Fund Administration Research Articles

Pricing schemes and market efficiency in private retirement systems

AbstractWe study the effects of different pricing schemes on the overall surplus in a privately managed retirement system with multiple service providers and switching costs. We develop a theoretical model based on the Chilean retirement system and consider a repeated auction for monopoly rights over new enrollees. We consider a dynamic model solved by pension fund administrators and by consumers. We compare three different pricing schemes: (a) fees on contributions, (b) fees on returns, and (c) a two‐part tariff including an auction over a guaranteed rate of return and allowing the firm to keep a portion of returns generated above this guaranteed rate. We also consider heterogeneity across individuals where agents earn high or low wages and high‐wage customers have proportionally lower switching costs due to more cost‐effective access to financial planning services. We find that auction participants subsidize consumers. We also treat savings as a durable good. In this case, pricing over returns worsens the switching related inefficiencies just described relative to pricing over contributions, despite the better incentives it provides. These inefficiencies can be resolved by allowing firms to price discriminate.

Mecanismo de pago de prestaciones ambulatoria s de cáncer de cérvix y mama. INEN - FISSAL 2014 - 2016.

Objetivo. Evaluar el mecanismo de pago de la atención ambulatoria depacientes diagnosticadas con cáncer de cérvix y cáncer de mama en elInstituto Nacional de Enfermedades Neoplásicas - INEN, en el marco delconvenio INEN–SIS–FISSAL 2014-2016. Método. Se trata de un estudioobservacional, descriptivo y transversal. La población estuvo compuesta porpacientes con diagnóstico de cáncer de cérvix y cáncer de mama, afliadas alSeguro Integral de Salud (SIS) en el Perú que recibieron atenciones de formaambulatoria en el Instituto Nacional de Enfermedades Neoplásicas (INEN),durante el periodo 2014 – 2016. Se recabó la información de la Ofcina deSeguros e Informática, en cuanto al convenio suscrito entre INEN-SIS-FISSAL.Resultados. No existe relación temporal entre la prestación dada por elINEN y el desembolso fnanciero de parte de la Institución Administradorade Fondos de Aseguramiento en salud del Ejercito del Perú (IAFAS). Existeun incremento anual en cuanto a atenciones y atendidos en cáncer de cérvixy cáncer de mama. Por tipo de cáncer: el cáncer de mama presentó unaconcentración de consulta máxima de 8.74 en el 2014 y una concentración deconsulta mínima de 8.46. En el caso de cáncer de cérvix tuvo un máximo de6.72 (2015) y un mínimo de 6.34 (2016). Consultorio externo fue la atenciónambulatoria que ocupó el primer lugar en comparación con los otros dostipos de prestaciones revisadas como son Emergencia sin observación yEmergencia con observación para ambas patologías. Existe además unmayor número de atendidos en los estadios II y III para ambas patologías. Laconcentración de consultas para ambas patologías en el INEN es elevada, conresultados entre 6 y 8, por lo que superan el valor considerado para institutos(4-5 en promedio). Conclusiones. El mecanismo de pago usado por el FondoIntangible Solidario de Salud (FISSAL) es de pago retrospectivo por paquete.La atención ambulatoria reúne criterios para que su retribución económicasea a través del mecanismo de pago tipo cápita ajustado.

PENSION INVESTMENT FUNDS ANALYSIS: A VARIANCE-COMPARISON TESTS OF NON-CONTRIBUTORY (PRE) AND CONTRIBUTORY (POST) SCHEMES IN NIGERIA

In Nigeria, pension was established in 2004 through the Pension Reform Act, 2004 and since then, pension schemes have manifested in twofold: ‘old’ and ‘new’. The Pension Act No. 102 of 1979 is the “old pension” (non-contributory) and Pension Reform Act of 2004 (including the restructured/modified Pension Act, 2014) is the “new pension” (contributory) scheme. In this paper, we comparatively evaluated both the non-contributory (pre) and contributory (post) pension schemes in Nigeria. In order to do this, secondary data of pension investment funds was obtained during the period 1994-2014. Based on the analysis of data, we found that the contributory (post) scheme is healthy, reliable and poised towards helping retirees survive as soon as they retire from service. Thus, the contributory (post) scheme significantly improved as a result of the reform in Nigeria, especially in the area of pension investment funds. On the basis of the findings, it was recommended among others that there should be an unrestricted retirement savings scheme and non-remittance of pension contributions by employers to PENCOM. Also, a better return on investment and service delivery from pension fund administrators should be enhanced so as to enhance pension investments and voluntary contributions. Besides this, the internal procedures should be improved upon so that contributions and returns on pension investments due to retirees can be efficiently and swiftly made from pension fund administrators to pensioners on retirement.

