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Eszter Sinkó — 2025-06-13

Administrative data-based retrospective study of patients with heart failure and other comorbidities, diagnosed between 2012 and 2020

Fruzsina Mária Sinka — 2025-06-13

Heart failure is a widespread condition affecting more than 23 million people globally, with an increasing year-by-year prevalence due to the aging population, despite continuous development of new therapeutic options. This research seeks to answer how the occurrence of comorbidities, which are typically prevalent among heart failure patients, change in the analysed patient population and to what extent these diseases contribute to the development of heart failure.

The analysis was based on multiple databases, such as the inpatient and outpatient healthcare utilization data and demographic data from the TAJ database. By linking these databases, we conducted trend analysis and multivariable logistic regression analysis on the data of patients with diagnosed heart failure between 2012 and 2020 while examining their demographic characteristics.

Said heart failure population in Hungary is highly multimorbid and various diseases are simultaneously contributing to the deterioration of health. We found that compared to the 40-49 age group, the 50-59 age group had a 1.848 times higher, the 60-69 age group had a 2.500 times higher, and the 70-79 age group had a 3.121 times higher chance of developing heart failure. In terms of counties, we did not find any significant differences. The highest risk for developing heart failure was observed among patients with acute myocardial infarction within the previous year (9.247 times higher). The risk of developing heart failure was 7.377 times higher for cardiomyopathy, 4.127 times higher for hypertension, 3.070 times higher for COPD, 2.839 times higher for kidney failure, 2.836 times higher for ischemic heart disease, 2.731 times higher for atrial fibrillation, 2.151 times higher for arrhythmia, and 1.507 times higher for diabetes.

Based on our analysis of administrative data, scientifically known risk factors also become highlighted. All of these underline the importance of prevention and screening so that patients with known morbidities can start treatments in the early stages of heart failure; thereby, maximizing their life expectancy. In terms of comorbidities, significant differences were observed between the heart failure population and the control group. In the control group, comorbidities occur less frequently, regardless of the level of healthcare utilization, compared to the heart failure population. However, within the heart failure population, the proportion of comorbidities increased with age. In 2020, a decrease was observed for several comorbidities, which can most likely be explained by the Covid19 pandemic.

To the best of our knowledge, no study covering almost 10 years and processing such a large number of patients has been published. Our study confirmed the results of previous studies regarding the risk factors and comorbidities of heart failure. Additionally, based on the logistic regression results, we weighted the risk factors, thereby determining the order of preventive measures.

The missing link

Csaba László Dózsa — 2025-06-13

The aim of this study is to present the objectives of the oncology patient pathway management program launched in 2023 within the framework of the Healthy Budapest Program (EBP), the early experiences of district clinics and the possible directions for further progress. In accordance with the agreement between the Government and the Municipality of Budapest, that will implement several programs related to cancer care from the EBP resources provided in 2020 and 2021 until the end of 2025 based on the actual government decisions. As part of this, under the organization Municipality of Budapest, signed Cooperation Agreement with 11 Budapest district outpatient (poly)clinics from 2023 and 2024 to carry out oncology patient pathway management tasks.

This article provides a systematic overvies of the current situation, organizational activities, patient pathways and care experiences carried out in the past period. It is a challenge for Capital district outpatient clinics to build and strengthen professional relationships, on the one hand, with diagnostic service providers (imaging, laboratory, pathology) and, on the other hand, with oncology centres operating in national institutes, Semmelweis University or capital city hospitals. The specific tasks related to the organization among others are the training of the employees who carry out the organization, the development of supporting IT solutions, capacity development (number of hours), even set up new medical professions. In addition, several rounds of horizontal consultations have taken place between the professional managers of the specialist clinics involved in the program. At the end of the study, proposals are formulated by the authors for the further development of the oncology patient pathway management, and for the establishment of a policy and financing supportive environment.

Euthanasia and end-of-life care in childhood

Edit Nagy — 2025-06-13

Abstract
The central theme of my thesis is end-of-life care in childhood.
The objective was to conduct a comprehensive review of the practice of euthanasia,
encompassing both international and domestic contexts, as well as palliative, hospital, and
child hospice care. It is also imperative to emphasise the role of the parent as a further
specialist in paediatric care.
Furthermore, the paper examines the evolution of child hospices in Hungary and abroad over
time.
The paper discusses the standards of end-of-life care, outlining the options for hospital care
of the child and personal experiences in daily work.
End-of-life care is painful and difficult at all stages of life, for the patient and, in the case of
children, for the parent, who can be both active and still only be able to participate passively.
As a healthcare professional, knowing and using the options mentioned above can
accompany and help in such difficult journeys in everyday life.
Key words: end-of-life, euthanasia, children's care, palliative, hospice

Feasibility of prehabilitation before major urological surgery in the Hungarian Public Health Care System

Zoé Molnár — 2025-06-13

Abstract

The period from diagnosis to surgery offers an opportunity for prehabilitation, i.e. improving the physical and mental well-being of patients, thereby reducing the risk of postoperative complications. Although the effectiveness of prehabilitation has been demonstrated in numerous studies, its use is not yet standard care in our country.

