TEMPORAL DYNAMICS, PANDEMIC DISRUPTION AND FORECASTING OF DAY SURGERY CASES IN HUNGARY FOR 2030
Author(s)
Róbert Pónusz, MSc, PhD1, Dalma Pónusz-Kovács, MSc2, Csaba Könczei, MSc2, Kristóf Mangel, MSc3, Attila Vas Tifán, MD, MSc2, Dora Endrei, MD, MSc, PhD, Habil1, Imre Boncz, MD, MSc, PhD, Habil1.
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 key efficiency lever in publicly funded healthcare. We characterized the temporal dynamics of day surgery volume in Hungary, quantified the COVID-19 disruption against a counterfactual, and produced an objective forecast to 2030 to support capacity planning.
METHODS: We used the dataset of the National Directorate General for Hospitals of Hungary, covering every day-surgery-eligible case and DRG cost-weight for the complete years between 2014-2024. The annual growth rate was estimated with a log-linear Poisson trend model. Pandemic impact was assessed via an interrupted time-series counterfactual, projecting the 2014-2019 trend forward with 95% prediction bands. Volume to 2030 was forecast with a log-linear OLS model fitted to 2014-2024, excluding the 2020-2021 COVID outlier years, reported with 95% prediction intervals. The observed 2025 value served as external validation.
RESULTS: Day surgery volume rose from 226,467 (2014) to 337,452 cases (2024). The pre-pandemic trend was +9.0% per year (R²=0.98). COVID-19 caused a sharp deviation: observed 2020 volume was 36.5% below the counterfactual (245,396 vs 386,607 expected; p<0.001), and 2021 fell 50.7% short (207,881 vs 421,424; p<0.001). The shortfall persisted through 2024 (−38.2%; p<0.001), indicating no full recovery to the pre-pandemic trajectory. The national Poisson growth rate was +1.70%/year (IRR=1.017; 95% CI 1.0166-1.0173; p<0.001), led by university clinics (+6.70%/year). The post-COVID log-linear trend (+2.62%/year; R²=0.44) projects 345,671 cases in 2025 (95% PI 263,681-453,155) and 393,426 by 2030 (95% PI 280,318-552,174), a 16.6% increase versus 2024. The observed 2025 volume (357,229) fell within the prediction band, confirming forecast validity.
CONCLUSIONS: Hungarian day surgery growth was robust pre-pandemic but structurally interrupted by COVID-19, with a persistent shortfall against the counterfactual through 2024. A validated log-linear forecast indicates continued but slower expansion to nearly 400,000 cases by 2030. These objective projections provide a quantitative basis for capacity planning and identify a recoverable gap left by the pandemic.
METHODS: We used the dataset of the National Directorate General for Hospitals of Hungary, covering every day-surgery-eligible case and DRG cost-weight for the complete years between 2014-2024. The annual growth rate was estimated with a log-linear Poisson trend model. Pandemic impact was assessed via an interrupted time-series counterfactual, projecting the 2014-2019 trend forward with 95% prediction bands. Volume to 2030 was forecast with a log-linear OLS model fitted to 2014-2024, excluding the 2020-2021 COVID outlier years, reported with 95% prediction intervals. The observed 2025 value served as external validation.
RESULTS: Day surgery volume rose from 226,467 (2014) to 337,452 cases (2024). The pre-pandemic trend was +9.0% per year (R²=0.98). COVID-19 caused a sharp deviation: observed 2020 volume was 36.5% below the counterfactual (245,396 vs 386,607 expected; p<0.001), and 2021 fell 50.7% short (207,881 vs 421,424; p<0.001). The shortfall persisted through 2024 (−38.2%; p<0.001), indicating no full recovery to the pre-pandemic trajectory. The national Poisson growth rate was +1.70%/year (IRR=1.017; 95% CI 1.0166-1.0173; p<0.001), led by university clinics (+6.70%/year). The post-COVID log-linear trend (+2.62%/year; R²=0.44) projects 345,671 cases in 2025 (95% PI 263,681-453,155) and 393,426 by 2030 (95% PI 280,318-552,174), a 16.6% increase versus 2024. The observed 2025 volume (357,229) fell within the prediction band, confirming forecast validity.
CONCLUSIONS: Hungarian day surgery growth was robust pre-pandemic but structurally interrupted by COVID-19, with a persistent shortfall against the counterfactual through 2024. A validated log-linear forecast indicates continued but slower expansion to nearly 400,000 cases by 2030. These objective projections provide a quantitative basis for capacity planning and identify a recoverable gap left by the pandemic.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH265
Topic
Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas