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Az egészségipar sokrétűen járul hozzá az egészségügyi ellátórendszer működéséhez, ezért a fejlesztése mindig is nemzetgazdasági prioritás volt, ami azonban a 2020-ban kirobbant világjárvány következtében még sürgetőbbé vált. A tanulmány célja, hogy bemutassa egyrészt az Egészségipari Támogatási Programból részesült egészségipari vállalkozások fontosabb jellemzőit, másrészt, hogy a támogatások hogyan segítették az egészségipar alkalmazkodását az új kihíváshoz a negyedik ipari forradalom idején.

The availability of health care services is an important issue, however, improving availability of health care services does not necessarily mean better accessibility for everybody. The main aim of this study is to find out how better availability in the care of acute myocardial infarction vary with accessibility of patients’ geographical location within Hungary. We applied statistical analysis and interview techniques to unfold the role of spatiality in the conditions of access to health care. Results of statistical analysis indicate significant health inequalities in Hungary. Decreasing national mortality rates of acute myocardial infarction, has been coupled by increasing spatial inequalities within the country especially at micro-regional level. According to in-depth interviews with local health care stakeholders we defined factors that support access to health care as well as important barriers. The supporting factors are related to the improvement of availability (i.e. infrastructural developments), while geographical distance, lack of material and human resources, or low level of health literacy proved to be the most relevant barriers. Main conclusion is that barriers to accessibility and availability are not only spatial but are also based on individual stages of acute myocardial infarction care. The development of cardiac catheter centres in Hungary has improved the short-term chances of infarction survival, but long-term survival chances have worsened in recent years due to deficiencies in rehabilitation care as well as low level of health literacy.

This paper examines the spatial dynamics and regional distribution of the novel coronavirus epidemic in Hungary in an effort to obtain a deeper understanding of the connection between space and health. The paper also presents comprehensive epidemiologic data on the spatiotemporal spread of the COVID-19 pandemic in terms of the epidemic waves. Following a comparison of the growth rates of infection numbers, the current study explores the geographical dimension of the three pandemic waves. The partial transformation of spatial characteristics during the three epidemic waves is among the most important results found. While geographical hotspots influenced the first wave, newly confirmed coronavirus cases in the second and third waves were due to community-based epidemic spreading. Furthermore, the western-eastern spatial relation and the core-periphery model also affected the regional distribution of new cases and deaths in the initial two waves. However, a new spatial pattern - realised by the northern-southern spatial orientation - appeared during the third wave. The outputs of this paper offer feasible suggestions for evidence-based policymaking in pandemic prevention, mitigation, and preparedness.

Relevance. The new coronavirus pandemic (COVID-19) has brought major changes to everyday life and economy in 2020. The impacts of the pandemic are still difficult to measure and interpret. This paper analyses the key socio-economic factors that shaped the course of the pandemic and its regional effects in Hungary. Research objective. The aim of this paper is to provide a secondary data-based analysis of regional disparities in Hungary as well as the implications of the coronavirus pandemic and the related policy responses. Data and methodology. The analysis consisted of the three stages: first, we processed the official epidemiologic data related to the coronavirus pandemic and the territorial patterns of infections as well as the data on the socio-economic impacts of the lockdown (on retail trade, employment, tourism, local governments’ revenues, etc). Second, we collected the data related to the socio-economic effects of the pandemic and revealed the territorial impacts of the crisis. Finally, we evaluated the government’s measures and interventions introduced in the first wave of the pandemic in terms of their efficiency. Results. Our results demonstrate that while the epicentre of the pandemic was the capital city and its surrounding area, the socio-economic impacts of containment measures implemented by the Hungarian government were felt across the whole country. In some areas, the lockdown measures could have been unreasonably tight as no reasonable justification for these restrictions was provided. Therefore, territorial monitoring and development of regionally differentiated policies are the main tasks in preparation for further waves of the pandemic. In our opinion, it is necessary to devise an action plan that would regulate the protocols of prevention and protection in connection with the regional focal points (hospitals, nursing homes, schools, etc.) and their immediate surroundings. Conclusions. Although territorial aspects have been taken into account by the government in their efforts to contain the pandemic in Hungary, they have been given significantly less attention in terms of socio-economic support. Thus, as the article makes clear, it is important to devise and implement regionally differentiated policies of containment as well as socio-economic protection measures.