The context and state of open source software adoption in US academic libraries

Purpose The purpose of this paper is to identify barriers and drivers to open source software (OSS) adoption, and measures awareness and adoption stages of OSS in US academic libraries. Design/methodology/approach An online survey of chief information officers, chief technology officers or heads for IT in US academic libraries was conducted. A total number of 179 responses were used for data analysis. Findings From the survey, the authors identify significant barriers and drivers that US academic libraries may consider before adopting OSS and found that awareness itself is not a barrier. While about half of respondents confirmed using OSS, the authors found surprisingly low levels of intent to adopt from current non-adopters. Practical implications This research offers insights for promoting OSS adoption. Also, it provides funding agencies and administrators with guidelines to encourage successful deployment of OSS in higher education. Originality/value While extant research is mostly anecdotal, this research draws from an online survey to snap-shot the current state of OSS adoption in US academic libraries and provides a baseline for practice and research.

Variation in the structure and administration of student-managed investment funds

PurposeThe purpose of this paper is to understand the differences present in student-managed investment funds (SMIF).Design/methodology/approachThe paper uses primary data collected by survey and interviews.FindingsThe findings of this paper suggest that research efforts need to be focused on the topical area and transparency in the field needs to be improved.Research limitations/implicationsPast research is validated and future research is needed.Practical implicationsThe need to develop and disseminate best practices in the management of SMIF’s.Social implicationsStudent-managed funds are widespread and growing but operate as independent entities.Originality/valueThe paper is original and based on primary research.

PSU25 THE CHANGE OF CASE MIX INDEX IN THE PUBLICLY FINANCED HUNGARIAN ONE-DAY SURGERY CARE

In the past decade, the progression of one-day surgery was significant in Hungary, because there were few important initiations in the Hungarian health policy which were able to facilitate the spreading of one-day surgery from the beginning of 2010s’. The aim of the study is to evaluate the changes of Case Mix Index (CMI) within the Diagnosis Related Groups (DRG) system in publicly financed Hungarian one-day surgery care between 2008-2018. Data were provided from the financial database of the National Health Insurance Fund Administration of Hungary. The database of the research consisted all publicly financed one-day surgery case and DRG cost weight numbers related to the type, name and financing code of health care institutes between 2008-2018. During the examined period, 2,322,879 public financed one-day surgery cases, and 1,241,708 DRG cost weight numbers were reimbursed by the National Health Insurance Fund Administration of Hungary. The number of cases increased 275%, meanwhile the DRG cost weight numbers increased 370% between 2008-2018. Nationally, the mean CMI was 0.52307 (SD=0.4428- 0.6032) between 2008-2018. It was the highest in 2018 (CMI=0.5989) and the lowest in 2008. (CMI=0.4409). The changes of CMI from the viewpoint of the type of health care institutes were rather different. The CMI of universities (0.6388), county hospitals (0.5232), national institutes (0.5977), and specialized hospitals (0.5989) were above the national average (0.5346). According to our results, the type of health care institute influenced the value of CMI (p=0.001). The changes of CMI among universities were rather different. We could verify that the constant increase in the utilization of one-day surgery did not affect the increase in CMI on the national level, but the type of the health care institute influenced the value of CMI.

PMS25 NATIONWIDE ANNUAL HEALTH INSURANCE TREATMENT COST OF INJURIES TO THE KNEE AND LOWER LEG IN HUNGARY: COST OF ILLNESS STUDY BASED ON REAL WORLD DATA

