BENCHMARKING DAY SURGERY POTENTIAL IN HUNGARY USING THE BEDS METHODOLOGY: THEORETICAL RESERVES IN CASE VOLUMES AND HOSPITALIZATION DAYS, 2015-2025
Author(s)
Róbert Pónusz, MSc, PhD1, Dalma Pónusz-Kovács, MSc2, Csaba Könczei, MSc2, Kristóf Mangel, MSc3, Attila Vas Tifán, MD, MSc2, Dora Endrei, MSc, PhD, MD1, Imre Boncz, MSc, PhD, MD1.
1Institute for Health Insurance, University of Pécs, Faculty of Health Sciences, Pécs, Hungary, 2Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary, 3Legal department, National Directorate General for Hospitals, Budapest, Hungary.
1Institute for Health Insurance, University of Pécs, Faculty of Health Sciences, Pécs, Hungary, 2Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary, 3Legal department, National Directorate General for Hospitals, Budapest, Hungary.
OBJECTIVES: Day surgery is a cost-effective alternative to inpatient care, yet many countries underutilize its potential. The Basket of European Day Surgery (BEDS) benchmarks, developed by the International Association of Ambulatory surgery (BADS), define evidence-based target rates for specific procedures. This study applies the BEDS methodology to Hungarian national claims data to quantify theoretical reserves in day surgery volumes and estimate nursing days that could be freed.
METHODS: A retrospective analysis used the complete national DRG database from the National Directorate General for Hospitals, covering all publicly funded surgical episodes between 2015 and 2025 (n=7,376,789) in Hungary. Fifteen high-volume procedures were benchmarked against BEDS target day surgery rates. For each procedure, the gap between actual and target rates was calculated, and the additional day surgery potential and nursing day savings were estimated using procedure-specific mean inpatient lengths of stay.
RESULTS: The national day surgery share rose from 38.0% (2015) to 54.1% (2025). However, substantial BEDS gaps persist: laparoscopic cholecystectomy reached only 24.5% versus a 70% BEDS target (gap: 45.5 pp); adenoidectomy 32.7% versus 85% (gap: 52.3 pp); tonsillectomy 16.7% versus 50% (gap: 33.3 pp). Applying BEDS benchmarks to the 15 key procedures in 2025, an estimated 25,443 additional cases could have been performed as day surgery, conservatively freeing 52,943 inpatient nursing days. The five largest contributors to nursing day savings were laparoscopic cholecystectomy (21,271 days), adenoidectomy (6,711), inguinal hernia repair (5,715), metal removal (5,670), and tonsillectomy (3,371).
CONCLUSIONS: Despite sustained growth, Hungarian day surgery rates remain below BEDS benchmarks for several high-volume procedures. Conservative estimation reveals over 52,000 nursing days of theoretical capacity that could be redirected to reduce waiting lists or expand elective services. Aligning DRG incentives and clinical pathways with international benchmarks represents a tangible opportunity for efficiency gains in Hungarian public healthcare.
METHODS: A retrospective analysis used the complete national DRG database from the National Directorate General for Hospitals, covering all publicly funded surgical episodes between 2015 and 2025 (n=7,376,789) in Hungary. Fifteen high-volume procedures were benchmarked against BEDS target day surgery rates. For each procedure, the gap between actual and target rates was calculated, and the additional day surgery potential and nursing day savings were estimated using procedure-specific mean inpatient lengths of stay.
RESULTS: The national day surgery share rose from 38.0% (2015) to 54.1% (2025). However, substantial BEDS gaps persist: laparoscopic cholecystectomy reached only 24.5% versus a 70% BEDS target (gap: 45.5 pp); adenoidectomy 32.7% versus 85% (gap: 52.3 pp); tonsillectomy 16.7% versus 50% (gap: 33.3 pp). Applying BEDS benchmarks to the 15 key procedures in 2025, an estimated 25,443 additional cases could have been performed as day surgery, conservatively freeing 52,943 inpatient nursing days. The five largest contributors to nursing day savings were laparoscopic cholecystectomy (21,271 days), adenoidectomy (6,711), inguinal hernia repair (5,715), metal removal (5,670), and tonsillectomy (3,371).
CONCLUSIONS: Despite sustained growth, Hungarian day surgery rates remain below BEDS benchmarks for several high-volume procedures. Conservative estimation reveals over 52,000 nursing days of theoretical capacity that could be redirected to reduce waiting lists or expand elective services. Aligning DRG incentives and clinical pathways with international benchmarks represents a tangible opportunity for efficiency gains in Hungarian public healthcare.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH210
Topic
Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas