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Introduction: The development of the medical career model is a priority issue from the point of view of safe patient care., Objective: In our research, we aimed to examine the average monthly income of doctors employed in Hungary between 1998 and 2021, especially with regard to the significant increase in medical payment in 2021., Data and Methods: Data were derived from the database of the National Directorate General for Hospitals. Doctors employed full-time in all public health institutions were included in our time-series analysis. In our institutional-level analysis, we considered all employed doctors of all public hospitals. Each healthcare institution was grouped according to the type of institution., Results: The payment of full-time doctors in Hungary increased by 16.1 times between 1998 and 2021. In 2020, the payment of hospital doctors at the national level was 767 505 Ft (2186 €), while in 2021, as a result of the increase in medical income, it was 1 415 481 Ft (3948 €) (+84%). In 2021, this was 1 435 972 Ft (4005 €) in national institutes, 1 204 258 Ft (3359 €) in clinical centers, 1 397 181 Ft (3897 €) in capital hospitals, 1 520 821 Ft (4242 €) in county hospitals and 1 688 726 Ft (4710 €) in city hospitals. The difference between the highest and the lowest payment was 1.90 times in national institutes, 1.26 times in clinical centers, 1.93 times in capital hospitals, 1.47 times in county hospitals and 1.75 in city hospitals., Conclusion: In 2021, as a result of the increase in medical incomes, the average incomes increased significantly. We observed significant differences between the types of institutions. Orv Hetil. 2023; 164(29): 1146-1154.

Összefoglaló. Bevezetés: A rheumatoid arthritisszel kapcsolatos szolgáltatások igénybevétele nagy teher az egészségügyi rendszerek számára. Célkitűzés: Elemzésünk célja volt a rheumatoid arthritis okozta éves epidemiológiai és egészségbiztosítási betegségteher meghatározása Magyarországon. Adatok és módszerek: Az elemzésben felhasznált adatok a Nemzeti Egészségbiztosítási Alapkezelő (NEAK) finanszírozási adatbázisából származnak, és a 2018. évet fedik le. Meghatároztuk az éves betegszámokat, a prevalenciát 100 000 lakosra, továbbá az éves egészségbiztosítási kiadásokat korcsoportos és nemenkénti bontásban valamennyi egészségbiztosítási ellátás tekintetében. A rheumatoid arthritis kórképet fődiagnózisként a Betegségek Nemzetközi Osztályozása (BNO, 10. revízió) szerinti M0690-es kóddal azonosítottuk. Eredmények: Meghatározó betegforgalmat a gyógyszerek ártámogatása esetében találtunk: 7015 férfi, 23 696 nő, együtt 30 711 fő. A gyógyszer-ártámogatás betegforgalmi adatai alapján a 100 000 főre eső prevalencia férfiaknál 150,2 fő, nőknél 464,0 fő, együtt 314,1 fő volt. A rheumatoid arthritis kezelésére a NEAK 1,64 milliárd Ft-ot (6,07 millió USD, illetve 5,14 millió EUR) költött 2018-ban. A kiadások 19,3%-a férfiaknál, míg 80,7%-a nőknél jelenik meg. A gyógyszer-ártámogatás (az összes kiadás 42,8%-a), a járóbeteg-szakellátás (21,9%) és az aktívfekvőbeteg-szakellátás (12,4%) voltak a meghatározó költségelemek. Az egy betegre jutó átlagos éves egészségbiztosítási kiadás 53 375 Ft (198 USD/167 EUR) volt. Következtetés: A gyógyszerek ártámogatása bizonyult a fő költségtényezőnek. A rheumatoid arthritis előfordulási gyakorisága 3,1-szer magasabb a nők esetében a férfiakhoz képest. Orv Hetil. 2021; 162(Suppl 1): 30-37., Introduction: Utilisation of services related to the treatment of rheumatoid arthritis poses a great burden for healthcare systems. Objecive: Our aim was to determine the annual epidemiological disease burden and the health insurance treatment cost of rheumatoid arthritis in Hungary., Data and Methods: Data were derived from the financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary, for the year 2018. The data analysed included annual patient numbers and prevalence per 100 000 population and annual health insurance treatment costs calculated for age groups and sex according to all health insurance treatment categories. Patients with rheumatoid arthritis were identified as main diagnosis with the following code of the International Classification of Diseases, 10th revision: M0690., Results: We found a significant patient turnover in pharmaceutical reimbursement: 7015 men, 23 696 women, in total 30 711 patients. Based on patient numbers in pharmaceuticals, prevalence for 100 000 population among men was 150.2 patients, among women 464.0, in total 314.1 patients. In 2018, NHIFA spent 1.64 billion HUF (6.07 million USD, 5.14 million EUR) on the treatment of patients with rheumatoid arthritis. 19.3% of the costs was spent on the treatment of male, 80.7% on female patients. Pharmaceuticals (42.8% of the total expenditures), outpatient care (21.9%) and acute inpatient care (12.4%) were the main cost drivers. Average annual health insurance treatment cost per patient was 53 375 HUF (198 USD/167 EUR)., Conclusion: Pharmaceutical reimbursement was the major cost driver. The prevalence of rheumatoid arthritis was by 3.1 higher in women compared to men. Orv Hetil. 2021; 162(Suppl 1): 30-37.