Access to health care is one of determinative factors in understanding health inequalities. It is not an easy task to define it, because its conceptualisation and measuring depend on different approaches and socio-economic characteristics. In our three year course research project the main aim is to analyse the Hungarian health inequality and its regional differences related to the role of access to health care. The multi-factorial way in determination of barriers in access to health care means using mixed method with combination of quantitative and qualitative techniques. Acute myocardial infarction is one of non-communicable cardiovascular diseases, which was the example in the case study of our project. This was used to study the connection among accessibility, inequality and spatiality. The primary results of statistical analysis confirm a paradox situation in Hungary based on improving health with increasing inequalities. The most important experiences of making semi-structured interviews with medical stakeholders and patients can discover individual and institutional influencing factors in access to health care. The aim of this paper is to interpret basic theoretical and empirical framework of our research project with its most important results. In addition, many experiences of our examinations are suitable for making proposals for evidence based policy-making.

In times of epidemics and humanitarian crises, it is essential to translate scientific findings into digestible information for government policy makers who have a short time to make critical decisions. To predict how far and fast the disease would spread across Hungary and to support the epidemiological decision-making process, a multidisciplinary research team performed a large amount of scientific data analysis and mathematical and socioeconomic modeling of the COVID-19 epidemic in Hungary, including modeling the medical resources and capacities, the regional differences, gross domestic product loss, the impact of closing and reopening elementary schools, and the optimal nationwide screening strategy for various virus-spreading scenarios and R metrics. KETLAK prepared 2 extensive reports on the problems identified and suggested solutions, and presented these directly to the National Epidemiological Policy-Making Body. The findings provided crucial data for the government to address critical measures regarding health care capacity, decide on restriction maintenance, change the actual testing strategy, and take regional economic, social, and health differences into account. Hungary managed the first part of the COVID-19 pandemic with low mortality rate. In times of epidemics, the formation of multidisciplinary research groups is essential for policy makers. The establishment, research activity, and participation in decision-making of these groups, such as KETLAK, can serve as a model for other countries, researchers, and policy makers not only in managing the challenges of COVID-19, but in future pandemics as well.

This paper examines the spatial dynamics and regional distribution of the novel coronavirus epidemic in Hungary in an effort to obtain a deeper understanding of the connection between space and health. The paper also presents comprehensive epidemiologic data on the spatiotemporal spread of the COVID-19 pandemic in terms of the epidemic waves. Following a comparison of the growth rates of infection numbers, the current study explores the geographical dimension of the three pandemic waves. The partial transformation of spatial characteristics during the three epidemic waves is among the most important results found. While geographical hotspots influenced the first wave, newly confirmed coronavirus cases in the second and third waves were due to community-based epidemic spreading. Furthermore, the western-eastern spatial relation and the core-periphery model also affected the regional distribution of new cases and deaths in the initial two waves. However, a new spatial pattern - realised by the northern-southern spatial orientation - appeared during the third wave. The outputs of this paper offer feasible suggestions for evidence-based policymaking in pandemic prevention, mitigation, and preparedness.

One form of climate change vulnerability is the increase in the number, frequency and length of heat waves related to temperature rise. The protection against the health and sanitary risks of heat waves will pose a major challenge at national, regional, as well as local level in the future. The aim of the study is to present the main results of an assessment of climate change vulnerability conducted in a research project. Through statistical analyses, vulnerability was calculated based on the exposure, sensitivity and adaptive capacity at district level (LAU1), which is a complex information carrier about the vulnerability of population and institutions to heat waves. The territorial differences of vulnerability proved the West-East division of the country, but the centre-periphery relation also plays role in the development of territorial pattern. Based on statistical examinations it is ascertainable, that, in total, 42.5% of the country’s territory, where currently 39.5% of the population live, is severe and extreme vulnerable to the effects of climate change. The main results of the research can also be used as suggestions for the local decision-making related to the preparation for and adaptation to the health effects and sanitary consequences of heat waves.

