrated project framework. The combined methodology was applied in six case study areas.Common risk assessment methodology integrates the European Commission’s Risk Assessment and Mapping Guidelines for Disaster Management. Each case study area prepared a risk matrix focusing on the natural hazard that they chose as the most relevant for their area and developed a risk scenario describing the natural hazard and its consequences. The methodology offers various alternative solutions for implementing the risk assessment process, especially for developing risk maps.Examining the social aspect of climate change involved the assessment of awareness and preparedness of individuals and stakeholders in the pilot communities. The social survey of the project reflected on the awareness and preparedness of inhabitants and institutions in the pilot communities regarding climate-change-related natural hazards. The approach and behaviour of the inhabitants were studied by a non-representative questionnaire survey, while the approach of the institutions and decision makers was revealed by conducting interviews and by scrutinising local planning documents of the municipalities concerned. The questionnaire survey served to build firm knowledge about the local people’s awareness of climate change impacts on their life and their preparedness for related natural hazards. Personal interviewing and analysing planning documents contributed to understanding the administrative and institutional approach and reaction to climate change and its consequences in the Danube macro-region.By combining risk assessment and social surveys, gaps were identified between the actual exposure to hazards and the level of community preparedness. Finally, a collection of recommendations was compiled in a guideline of climate change mitigation and adaptation useful for decision makers, academics and individuals who are all equally exposed to the impacts of global climate change.

In order to examine the regional disparities in access to health care in Hungary we analysed all data on cataracta surgery financed by public sources in 2008. Cataracta surgery is one of the most frequent surgeries performed and is typically provided in an outpatient surgery setting. We used this type of treatment as an example to analyse inequalities in access to health care services in Hungary. The main goal was to develop a method to provide a decision-making basis for an informed health-care policy. We show that patients often cross administrative borders in order to find the surgery they preferred, and that there is a Budapest-centred typical pattern of such patient movements. Travel distance and time between the home address of the patient and the health care provider were analysed both for all surgeries and for out-patient surgeries separately. Rates of migration over the boundaries of regions, counties, and micro-regions as well as utilisation rates of the closest providers were evaluated. For a deeper understanding, two micro-regions were examined in detail. Lorenz curves and Gini coefficients were used to measure inequalities. In all, 62,938 cataracta surgeries were performed in Hungary in the year 2008. 36% of the surgeries were provided for patients from Hungary’s Central Region. Half of the total number of surgeries was performed by 18 providers - out of 73 where this treatment would have been also available. At the level of the micro-regions examined, the Gini coefficient was 0.15, showing only a moderate level of inequality. 50 out of 73 providers were able to offer an outpatient surgery option. The total ratio of outpatient surgery was 22%. Inequality in access to outpatient surgery was, however, much higher: At county level, the Gini coefficient was 0.38. Our study shows that the availability of a higher-quality health care depends on the place of residence. There was a huge inequality of the length of travel to the preferred surgery provider. This may be partly explained by the referral system. The study offers proposals for improving the regional health care organisation. Opportunities for economising on resources include eliminating unnecessary travel and increasing the rate of outpatient surgery: At present, the Hungarian ratio of 22% is well below the 50% of the OECD average. Increasing the role of outpatient surgery (ambulatory care) would lead to a marked decrease in the hospital beds required. In order to prevent unwanted negative effects, capacity adjustment in hospital beds should, however, not be accompanied by a lower budget for cataracta surgery. Optimising patient travel, improving efficiency of health care and improving health-care infrastructure require further scientific research in the field of health system analysis and modelling, based on patient migration data.

A tanulmány célja a magyar egészségügy átalakítása intézményi és területi vonatkozású következményeinek bemutatása. A struktúraátalakítás során az új ellátási hierarchiában a kórházi kapacitások meghatározása régiók szerint történik, így a területi különbségek földrajzi értelemben is vizsgálhatóvá válnak. Az egészségügy működésében és felépítésében tapasztalható változások közép- és hosszú távon szolgálják a hazánkra jellemző egészségügyi egyenl őtlenségek mérsékl ődését és a konfliktusok megoldását.