Introduction: In order to provide appropriate prevention, diagnosztics, decision on therapy and monitoring the results of medical treatment, there is an increasing need for laboratory examinations. Aim: The aim of our study is the health-ecnomics analysis of laboratory budget of the Hungarian Health Insurance Fund. Data and method: Data were derived from the financial database of the National Health Insurance Fund Administration. The analysis covered the period of 2002-2018. We analysed the annual budget for laboratory examinations, the number of patients and examinations, the market share of laboratory services providers according to their owner structure from the health insurance curative-preventive budget. Results: The budget available for financing the laboratory examinations (21-22 billion Hungarian forint (Ft)/év) did not change significantly between 2005 and 2015. There was a significant decrease in the number of both patients and examinations between 2006 and 2008. In the latest years, there were 14-15 million cases per year and 180 million examinations per year. The market share of for-profit companies decreased from 29.0% in 2010 to 10.6% in 2018, while the market share of governmental institutions increased from 27.1% in 2010 to 78.7% in 2018. Conclusion: The activity of laboratories was stabilized in the latest years. After the necessary correction of professional regulations and code maintenance, the laboratory budget can be increased towards the mainly public laboratory services providers. Orv Hetil. 2020; 161(12): 468-473.

Introduction: In Hungary, health expenditures - especially the question of health insurance subsidies for medicinal products - are becoming increasingly important., Aim: The aim of our analysis is to reveal the state's health insurance expenditure between 2010 and 2016 as well as the amount of health insurance subsidies for medicinal products., Data and Methods: Data were derived from the database of the National Health Insurance Fund of Hungary and of the Hungarian Central Statistical Office. During the analysis we examined the period between 2010 and 2016. We analysed the health expenditures in proportion to the gross domestic product (GDP) as well as the changes of drug traffic based on gross consumer prices and those of health insurance subsidies, and also our regional inequalities. When writing the present study, we used descriptive statistical methods., Results: The expenditures of the National Health Insurance Fund of Hungary significantly increased as proportions of the GDP from 5.5% in 2010 to 6.1% in 2016. The health insurance subsidies for medicinal products increased since 2013. The highest health insurance subsidies per 10 000 inhabitants could be seen in Baranya (405 788 HUF/inhabitant) and Csongrád (384 724 HUF/inhabitant) counties and in Budapest (377 316 HUF/inhabitant). The lowest health insurance subsidies were found in Nógrád (289 168 HUF/inhabitant) and Szabolcs-Szatmár-Bereg (271 104 HUF/inhabitant) counties., Conclusion: The trends of health and drug expenditure show a growing tendency. We can find significant regional inequalities in case of both the drug traffic based on gross consumer prices and the health insurance subsidies. It would be needed to strengthen the elements of prevention, and to popularize health-conscious lifestyle and doing sports. Orv Hetil. 2019; 160(Suppl 1): 49-54.

Introduction: With the improvement of the survival of acute cardiac events and the increasing age, there is a higher demand for cardiac rehabilitation care., Aim: The aim of our study is to analyse the performance indicators of cardiac inpatient rehabilitation care in Hungary financed by the statutory public health insurance system., Data and Methods: Data were derived from the financial database of the National Health Insurance Fund of Hungary. We analysed the period between 2014 and 2017. We investigated the distribution of cardiac rehabilitation hospital beds, the patient turnover and the rehabilitation rate following acute care., Results: In 2017, there were 1765 publicly financed cardiac rehabilitation hospital beds in Hungary (1.8 beds/10 000 population). We observed the lowest number of hospital bed number in Szabolcs-Szatmár-Bereg (0.27 beds/10 000 population), Hajdú-Bihar (0.28) and Fejér (0.6) counties. We found the highest number of hospital beds in Veszprém (11.47 beds/10 000 population), Győr-Moson-Sopron (4.94) counties and in Budapest (2.27). Between 2014 and 2017, the annual number of patients was between 24 834 and 26 146, while the number of nursing days varied between 510 thousand and 542 thousand. The average length of stay showed a moderate increase from 19.2 days/patient (2014) to 20.2 days/patient (2017). Only 6.6-7.6% of the patients who underwent acute myocardial infarction received cardiac rehabilitation care., Conclusion: We found significant regional inequalities in both the capacities and the access to and utilization of cardiac rehabilitation healthcare services, which should be mitigated by health policy activities. The low proportion (6.6-7.6%) of patients who underwent acute myocardial infarction and received cardiac rehabilitation care, should be increased. Orv Hetil. 2019; 160(Suppl 1): 6-12.

