Imre Boncz1, Andor Sebestyén. 1. Országos Egészségbiztosítási Pénztár, Szakmapolitikai és Koordináló Fóosztály, Budapest. boncz.i@oep.hu
Abstract
AIM: To analyse the predicted and observed role of medical schools in the progressive health care. DATA AND METHODS: The data derives from the financial database of the National Health Insurance Fund (NHIF) and covering the period 1998-2001. In this study the authors calculated the market share of the medical schools within the financing of the NHIF in the field of out- and in-patient care, renal dialysis, CT/MRI examinations, task financed services under special rules and fee for progressive (tertier level) care. The authors performed a detailed analysis concerning the Diagnosis Related Groups (DRG) of active inpatient care, where the market share of medical schools was calculated within the TOP-15 DRGs with highest and lowest point value, and within the TOP-15 most common and most infrequent DRGs. RESULTS: The market share of medical schools increased from 13.7% (1998) to 15.0% (2001). The increase was significant in the active and chronic in-patient care and in renal dialysis. The market share of medical schools from progressive fee decreased from 32.3% (1998) to 26.5% (2001). Within the active in-patient care the medical schools provide health care for 37.7% of the most difficult cases with highest DRG value and for 30.1% of the patients with rare diseases. The market share of the medical schools is much lower in cases with lowest DRG value (10.2%) and in most common cases (9.8%). CONCLUSION: The medical schools fulfilled their expected role in the progressive (tertier) care, answering the public and professional expectations.
AIM: To analyse the predicted and observed role of medical schools in the progressive health care. DATA AND METHODS: The data derives from the financial database of the National Health Insurance Fund (NHIF) and covering the period 1998-2001. In this study the authors calculated the market share of the medical schools within the financing of the NHIF in the field of out- and in-patient care, renal dialysis, CT/MRI examinations, task financed services under special rules and fee for progressive (tertier level) care. The authors performed a detailed analysis concerning the Diagnosis Related Groups (DRG) of active inpatient care, where the market share of medical schools was calculated within the TOP-15 DRGs with highest and lowest point value, and within the TOP-15 most common and most infrequent DRGs. RESULTS: The market share of medical schools increased from 13.7% (1998) to 15.0% (2001). The increase was significant in the active and chronic in-patient care and in renal dialysis. The market share of medical schools from progressive fee decreased from 32.3% (1998) to 26.5% (2001). Within the active in-patient care the medical schools provide health care for 37.7% of the most difficult cases with highest DRG value and for 30.1% of the patients with rare diseases. The market share of the medical schools is much lower in cases with lowest DRG value (10.2%) and in most common cases (9.8%). CONCLUSION: The medical schools fulfilled their expected role in the progressive (tertier) care, answering the public and professional expectations.