Sport and related injuries are a major cause of morbidity in developing and in industrialized regions. The aim of our study was to calculate the annual health insurance treatment cost of injuries to the knee and lower leg in Hungary. The data were derived from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), the only health care financing agency in Hungary. We analyzed the number of patients and the health insurance treatment cost for the year 2018. The following cost categories were included into the study: out-patient care, laboratory diagnostics, medical imaging, acute in-patient care, chronic in-patient care and drugs. Patients with injuries to the knee and lower leg were identified with the following codes of the International Classification of Diseases 10threvision: S80-S89. The number of patients admitted to inpatient care was 29,652 (52.1% men and 47.9% women) with a mean age of 48.92 years (men: 43.23 years; women: 55.12 years). Number of patients underwent out-patient hospital care was 419,364 (50.2% men and 49.8 % women and) with a mean age of 44.80 years (men: 40.03 years; women: 49.62 years). For the treatment of patients with injuries to the knee and lower leg in 2018 the Hungarian National Health Insurance Fund Administration spent 22.083 billion Hungarian Forint (HUF) which equals 69.255 million Euros (EUR) or 81.715 million American Dollars (USD). Major cost drivers were acute inpatient care (86.5% of total health insurance costs), outpatient care (8.1%) and chronic inpatient care (2.5%). Injuries to the knee and lower leg represent a significant burden for the Hungarian health insurance system. The disease is equally common in women and men. There is a significant difference (9-11 years) in the onset of the disease between women and men.

PMS34 NATIONWIDE ANNUAL HEALTH INSURANCE TREATMENT COST OF INJURIES TO THE WRIST AND HAND IN HUNGARY: COST OF ILLNESS STUDY BASED ON REAL WORLD DATA

Sport related accidents and injuries are a major cause of morbidity in developing and in industrialized countries. The aim of our study was to calculate the annual health insurance treatment cost of injuries to the wrist and hand in Hungary. The data were derived from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), the only health care financing agency in Hungary. We analyzed the number of patients and the health insurance treatment cost for the year 2018. The following cost categories were included into the study: out-patient care, laboratory diagnostics, medical imaging, acute in-patient care, chronic in-patient care and drugs. Patients with injuries to the wrist and hand were identified with the following codes of the International Classification of Diseases 10threvision: S60-S69. The number of patients admitted to inpatient care was 12,439 (68.6 % men and 31.4 % women) with a mean age of 44.24 years (men: 41.0 years; women: 51.29 years). Number of patients underwent out-patient hospital care was 522,736 (58.3 % men and 41.7 % women and) with a mean age of 36.73 years (men: 34.61 years; women: 39.68 years). For the treatment of patients with injuries to the wrist and hand in 2018 the Hungarian National Health Insurance Fund Administration spent 7.058 billion Hungarian Forint (HUF) which equals 22.135 million Euros (EUR) or 26.117 million American Dollars (USD). Major cost drivers were acute inpatient care (64.9 % of total health insurance costs), outpatient care (28.2 %)and medical imaging (5.7 %). Injuries to the wrist and hand represent a significant burden for the Hungarian health insurance system. The disease is equally common in men compared to women. There is a significant difference (5-10 years) in the onset of the disease between women and men.

PSU27 ANALYSIS OF THE UTILIZATION OF ONE-DAY SURGERY AMONG CASES RELATED TO THE DISEASES OF THE MUSCULOSKELETAL SYSTEM OR CONNECTIVE TISSUE

In Hungary, most of the theoretically performable one-day surgery interventions are linked to musculoskeletal diseases. Because of the constantly increasing life expectancy at birth, the incidence of degenerative diseases related to the musculoskeletal system are increasing. The aim of the study was to analyze the change of the role of one-day surgery in musculoskeletal diseases. The database of the research was ensured by the National Health Insurance Fund Administration of Hungary, and it contained both inpatient, and one-day surgery cases related to the diseases of musculoskeletal system and connective tissue (M00–M99) according to the WHO ICD-10 between 2010-2018. The database also consisted data related to the codes of DRG, the types of health care institutes, as well as information about related medical fields. During the analyzed period the total case number related to musculoskeletal diseases were 1,239,355. The market share of inpatient treatment was significant (88.2%), while the market share of one-day surgery was marginal (11.8%). Between 2010-2018, the number of inpatient case numbers increased only 103.5% in comparison with the one-day surgery case numbers, which increased significantly (294.5%). During the analyzed period the quantity of theoretically performable one-day surgery interventions related to musculoskeletal diseases were increased (2010: 52 interventions, 2018: 130 interventions) according to the 9th appendix of the 9/1993. (IV.2.) Decree adopted by the Minister of Public Welfare. The most common diagnosis was the damage of meniscus because of previous injury (35,013 cases) (WHO ICD – M2320) with the market share of 23,9% from the total one-day surgery case numbers. One-day surgery interventions related to the musculoskeletal diseases have been increasing, but most of the cases were treated in inpatient form. Based on recent experiences related the constantly increasing utilization of one-day surgery in Hungary, its market share could increase in the following years related to musculoskeletal diseases.

