[The role of medical schools in progressive health care].
OBJECTIVE
To analyse the predicted and observed role of medical schools in the progressive health care.


METHODS
The data derives from the financial database of the National Health Insurance Fund (NHIF) and covering the period 1998-2001. In this study the authors calculated the market share of the medical schools within the financing of the NHIF in the field of out- and in-patient care, renal dialysis, CT/MRI examinations, task financed services under special rules and fee for progressive (tertier level) care. The authors performed a detailed analysis concerning the Diagnosis Related Groups (DRG) of active inpatient care, where the market share of medical schools was calculated within the TOP-15 DRGs with highest and lowest point value, and within the TOP-15 most common and most infrequent DRGs.


RESULTS
The market share of medical schools increased from 13.7% (1998) to 15.0% (2001). The increase was significant in the active and chronic in-patient care and in renal dialysis. The market share of medical schools from progressive fee decreased from 32.3% (1998) to 26.5% (2001). Within the active in-patient care the medical schools provide health care for 37.7% of the most difficult cases with highest DRG value and for 30.1% of the patients with rare diseases. The market share of the medical schools is much lower in cases with lowest DRG value (10.2%) and in most common cases (9.8%).


CONCLUSIONS
The medical schools fulfilled their expected role in the progressive (tertier) care, answering the public and professional expectations.
Boncz
Imre
I
Országos Egészségbiztosítási Pénztár, Szakmapolitikai és Koordináló Fóosztály, Budapest. boncz.i@oep.hu
Sebestyén
Andor
A
D000046:Academic Medical Centers / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D003953:Diagnosis-Related Groups / Q000145:classification; D019981:Health Care Sector / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D006814:Hungary; D012577:Schools, Medical / Q000191:economics* / Q000639:trends; D014600:Utilization Review / Q000706:statistics & numerical data*