The project, jointly organised by the Péterfy Sándor Utca Hospital and the Centre for Management Training at Semmelweis University, aimed to provide multidisciplinary support to patients undergoing cystectomy and to assess the feasibility of the programme. To this end, we have developed a prehabilitation framework providing surgical preparation, which we intend to be applicable before any planned major surgery and which can be easily integrated into the practice of healthcare institutions.

During the pilot program, we conducted multidisciplinary prehabilitation coaching of three high-risk patients with the participation of physiotherapy, dietetics and psychology, complemented by one session of medical information and consultation. Patients continued the learning at home with the help of the programme's publications. Improvements in functional capacity and nutritional status were observed, and patients became motivated and actively involved in their own complex treatment.

Based on the risk grouping (and estimated willingness to participate), individual coaching could be planned for 60-80 patients in the study ward with 2000 surgeries per year, and small group coaching for a further 500-600 patients.

Training can be provided in outpatient care, although funding for the different professions is not balanced. The literature suggests that prehabilitation not only reduces complications and missed operations, but is also cost-effective. Successful implementation requires multidisciplinary collaboration and the education of the entire care team.

Presentation of the mentoring programme to support organisational retention, the pilot programme of the National Institute of Pulmonology

Krisztina Bogos — 2025-06-13

Introduction Several crises have shaken the health sector in recent years; health workers and health organisations face many challenges, and from an institutional management perspective, there is a major struggle to retain staff. To this end, we have launched a mentoring process at the Institute.

Method 85 number of potential staff members were selected by the Director's Council and the Heads of Department and 14 of them participated in the mentoring pilot programme in the company of 13 mentors. In the mentoring process, a personal development programme was designed based on individual consultation and management needs. At the end of the five-month pilot, a questionnaire survey was conducted to assess the perception and impact of the programme.

Result The pilot programme was successful in supporting the institution facing organisational challenges, and the participants' summaries showed that it helped them to manage their individual, managerial and professional tasks more easily and effectively.

Conclusion Health care organisations are disproportionately affected by external and internal crises. An organisation should aim to support its staff towards mental well-being by keeping them together. This is why we decided to continue the mentoring programme implemented at the Institute.

Keywords: mentoring, human resources, retention

Az orvoshiány kihívásai Közép és Kelet Európában

Bence Gusztáv Dr. Stubnya — 2025-06-13

The shortage of physicians presents a significant and escalating challenge for healthcare systems across Europe, particularly in rural and disadvantaged regions. To address this issue, countries in Central and Eastern Europe have implemented a range of strategies, including the utilisation of telemedicine, the recruitment of foreign healthcare professionals, and the temporary reassignment of physicians. This study explores the practices of physician reassignment in Hungary, Slovakia, Austria, Slovenia, Croatia, Romania, Ukraine, and Serbia while disseminating preliminary findings from the “Human Resources for Health Research 2024”. In neighbouring countries, variations in the legal frameworks governing physician reassignment are observed; these frameworks also tend to emphasise the financial and professional incentives and foster the active involvement of healthcare professionals in the decision-making process. In Hungary, the reassignment of physicians is governed by Act C of 2020 on the Legal Status of Healthcare Service Personnel, which endows employers with considerable authority to make deployment decisions. However, the current legislative framework does not address healthcare workers' preferences. Preliminary results from the “Human Resources for Health Research 2024” indicate that 29% of resident respondents experienced alterations to their training plans due to reassignments. Furthermore, 68% expressed a willingness to pursue professional rotations in other cities, provided such opportunities were associated with career development. Additionally, 55.5% of respondents indicated an openness to commuting for work if appropriate job opportunities were available. These findings suggest that residents demonstrate receptiveness to mobility within the healthcare system, contingent upon the availability of clear professional benefits and incentives. The approaches adopted across Central and Eastern Europe highlight the need for more structured, staff-centred frameworks that align institutional demands with individual career aspirations. Future research should also investigate additional demographic, personal, and institutional factors that may influence the efficacy and perceptions of reassignments. Moreover, policy considerations should emphasise financial and professional incentives, transparent decision-making processes, and the active participation of healthcare professionals in career planning.

Digitális megoldások a betegellátás szolgálatában

Orsolya Tarcza — 2025-06-13