PCV66 NATIONWIDE ANNUAL HEALTH INSURANCE TREATMENT COST OF ARTERIAL EMBOLISM AND THROMBOSIS IN HUNGARY: COST OF ILLNESS STUDY BASED ON REAL WORLD DATA

Arterial embolism and thrombosis is a major cause of morbidity and mortality in developing and in industrialized regions. The aim of our study was to calculate the annual health insurance treatment cost of arterial embolism and thrombosis in Hungary. The data were derived from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), the only health care financing agency in Hungary. We analyzed the number of patients and the health insurance treatment cost for the year 2018. The following cost categories were included into the study: out-patient care, laboratory diagnostics, medical imaging, acute in-patient care, chronic in-patient care and drugs. Patients with arterial embolism and thrombosis were identified with the following codes of the International Classification of Diseases 10threvision: I-74. The number of patients admitted to inpatient care was 9,517 (58.8% men and 41.2% women) with a mean age of 68.37 years (men: 66.73 years; women: 70.70 years). Number of patients underwent out-patient hospital care was 33,230 (59.6 % men and 40.4% women) with a mean age of 67.55 years (men: 66.53 years; women: 69.06 years). For the treatment of patients with arterial embolism and thrombosisin 2018 the Hungarian National Health Insurance Fund Administration spent 9.267 billion Hungarian Forint (HUF) which equals 29.062 million Euros (EUR) or 34.291 million American Dollars (USD). Major cost drivers were acute inpatient care (80.9% of total health insurance costs), medical imaging (11.7%) and pharmaceuticals (3.0%). Arterial embolism and thrombosisrepresent a significant burden for the Hungarian health insurance system. The disease is slightly more common in men compared to women. There is no significant difference (2-3 years) in the onset of the disease between women and men.

PCN110 NATIONWIDE ANNUAL HEALTH INSURANCE TREATMENT COST OF MALIGNANT MELANOMA OF SKIN IN HUNGARY: COST OF ILLNESS PILOT STUDY BASED ON REAL WORLD DATA

Malignant melanoma of skin is major cause of morbidity and mortality in developing and in industrialized regions. The aim of our study was to calculate the annual health insurance treatment cost of malignant melanoma of skin in Hungary. The data were derived from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), the only health care financing agency in Hungary. We analyzed the number of patients and the health insurance treatment cost for the year 2018. The following cost categories were included into the study: out-patient care, laboratory diagnostics, medical imaging, acute in-patient care, chronic in-patient care and drugs. Patients with malignant melanoma of skinwere identified with the following codes of the International Classification of Diseases 10threvision: C43. The number of patients admitted to inpatient care was 3,394 (52.0% men and 48.0% women) with a mean age of 63.38 years (men: 64.16 years; women: 62.53 years). Number of patients underwent out-patient hospital care was 25,135 (45.3% men and 54.7% women and) with a mean age of 61.46 years (men: 63.22 years; women: 60.01 years). For the treatment of patients with malignant melanoma of skinin 2018 the Hungarian National Health Insurance Fund Administration spent 2.692 billion Hungarian Forint (HUF) which equals 8.444 million Euros (EUR) or 9.963 million American Dollars (USD). Major cost drivers were acute inpatient care (69.9% of total health insurance costs)out-patient care (12.7%) and pharmaceuticals (12.3%). Malignant melanoma of skinrepresents a significant burden for the Hungarian health insurance system. The disease is equally common in women and men. There is not a significant difference (1-3 years) in the onset of the disease between women and men.