Received July 8, 2020; accepted August 30, 2020. Дата поступления 8 июля 2020 г.; дата принятия к печати 30 августа 2020 г. Relevance. The new coronavirus pandemic (COVID-19) has brought major changes to everyday life and economy in 2020. The impacts of the pandemic are still difficult to measure and interpret. This paper analyses the key socio-economic factors that shaped the course of the pandemic and its regional effects in Hungary. Research objective. The aim of this paper is to provide a secondary data-based analysis of regional disparities in Hungary as well as the implications of the coronavirus pandemic and the related policy responses. Data and methodology. The analysis consisted of the three stages: first, we processed the official epidemiologic data related to the coronavirus pandemic and the territorial patterns of infections as well as the data on the socio-economic impacts of the lockdown (on retail trade, employment, tourism, local governments’ revenues, etc.). Second, we collected the data related to the socio-economic effects of the pandemic and revealed the territorial impacts of the crisis. Finally, we evaluated the government’s measures and interventions introduced in the first wave of the pandemic in terms of their efficiency. Results Our results demonstrate that while the epicentre of the pandemic was the capital city and its surrounding area, the socio-economic impacts of containment measures implemented by the Hungarian government were felt across the whole country. In some areas, the lockdown measures could have been unreasonably tight as no reasonable justification for these restrictions was provided. Therefore, territorial monitoring and development of regionally differentiated policies are the main tasks in preparation for further waves of the pandemic. In our opinion, it is necessary to devise an action plan that would regulate the protocols of prevention and protection in connection with the regional focal points (hospitals, nursing homes, schools, etc.) and their immediate surroundings. Conclusions. Although territorial aspects have been taken into account by the government in their efforts to contain the pandemic in Hungary, they have been given significantly less attention in terms of socio-economic support. Thus, as the article makes clear, it is important to devise and implement regionally differentiated policies of containment as well as socio-economic protection measures. Актуальность. Новая пандемия коронавируса (COVID-19) внесла серьезные изменения в повседневную жизнь и экономику в 2020 году. Воздействие пандемии по-прежнему трудно измерить и интерпретировать. В данной статье анализируются ключевые социально-экономические факторы, которые сформировали течение пандемии и ее региональные последствия в Венгрии. Цель исследования. Цель этого документа – предоставить вторичный анализ региональных различий в Венгрии на основе данных, а также последствий пандемии коронавируса и соответствующих ответных мер правительства. Данные и методы. Анализ состоял из трех этапов: во-первых, мы обработали официальные эпидемиологические данные, связанные с пандемией коронавируса и территориальными структурами инфекций, а также данные о социально-экономических последствиях ограничений (на розничную торговлю, занятость, туризм, доходы органов местного самоуправления и т.д.). Во-торых, мы собрали данные о социально-экономических последствиях пандемии и выявили территориальные последствия кризиса. Наконец, мы оценили меры вмешательства правительства, введенные в ходе первой волны пандемии, с точки зрения их эффективности. Результаты. Наши результаты показывают, что, хотя эпицентром пандемии была столица и ее окрестности, социально-экономические последствия ограничительных мер, введенных правительством Венгрии, ощущались по всей стране. В некоторых районах меры изоляции могли быть неоправданно жесткими, поскольку не было предоставлено разумного обоснования для этих ограничений. Следовательно, территориальный мониторинг и разработка регионально дифференцированной политики являются основными задачами при подготовке к новым волнам пандемии. По нашему мнению, необходимо разработать план действий, который регулировал бы профилактику и защиту в координации с региональными центрами (больницами, домами престарелых, школами и т.д.) и их непосредственным окружением. Выводы. Хотя территориальные аспекты были приняты во внимание правительством в усилиях по сдерживанию пандемии в Венгрии, им уделялось значительно меньше внимания с точки зрения социально-экономической поддержки. Таким образом, как поясняется в статье, важно разработать и реализовать дифференцированную по регионам ограничительную политику, а также меры социально-экономической защиты.

