Bálint Csaba
Institute of Regional Economics and Rural Development, Szent István University, H-2100 Gödöllő, Hungary.
Eur J Investig Health Psychol Educ. 2019 Dec 23;10(1):327-345. doi: 10.3390/ejihpe10010025.
In the establishment, development, and provision of equal access to the health care system, the operation of adequate primary health care is essential and has undergone significant transformation in the most developed countries over the past decades. The central and eastern European countries, including Hungary, are struggling with the disadvantages of the traditional model of primary health care, based on independent general practitioner and family paediatrician practices: the ability of the system is extremely limited to meet emerging needs and is facing a chronic human resource crisis. In the current study, the functions, legislation, and challenges of the Hungarian primary health care system, as well as the basic interrelations of the development of vacant general practitioner and family paediatrician districts were examined, and the government measures for the sake of solving the occurrence of the vacancy and improving access in the lagging areas. (The situation of the other fields of primary health care-e.g., dental care, child care officer care, etc.-was not subject of the analysis.). The basic characteristics of the vacant districts (type by supplied age group, bounding region, population size, length of vacancy) were primarily examined by the analysis of categorical and metric variables, with the use of cross-tabulation and nonparametric correlation, while the discovery of soft interrelations was supported by an expert interview conducted with the professionals of the Primary Health Care Department of the National Health Care Services Centre. In Hungary, the fundamentals of primary health care are made up of the individual practices of general practitioners and paediatricians, and there is a growing concern about the permanent vacancy of the districts, and the fact that the system is less suitable for meeting the needs of the population. The ever-increasing number of vacant general practitioner and family paediatrician districts due to the growing shortage of professionals because of aging and emigration poses the burden of substitution on the physicians in existing practices, that concerns the access of more than a half million people to health care, almost 70 percent of which live in settlements with a population less than 5000 inhabitants.
在建立、发展和提供平等的医疗保健系统准入机会方面，充分的初级医疗保健运作至关重要，并且在过去几十年里，最发达国家的初级医疗保健已经历了重大变革。包括匈牙利在内的中东欧国家，正努力应对基于独立全科医生和家庭儿科医生执业模式的传统初级医疗保健模式的弊端：该系统满足新出现需求的能力极其有限，并且面临着长期的人力资源危机。在本研究中，对匈牙利初级医疗保健系统的功能、立法和挑战，以及空缺的全科医生和家庭儿科医生地区发展的基本相互关系进行了研究，并探讨了政府为解决空缺问题和改善落后地区医疗保健可及性所采取的措施。（初级医疗保健的其他领域，如牙科护理、儿童护理人员护理等情况，不在分析范围内。）主要通过分类变量和度量变量分析，利用交叉列表和非参数相关性，对空缺地区的基本特征（按提供服务的年龄组类型、边界区域、人口规模、空缺时长）进行了研究，同时，通过与国家医疗服务中心初级医疗保健部专业人员进行的专家访谈，辅助发现软性的相互关系。在匈牙利，初级医疗保健的基础由全科医生和儿科医生的个体执业构成，人们越来越关注地区的长期空缺，以及该系统不太适合满足民众需求这一事实。由于老龄化和移民导致专业人员日益短缺，空缺的全科医生和家庭儿科医生地区数量不断增加，给现有执业医生带来了替代负担，这涉及到超过50万人的医疗保健可及性问题，其中近70%居住在人口不足5000人的定居点。