PMS27 NATIONWIDE ANNUAL HEALTH INSURANCE TREATMENT COST OF INJURIES TO THE HIP AND THIGH IN HUNGARY: COST OF ILLNESS STUDY BASED ON REAL WORLD DATA

Sport and related injuries are a major cause of morbidity in developing and in industrialized regions. The aim of our study was to calculate the annual health insurance treatment cost of injuries to the hip and thigh in Hungary. The data were derived from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), the only health care financing agency in Hungary. We analyzed the number of patients and the health insurance treatment cost for the year 2018. The following cost categories were included into the study: out-patient care, laboratory diagnostics, medical imaging, acute in-patient care, chronic in-patient care and drugs. Patients with injuries to the hip and thigh were identified with the following codes of the International Classification of Diseases 10threvision: S70-S79. The number of patients admitted to inpatient care was 32,706 (32.0% men and 68.0 % women) with a mean age of 73.85 years (men: 65.66 years; women: 77.71 years). Number of patients underwent out-patient hospital care was 175,083 (37.2 % men and 62.8 % women and) with a mean age of 67.29 years (men: 57.75 years; women: 72.95 years). For the treatment of patients with injuries to the hip and thigh in 2018 the Hungarian National Health Insurance Fund Administration spent 48.576 billion Hungarian Forint (HUF) which equals 152.339 million Euros (EUR) or 178.746 million American Dollars (USD). Major cost drivers were acute inpatient care (92.3 % of total health insurance costs), chronic inpatient care (5.1 %) and outpatient care (1.6 %). Injuries to the hip and thigh represent a significant burden for the Hungarian health insurance system. The disease is more common in women compared to men. There is a significant difference (12-15 years) in the onset of the disease between women and men.

Transparency in the governance of landscape restoration finance: A case study of Ghana's Forest Plantation Development Fund

Abstract Many global and national initiatives have evolved in recent year to finance plantation forestry as a means to restore degraded landscapes. However, little information is available in the academic literature on how these funds are governed to optimise their reach and application. Using Ghana's Forest Plantation Development Fund as a case study, this study bridges this knowledge gap and provides insights into how without insistence on transparency, accountability can be lacking on the way such funds are utilised. Data was collected from 103 plantation developers in five forest districts using semi-structured questionnaires and key informant interviews with other stakeholders, including administrators of the Fund. The study found that there were no mechanisms in place to address stakeholders' information needs about the Fund. This translated into low awareness and limited access to the fund by its intended beneficiaries as well as weak participation of stakeholders in the governance of the Fund, including stakeholders' capacity to demand accountability. Fund administrators were unwilling to disclose information to stakeholders which is reinforced by a lack of incentives to do so. The study recommends the implementation of a right to information legislation and an active press to demand accountability and ensure transparent use of the fund. The findings further highlight an opportunity for global discourse calling for landscape restoration investments in sub-Saharan Africa to be accompanied with governance reforms to address barriers that militate against the efficient use of climate mitigation investments.

Structural Changes in the Hungarian Healthcare System Between 2000 and 2017

BackgroundThe rigid and old-fashioned structure of the Hungarian healthcare system has been discussed since the mid-1990s and is at the center of professional and policy debates. It is characterized by the too high number of acute care hospital beds in international comparison; access is regionally unequal; levels of progressive care are mixed; and there is a nonuniform emergency service system with unequal access to the emergency room, heterogeneous quality of care, and unexploited opportunities of modern health technology (eg, 1-day surgery, minimally invasive procedures, telemedicine). ObjectivesThe aim of this study is to analyze the indicators of ongoing structural changes of the Hungarian healthcare system between 2000 and 2017. MethodsData are derived from the Organisation for Economic Co-operation and Development Heath Statistics, Hungarian National Statistical Office, National Health Insurance Fund Administration and the database of the European Structural Funds. The methods used for the analysis are descriptive statistics, trend analysis, and longitudinal data. ResultsThe total number of hospitals beds showed a 32% reduction between 2005 and 2017. Parallel with this subsequent reduction of hospital bed capacities, we can see a moderate reduction (22.3%) in the number of discharged patients from hospitals: from 2005 to 2017, 2.55 million to 1.95 million. The average length of stay in acute hospital care has decreased from 6.3 to 5.1 days. About 25 to 27 small local hospitals lost their acute or short-term care profile (mainly intensive care units, internal medicine, surgery, and pediatric care wards) and became long-term care, chronic care, or rehabilitation profile hospitals. ConclusionStructural change is in progress in the Hungarian healthcare system, and some efficiency gains have been reached. Nevertheless, still there are significant potential efficiency gains in the better organization and management of health services in addition to the dissemination and better incorporation of modern healthcare technologies.