Összefoglaló a 2019. április 1-én rendezett szakmai találkozóról és a mini-konferencia előadásairól a hazai egészségegyenlőtlenségek témakörben., Egészségfejlesztés folyóirat, Évf. 60, Szám 2 (2019)

Bevezetés: Az elmúlt másfél évtizedben az EU tagországaiban javult a keringési rendszeri, azon belül az ischaemiás szívbetegségek és az infarktus okozta halálozások aránya, legkisebb mértékben éppen Magyarországon. A 2000-es évek eleje óta tartó javuló tendencia ellenére jelentős a lemaradásunk Európa legfejlettebb államaihoz képest. A paradox helyzet feltárása érdekében a tanulmány célja az akut szívizominfarktus (AMI) hazai időbeli alakulásának és területi különbségeinek elemzése. Ez hozzájárul hazai egészségegyenlőtlenségek és az egészségügyi ellátáshoz való hozzáférés szerepének értelmezéséhez, mivel az AMI túlélési esélyeit növeli a gyors diagnózis, az időben elvégzett beavatkozás és a hatékony rehabilitáció. Módszerek: A statisztikai vizsgálatok során a BNO I21-23 kódok alapján definiált AMI-halálesetek elemzése történt meg 2005-2015 között, megyei és járási, illetve férfi-nő bontásban. Az egyenlőtlenség jellemzése különböző szempontok alapján kiválasztott egyenlőtlenségi mutatók alkalmazásával valósult meg. A szomszédsági hatás vizsgálata a területi autokorreláció módszerére épült, a térbeli hatás elemzése az ún. térbeli késleltetési modell (Spatial Autoregressive Lagged Model – SAR Lag) használatával történt. Eredmények: Az AMI halandósági adatai eloszlásának teljes terjedelmét figyelembe véve megállapítható, hogy az ország különböző részei között jelentős területi egyenlőtlenségek tapasztalhatók az infarktusos halálesetek előfordulásában. Az egyenlőtlenségek mértékét befolyásolta az idő, az adatok területi bontása, és a nemek szerinti megoszlás. Noha 2005 óta látványosan javult az infarktus okozta halálozás Magyarországon, a területi egyenlőtlenségek növekedtek, a nőknél kifejezettebben. Következtetések: Az AMI ellátásához való hozzáférés esélyeinek javításában a társadalmi-gazdasági befolyásoló tényezők – például egészségtudatosság, munkaerőpiaci pozíció – területi különbségeinek kiegyenlítése az egészségegyenlőtlenségek csökkenését eredményezhetik a jövőben. Az AMI-halandóságban tapasztalható területi egyenlőtlenségek növekedése felveti, hogy milyen társadalmi-gazdasági tényezők befolyásolják, illetve akadályozzák az AMI-ellátáshoz való hozzáférés esélyét. Ezek elemzésére ugyan a tanulmány nem tért ki, de kutatásuk indokolt helyi esettanulmányok segítségével. Szintén további elemzéseket igényel a nők AMI-halálozásában megfigyelhető egyenlőtlenség növekedése és a legutóbbi gazdasági válság hosszú távú társadalmi hatásai közötti összefüggések feltárása. Introduction: An improving tendency of cardiovascular mortality such as mortality from ischemic heart disease and infarction can be experienced in the last 15 years in the member states of the European Union, but this improvement is the most moderated in Hungary. The country is significantly lagging behind the most developed European countries, in spite of the improving tendency since the first years after 2000. The aim of this paper is to study the changes and spatial differences of acute myocardial infarction (AMI) in Hungary, in order to analyse this paradox. This can help in defining the Hungarian health inequalities and the difficulties in access to health care because a quick diagnosis, timely interventions and efficient rehabilitation can increase the survival chances of AMI. Methods: Our applied statistical methods are based on the examination of AMI mortality data (ICD I21-23) and its spatial inequalities between 2005 and 2015 at the level of counties and districts, by gender. Description of inequalities was based on selected inequality indicators. The neighbouring impact was examined by spatial autocorrelation, while spatial impact was analyzed by spatial autoregressive lagged model (SAR Lag) estimation. Results: There are significant differences among the different parts of the country according to AMI mortality and its spatial inequalities based on the total distribution of AMI mortality data. The scale of these inequalities was influenced by changes in time, spatial distribution and gender balance. There has been a remarkable improvement in AMI mortality in Hungary since 2005, but it is associated with increased inequality, which is especially true for female AMI mortality. Conclusions: Reducing spatial inequalities in socioeconomic determinants, such as health consciousness and labour market position, can result in declining inequalities in access to AMI care in the future. Rising spatial inequalities in AMI mortality raises the issue of defining socio-economic determinants which influence or hinder access to AMI care. Analysing these determinants is not part of this paper but they should be examined in the future, especially by local case studies. It is also worth studying the relationship between rising inequalities in female AMI mortality and the long term effects of the latest economic crisis., Egészségfejlesztés folyóirat, Évf. 58, Szám 3 (2017)

