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Background: Timely management of sepsis in the emergency department, including the use of appropriate antimicrobials, is crucial for improving patient outcomes. Inadequate empiric antimicrobial treatment is associated with potential changes in patient outcomes. We aimed to pinpoint risk factors, characterize antibiotic resistance trends, and investigate the association between antibiotic resistance and mortality among patients with bacteremia admitted to the emergency department. Methods: We conducted a retrospective analysis of emergency department patients admitted between 15/06/2016 and 30/09/2022. Patients with a positive blood culture receiving emergency department-initiated antibiotic therapy were included. Antibiotic administration, resistance, and survival data were collected. Descriptive statistics, survival analysis, and Cox proportional hazards models were performed. Results: Of 157,884 emergency department visits, 1,136 patients had a positive blood culture and received antibiotic therapy initiated in the emergency department. Resistance against empiric antibiotics was 14.5%. The overall 30-day and one-year mortality was 38.6% and 61.8%, respectively. In adjusted Cox models, patients with Escherichia coli or Staphylococcus aureus infection had 36% lower and 44% higher risk of death, respectively. Although resistance to emergency department-administered antibiotic therapy was not associated with overall mortality, one-year mortality of patients with Escherichia coli bacteremia was higher in those with antibiotic resistance (69.0% vs. 49.4%, p = 0.011); these patients had a 1.5-fold increased risk of death in an adjusted Cox model. Conclusion: The mortality of patients with bloodstream infection is high. The association of mortality with empiric emergency department-initiated antibiotic adequacy is pathogen-dependent. [ABSTRACT FROM AUTHOR]

On the basis of documentary analysis and interviews with decision makers, this paper discusses the cost accounting methodologies used for price setting of inpatient services in the Hungarian health care system focusing on sector of acute inpatient care, which is financed through the Hungarian adaptation of Diagnosis Related Groups since 1993. Hungary has a quite sophisticated DRG system, which had a deep impact on the efficiency of the acute inpatient care sector. Nevertheless, the system requires continuous maintenance, where the cooperation of hospitals, as well as the minimisation of political influence are critical success factors. [ABSTRACT FROM AUTHOR]

This contribution considers entitlements and benefits in the Hungarian health care system. After a brief introduction to the organizational structure of the system the decision-making processes are discussed in detail, including the most important actors, types and pieces of legislation, formal structures, decision-making criteria, and outputs in terms of benefit catalogues. Within the two main public financing systems (social insurance and tax-funded services) there are four types of regulatory regimes: (a) traditional political decision making, (b) price negotiations, (c) updating of classification systems for payment purposes, and (d) the procedure for the inclusion of registered medicines in the scope of the social health insurance system. As an example we discuss the benefit regulations and benefit catalogues in the category of services of curative care (HC.1) of the OECD classification of health services. [ABSTRACT FROM AUTHOR]

Informal payments are known to be widespread in the post-communist health care systems of Central and Eastern Europe. However, their role and nature remains contentious with the debate characterized by much polemic. This paper aims to make sense of this debate by reviewing and summarizing the main arguments of the theoretical debate in Hungary. The review examines the possible causes of informal payment, the motivation of the actors involved and the impact of informal payment on system performance, focusing on efficiency and equity. The lines of arguments are summarized in two contrasting hypotheses, which envisage informal payment as either a donation or a fee-/bra-service. Evidence pertaining to the scale of informal payments and the motivation of patients are reviewed, but found to be inconclusive to verify the hypotheses. Although focused on Hungary, accounts from other countries facing informal payments show similar threads of discussion and dilemmas. These theories should be tested further using evidence from existing studies and new empirical research, since the validity of the gratitude payment concept is a central dilemma of effective policy making in the area. To orient future research, a possible agenda is outlined, which links evidence to be obtained to the defining features of gratitude payments. [ABSTRACT FROM AUTHOR]

This study aims to analyse the number of registered stocks (n), sex ratio (Nm/Nf), effective population size (Ne) and inbreeding rate (ΔF) within populations as well as the relationship between n, Ne and ΔF of 14 local Hungarian poultry breeds including Yellow Hungarian chicken (YHc), White Hungarian chicken (WHc), Speckled Hungarian chicken (SHc), Partridge Coloured Hungarian chicken (PHc), White Transylvanian Naked Neck chicken (WTc), Black Transylvanian Naked Neck chicken (BTc), Speckled Transylvanian Naked Neck chicken (STc), Hungarian Landrace Guinea Fowl (HLgf), Frizzled Hungarian Goose (FHg), Hungarian Goose (HUg), White Hungarian Duck (WHd), Wild Coloured Hungarian Duck (WId), Copper Turkey (COt) and Bronze Turkey (BRt) from 2000 to 2015 in conservation practice. The n of most breeds increased yearly and reached its peak in either 2012 or 2013. The Nm/Nf ranged between 0.110 and 0.742. The Ne varied widely from 92 (COt in 2000) to 2581 (HLgf in 2012). The Ne of WTs, BTc, STc, WHd and COt always stayed below 1000 individuals. Significant enhancement of Ne can be seen in PHc (from 242 in 2009 to 1640 in 2013), in HLgf (from 633 in 2009 to 2581 in 2012) or in HUg (from 163 in 2010 to 1262 in 2012). The Ne/N of all breeds was higher than 0.400 and the highest in HLgf (0.980 in 2008). The lowest ΔF of 0.019% and the highest ΔF of 0.794% were recorded in 2012 (HLgf) and 2009 (WHd), respectively. YHc and SHc always had ΔF lower than 0.108%, and in the last 2 years of the investigation only HUg and WHd had ΔF higher than 0.200%. Noticeably, there was a gradual decline in the ΔF of PHc, HLgf, COt and BRt. With the exception of HUg, the n correlates positively with Ne, and negatively with ΔF (P< 0.01), which reflects the significance of n in conservation practice. In brief, the study suggested the importance of monitoring n, Ne and ΔF as frequently as possible. The high n, as well as sustainable subsidies are essential to eliminate any risk of dramatic decrease in Ne, thus assuring the safety of a breed conservation programme. A conservation strategy to minimise ΔF by maximising Ne and increasing Nm/Nf is recommended. Based on effectiveness and reliability, the study can promote the use of the Hungarian conservation programme as a model in practice. [ABSTRACT FROM AUTHOR]