GEOSPATIAL EQUITY AND ECONOMIC IMPLICATIONS OF HEALTH DEVELOPMENT OFFICES IN HUNGARY
Author(s)
Peter Domjan, MSc, PhD candidate1, Ádám Bertalan, PharmD, PhD candidate1, Viola Angyal, MSc2, Ivan Petrov, MSc1, Istvan Vingender, PhD, habil.1;
1Semmelweis University, Budapest, Hungary, 2Semmelweis University, Budapest - XI. kerület, Hungary
1Semmelweis University, Budapest, Hungary, 2Semmelweis University, Budapest - XI. kerület, Hungary
OBJECTIVES: Hungary operates 108 Health Development Offices (HDOs), which are financed by an annual grant of 25.2 million HUF (approximately $ 65,500 USD). Our geospatial analyses have shown unequal accessibility of HDOs across regions. This study extends that work by integrating spatial equity assessment with economic forecasting to evaluate the policy relevance of HDOs for the Hungarian National Health Insurance System. This model supports health system efficiency and equitable resource distribution.
METHODS: We combined geospatial modeling with an economic evaluation framework. Accessibility was quantified using population density through the elderly proportion. Geographic Information System (GIS) based methods were applied to assess spatial inequities and highlighted the importance of service coverage. The total annual cost of the national HDO program was estimated at 2.7 billion HUF (about 8.2 million USD). A budget impact analysis was conducted from the macroeconomic perspective with a 3-year time horizon, extrapolated to 10 years. Expected relative risk reductions (1-3%) for type 2 diabetes, cardiovascular disease, and mental health service use were derived from evidence-based prevention outcomes. A probabilistic sensitivity analysis using Monte Carlo simulation explored uncertainty related to adherence and cost parameters.
RESULTS: Our geospatial analysis confirms regional disparities, with rural and economically deprived populations relatively better covered in service allocation. The estimated annual program cost provides a transparent baseline for economic evaluation. Predicted reductions in chronic disease incidence could generate measurable savings for the Hungarian National Health Insurance Fund (NEAK). The program costs support sustained investment in preventive healthcare.
CONCLUSIONS: Integrating geospatial modeling with economic forecasting offers a novel approach to assessing preventive health infrastructure. The findings indicate that HDOs not only enhance health equity but also provide a societal and long-term financial benefit, offering to inform policy decisions and optimize national resource allocation toward maximum societal value.
METHODS: We combined geospatial modeling with an economic evaluation framework. Accessibility was quantified using population density through the elderly proportion. Geographic Information System (GIS) based methods were applied to assess spatial inequities and highlighted the importance of service coverage. The total annual cost of the national HDO program was estimated at 2.7 billion HUF (about 8.2 million USD). A budget impact analysis was conducted from the macroeconomic perspective with a 3-year time horizon, extrapolated to 10 years. Expected relative risk reductions (1-3%) for type 2 diabetes, cardiovascular disease, and mental health service use were derived from evidence-based prevention outcomes. A probabilistic sensitivity analysis using Monte Carlo simulation explored uncertainty related to adherence and cost parameters.
RESULTS: Our geospatial analysis confirms regional disparities, with rural and economically deprived populations relatively better covered in service allocation. The estimated annual program cost provides a transparent baseline for economic evaluation. Predicted reductions in chronic disease incidence could generate measurable savings for the Hungarian National Health Insurance Fund (NEAK). The program costs support sustained investment in preventive healthcare.
CONCLUSIONS: Integrating geospatial modeling with economic forecasting offers a novel approach to assessing preventive health infrastructure. The findings indicate that HDOs not only enhance health equity but also provide a societal and long-term financial benefit, offering to inform policy decisions and optimize national resource allocation toward maximum societal value.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE328
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Geriatrics, STA: Nutrition