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.

This paper studies the connection between health—especially life expectancy—and unemployment in Hungary. Unemployment and health are recognised as being linked, though the relationship is complex. Unemployment happens to many people mainly in the period of crisis and can be a stressful and depressing time of life. On the one hand, the general state of health of the Hungarian people is worse than justified by the level of economic development. On the other hand, the role of the present economic crisis is to be predicted in the future run of health condition. Moreover, it would probably result health deterioration for those social groups who are most affected by unemployment and poverty. The study consists of two major structural parts. The theoretical part provides an insight to the specific literature, while the empirical chapter examines the link between socioeconomic indicators, unemployment, and life chances with correlation and regression calculations.

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.

The aim of this study is to analyze the changes and the regional differences of the Hungarian life chances with the indicators of average life expectancy and mortality rate. The spatial dimension of the Hungarian health inequalities was one of our priorities, which could help us to define the typical spatial structure of health status in Hungary. We can say, the socio-economic status of Hungarian regions can determine the advantageous and the disadvantageous counties by the life chances. On the other hand, the 'Western-Eastern gradient' of the Hungarian economic environment is not very relevant in the health indicators. In the Eastern part of Hungary there are better values of GDP, for example in the cities, where the health is more advantageous. But in the Western part of Hungary, for example in South Transdanubia can be experienced one of the worst economic and health indicators in the country. The regional differentiation of the Hungarian life chances were studied with the knowledge and methodology of Health Geography and Regional Science Studies. .

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.

A kornyezeti tenyezők kozvetlenul es kozvetetten is hatast gyakorolnak egeszsegi allapotunkra, betegsegeinkre, egeszsegmagatartasunkra. Az embert korulvevő kornyezetnek szamos definicioja letezik, melynek meghatarozasaval es vizsgalataval szinte mindegyik tudomanyterulet foglalkozik. Az egeszsegkutatasok szempontjabol mervado a WHO 1991-es Sundsvall-i Nyilatkozataban elfogadott ertelmezes. E szerint a kornyezet nem csupan fizikai hely, hanem szocialis, gazdasagi, politikai es kulturalis medium is. Mindezen dimenziok mellett szukseges ertelmezni az egeszseget tamogato kornyezeti felteteleket, lehetősegeket. Mind szűkebb (otthon, lakas), mind tagabb lakokornyezetunk (lakohely) fontos szerepet tolt be eletunkben. Befolyasolja egeszsegunket, hatassal van riziko- es egeszsegmagatartasunk alakulasara, valamint a kulonboző betegsegek es pszichoszomatikus tunetek megjelenesere. A kulonboző kornyezeti elemek a szabadidős tevekenysegek befolyasolasan keresztul meghatarozoak az eletkorulmenyekben es az eletmodban is...