Introduction: With the increasing number of the incidence of neuromusculoskeletal and brain circulation disorders, there is a higher demand for neuromusculoskeletal rehabilitation care., Aims: The aim of our study is to analyse the performance indicators of neuromusculoskeletal rehabilitation care in Hungary financed by the statutory public health insurance system., Methods: Data were derived from the financial database of the National Health Insurance Fund of Hungary. We analysed the period between 2014 and 2017. We investigated the distribution of neuromusculoskeletal rehabilitation hospital beds, the patient turnover and patients' pathways. We analysed the regional inequalities in the access to (hospital beds) and utilization (number of patients) of rehabilitation care., Results: In 2017, there were 6798 publicly financed neuromusculoskeletal rehabilitation hospital beds in Hungary (6.94 beds/10 000 population). We observed the lowest number of hospital bed in Komárom-Esztergom (1.5 beds/10 000 population), Somogy (2.0) and Pest (2.7) counties. We found the highest number of hospital beds in Zala (12.6), Győr-Moson-Sopron (12.2) and Baranya (11.5) counties. The more than 2-fold difference in the utilization (Komárom-Esztergom: 52.3 patients/10 000 population; Győr-Moson-Sopron: 136 patients/10 000 population) confirms regional inequalities. Between 2014 and 2017, the annual number of patients showed an increasing tendency, while the average length of stay varied between 21.8 and 22.4 days/patient. The correlation coefficient between hospitals beds and the number of patients was very high (0.798)., Conclusion: We found significant regional inequalities in the access to and utilization of neuromusculoskeletal rehabilitation. Orv Hetil. 2019; 160(Suppl 1): 13-21.

Introduction: The role of spa therapy is well defined and its importance has significantly increased in the healthcare but the utilization indicators of the implemented treatments are less known., Aim: The objective of our study was to analyze the utilization and the social insurance indicators of the healthcare publicly financed by health insurance in spa institutions., Data and Methods: The data used for the analysis were derived from the funding database of the National Health Insurance Fund of Hungary. The period examined covered the years between 2009 and 2016. The spa treatment counts, social insurance expenses, the territorial inequalities in utilization, sex and age distribution of the treatments were examined., Results: The treatment counts were the highest (7 349 587) in 2009 and they gradually decreased with 6 558  204 treatments by 2012. 'Spa pool of medicinal water' treatment was the most common care in each year which incidence showed a downward trend during the past years: 2 544  617 treatments were performed in 2009 but 2016 showed only 1 898  338 treatments. We found the highest health insurance expenditures in 2016: 4.261 billion HUF or 13.8 EUR. In the previous years, there was a lower health insurance expenditure: in 2010 3.928 billion HUF (14.3 million EUR), in 2011 3.921 billion HUF (14.0 million EUR) and in 2012 3.875 billion HUF (13.4 million EUR). The utilization made the highest incidence of treatments in Csongrád county with 13 174/10 000 inhabitants and 8160 thousand HUF/10 000 inhabitants of social security subsidy in 2016. The lowest utilization counts for treatments were found in Nógrád county with 3233/10 000 inhabitants and 2192 thousand HUF/10 000 inhabitants of social security subsidy. The highest utilization indicators were found in the age group between 60 and 69 in the distribution of population and genders., Conclusion: In the utilization of spa therapy funded by health insurance fund, no significant change has occurred during the past years but territorial discrepancies can be seen in sex, age, and county breakdown. Orv Hetil. 2019; 160(Suppl 1): 22-28.

Introduction and Aim: The aim of our study was to analyse the public price of the montelukast sodium therapy in Hungary., Method: Data derived from the nationwide pharmaceutical database of the Hungarian National Health Insurance Fund Administration. We observed the turnover and price of the medicaments containing the active substance montelukast sodium from 2007 to 2015. Accordingly, our indicators were: consumer price, DCT (daily cost of therapy), co-payment, quasi co-payment, DOT (days of treatment)., Results: Due to the increasing DOT, the total amount of the public price paid by the patients increased until 2011, reaching the amount of 1 million USD; then, due to the generic competition and the blind bid methods, it decreased to 490 000 USD. The total amount of the public price of the brand-name Singulair moved to the generics during 3 years (2011-2014). The DCT of the originator Singulair 10 mg tablets decreased from 1.1 USD to 0.34 USD; the DCT of the generic product Montelukast TEVA decreased from 0.67 USD to 0.16 USD in the period under review., Conclusion: Due to the generic competition, the patients' access to drugs containing montelukast sodium increased significantly: the DOT increased, the co-payment decreased. Orv Hetil. 2018; 159(17): 682-687.