NATIONAL DIFFUSION OF DAY SURGERY IN HUNGARY: REAL-WORLD TRENDS IN INPATIENT VS DAY-CASE BY DRG ACTIVITY 2014-2025
Author(s)
Róbert Pónusz, MSc, PhD1, Dalma Pónusz-Kovács, MSc2, Csaba Könczei, MSc2, Kristóf Mangel, MSc3, Attila Vas Tifán, MD, MSc2, Bettina Kovács, BSc, MSc2, Imre Boncz, MSc, PhD, MD1;
1University of Pécs, Faculty of Health Sciences, Institute for Health Insurance, Pécs, Hungary, 2University of Pécs, Doctoral School of Health Sciences, Pécs, Hungary, 3National Directorate General for Hospitals, Legal department, Budapest, Hungary
1University of Pécs, Faculty of Health Sciences, Institute for Health Insurance, Pécs, Hungary, 2University of Pécs, Doctoral School of Health Sciences, Pécs, Hungary, 3National Directorate General for Hospitals, Legal department, Budapest, Hungary
OBJECTIVES: One-day surgery becomes an ever-reliable alternative of the expensive inpatient care in many developed countries worldwide. The aim of the study is to quantify the national diffusion of day-surgery in the publicly funded Hungarian healthcare system and the associated shift from inpatient to day-case care.
METHODS: The study database was derived from the National Directorate General for Hospitals and contained all the cases and DRG cost-weights which were eligible to be treated in one-day surgical form. The study database covered the period of 2014-2025. The data from each year was completed despite the year of 2025 (it was available until October month). Outcomes were annual cases, DRG cost-weights, day-surgery shares, and mean cost-weight per case; trend in day-surgery odds over 2014-2024 was estimated with a binomial logit model.
RESULTS: Across 2014-2025, 6,838,487 cases generated 6,760,373.85 DRG cost-weights. Day surgery accounted for 3,424,140 cases (50.07%) and 2,251,426 DRG cost-weights (+33.30%). Day-surgery turnover increased from 226,734 cases in 2014 to 338,289 in 2024 (+49.2%), while inpatient cases dropped from 382,762 to 250,353 (-34.6%). The day-surgery case share increased from 37.20% (2014) to 57.47% (2024) (+20.27 percentage points) and the DRG cost-weight share from 24.08% to 39.53% (+15.45 points). Odds of day surgery increased by 7.39% per year during the entire study period (OR=1.074; p<0.001). The university clinics (767,344 cases) and the county hospitals (1,089,899 cases) covered the 54% of the domestic, public-funded one-day surgical cases. The same ratio with DRG cost-weights was 55% (1,248,308 DRG cost-weights).
CONCLUSIONS: Day surgery diffusion in Hungary was substantial and sustained, with clear substitution from inpatient care to day-surgery in cases which are feasible to be treated in one-day surgical form. Due to the current DRG-based funding technique makes the most complex type of hospitals interested to deliver high number of one-day surgical cases.
METHODS: The study database was derived from the National Directorate General for Hospitals and contained all the cases and DRG cost-weights which were eligible to be treated in one-day surgical form. The study database covered the period of 2014-2025. The data from each year was completed despite the year of 2025 (it was available until October month). Outcomes were annual cases, DRG cost-weights, day-surgery shares, and mean cost-weight per case; trend in day-surgery odds over 2014-2024 was estimated with a binomial logit model.
RESULTS: Across 2014-2025, 6,838,487 cases generated 6,760,373.85 DRG cost-weights. Day surgery accounted for 3,424,140 cases (50.07%) and 2,251,426 DRG cost-weights (+33.30%). Day-surgery turnover increased from 226,734 cases in 2014 to 338,289 in 2024 (+49.2%), while inpatient cases dropped from 382,762 to 250,353 (-34.6%). The day-surgery case share increased from 37.20% (2014) to 57.47% (2024) (+20.27 percentage points) and the DRG cost-weight share from 24.08% to 39.53% (+15.45 points). Odds of day surgery increased by 7.39% per year during the entire study period (OR=1.074; p<0.001). The university clinics (767,344 cases) and the county hospitals (1,089,899 cases) covered the 54% of the domestic, public-funded one-day surgical cases. The same ratio with DRG cost-weights was 55% (1,248,308 DRG cost-weights).
CONCLUSIONS: Day surgery diffusion in Hungary was substantial and sustained, with clear substitution from inpatient care to day-surgery in cases which are feasible to be treated in one-day surgical form. Due to the current DRG-based funding technique makes the most complex type of hospitals interested to deliver high number of one-day surgical cases.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HPR149
Topic
Health Policy & Regulatory
Topic Subcategory
Insurance Systems & National Health Care, Public Spending & National Health Expenditures, Reimbursement & Access Policy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas