Lege Artis Medicinae

[Resolution of the plenary meeting of the Scientific Council for Health of 21 October 1991]

JANUARY 01, 1991

Lege Artis Medicinae - 1991;1(01 KLSZ)

[The Plenary Session of the Scientific Council for Health has formulated the following opinion on the "Action Programme for the Renewal of our Health Care System" and the "Basic Concept of the Financing System of the Hungarian Health Care System".]

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Lege Artis Medicinae

[Dear Editorial Team!]

GYENES Géza

[We respectfully send you the position paper of the FAKOOSZ on the "Action Programme", which we have prepared at the request of Dr. István Mikola, State Secretary. We would ask you, if possible, to publish an extract of this document in your newspaper. Our association aims to formulate, coordinate, defend, represent and constantly assert the interests of district doctors working in villages in accordance with their specific living and working conditions. It operates independently of political parties, denominations, the medical trade union and the MOK. In addition to advocacy, we also provide charitable and economic services to our members, the profits from which are donated to the FAKOOSZ Foundation. Our membership is open to all doctors of Hungarian nationality working in the rural districts and municipalities attached to the town, as well as to doctors of non-Hungarian nationality who are resident in Hungary or have a residence permit. ]

Lege Artis Medicinae

[Summary of comments]

[The Ministry of Public Welfare has published a working paper entitled Action Programme for the Renewal of our Health System for discussion in the Medical Weekly and in the pages of Lege Artis Medicinae. The programme has received many comments, opinions and suggestions. In addition to our medical colleagues, economists, sociologists, churchmen, lawyers, entrepreneurs, health professionals, politicians and parliamentarians have also contributed. The majority of the 269 analytical reflections - just over 5,000 pages - were written by institutions, university clinics, hospital doctors' groups, district medical associations, scientific associations, bodies of interest representation bodies (Hungarian Medical Chamber, EDDSZ), the Health Science Council, health and social committees of local authorities, regional and expert working groups of social security institutions and many others. The reflections have been examined in detail by experts from the Ministry and members of the working committee that drew up the programme. They provided many good ideas and useful suggestions for the final version of the programme. We thank all those who took the trouble to contribute with constructive comments and good intentions to the design of the new health care system and the new way of working. The most representative comments are published as promised and a summary of the lessons learnt from the processing of the material is presented in a bundle.]

Lege Artis Medicinae

[Meeting of the International Social Security Association in Budapest]

[From 28 October to 1 November, the 239-member International Social Security Association (ISSA) Standing Committee on Health and Sickness Insurance held its twenty-fifth meeting in Budapest.Experts from 33 countries (nearly 100 participants) discussed the most topical issues of health care in their countries over five days.]

Lege Artis Medicinae

[Old and new pitfalls: comments on health care reform]

OROSZ Éva

[The following is an extract from a forthcoming book, the manuscript of which closed at the beginning of September, so it does not respond to the Ministry of Public Welfare programme that has been published since then - although it is still relevant. ]

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Microdiscectomy (MD) is a stan­dard technique for the surgical treatment of lumbar disc herniation (LDH). Uniportal percutaneous full-endoscopic in­terlaminar lumbar discectomy (PELD) is another surgical op­tion that has become popular owing to reports of shorter hos­pitalization and earlier functional recovery. There are very few articles analyzing the total costs of these two techniques. The purpose of this study was to compare total hospital costs among microdiscectomy (MD) and uniportal percutaneous full-endoscopic interlaminar lumbar discectomy (PELD). Forty patients aged between 22-70 years who underwent PELD or MD with different anesthesia techniques were divided into four groups: (i) PELD-local anesthesia (PELD-Local) (n=10), (ii) PELD-general anesthesia (PELD-General) (n=10), (iii) MD-spinal anesthesia (MD-Spinal) (n=10), (iv) MD-general anesthesia (MD-General) (n=10). Health care costs were defined as the sum of direct costs. Data were then analyzed based on anesthetic modality to produce a direct cost evaluation. Direct costs were compared statistically between MD and PELD groups. The sum of total costs was $1,249.50 in the PELD-Local group, $1,741.50 in the PELD-General group, $2,015.60 in the MD-Spinal group, and $2,348.70 in the MD-General group. The sum of total costs was higher in the MD-Spinal and MD-General groups than in the PELD-Local and PELD-General groups. The costs of surgical operation, surgical equipment, anesthesia (anesthetist’s costs), hospital stay, anesthetic drugs and materials, laboratory wor­kup, nur­sing care, and postoperative me­dication diffe­red significantly among the two main groups (PELD-MD) (p<0.01). This study demonstrated that PELD is less costly than MD.

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