STAFF PARTICIPATION IN FINANCIAL ADMINISTRATION IN COLLEGES OF EDUCATION

Financial Administration has become a vital and a crucial function in modern organizations and educational institutions. This is because financial resources are scarce in relation to the demand for them. As a result, it is imperative to have a very sound administration of public funds allocated to educational institutions. The study sought to investigate “Staff Participation in Financial Administration of Colleges of Education in Ashanti Region, Ghana.” The study was conducted in three Colleges with a sample size of One Hundred and Twenty (120) respondents, selected by using simple randomization and purposive sampling procedures. The main instrument used in the collection of data for the study was questionnaire but at certain instances, an interview guide was employed. The researcher made use of descriptive analysis approach to discuss the data in order to make conclusions. The study unveiled a closed nature of financial administration of the Colleges. As against this discovery, most of the respondents overwhelmingly emphasized that staff participation in financial administration has great significance on the Colleges’ development and as a result, were in favour of the practice of open college financial administration. It is therefore recommended that financial administration of the Colleges be made open to involve staff members. Staff members need to have access to financial information to inform their decisions, and also to motivate them for high performance to improve the Colleges. Article visualizations:

ORGANIZATION OF INTERNAL CONTROL BY BUDGET ORGANIZATIONS (INSTITUTIONS) AS A BUDGETARY FUNDS MANAGER

This article is devoted to the study of the organization and formation of the system of internal control by budget organizations (institutions), the definition and substantiation of the components and procedures of internal control, as well as the development of a mechanism for the practical implementation of this system in a budget institution (organization). The construction of an internal control system of a budgetary institution is based on the components: control environment (construction of the structure of the internal control system and its subordination, responsibilities and powers of internal controllers, requirements to their competence, their independence with respect to utsanov), risk management (identification and assessment of the probability and risk impact on the institution’s activities, costs, the risk response, in comparison with the resulting benefit from its reduction), control measures (which procedures and measures are implemented by the institution in order to ensure the effectiveness of internal control), information and communication, monitoring (reporting of internal control units and checking the results of its work by the supreme body). The organizational principles for the construction of internal control, the principles on which internal control is to be based, as well as the essence of the five elements of internal control, in accordance with which internal control is to be carried out by the administrators of budget funds, is regulated in the Methodological Recommendations on the organization of internal control by budgetary funds managers. in their institutions and in subordinate budget institutions (approved by the order of the Ministry of Finance of Ukraine dated September 14, 2012 No. 995). An important factor in the effectiveness of the internal control system’s operation is the accountability of the internal control units to the manager and parent organization, embodied in the provision of written reports on the results of control measures carried out with a certain periodicity, as well as the introduction of a mechanism for monitoring the elimination of identified deficiencies and violations. The existence and effectiveness of the internal control system’s functioning forms the basis for ensuring the effectiveness of the organization, including the efficient use of economic resources. Key words: budgetary institution, internal control, internal control system, internal audit department.

PCV34 ANNUAL HEALTH INSURANCE TREATMENT COST OF PHLEBITIS AND THROMBOPHLEBITIS: A NATIONWIDE, REAL-WORLD COST OF ILLNESS STUDY

Phlebitis and thrombophlebitis arecommon diseases resulting in significant health insurance cost and societal burden in many developed countries.The aim of our study was to calculate the annual health insurance treatment cost of phlebitis and thrombophlebitis in Hungary. The data derive from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), the only health care financing agency in Hungary. We analyzed the health insurance treatment cost and the number of patients for the year 2017. The following cost categories were included into the study: out-patient care, laboratory diagnostics, medical imaging, acute in-patient care, chronic in-patient care and drugs. Phlebitis and thrombophlebitis were identified with the following codes of the International Classification of Diseases 10threvision: I80. The number of patients underwent outpatient care was 98,672 (57.0 % women and 43.0 % men) with a mean age of 60.78 years (women: 61.27 years; men: 60.09 years). Number of patients admitted to in-patient hospital care was 15,323 (54.1 % women and 45.9 % men) with a significantly higher mean age of 64.48 years (women: 66.820 years; men: 61.72 years). For the treatment of patients with phlebitis and thrombophlebitis in 2017 the Hungarian National Health Insurance Fund Administration spent 5.114 billion Hungarian Forint (HUF) which equals 16.540 million Euros (EUR). Major cost drivers were acute inpatient care (75.3 % of total health insurance costs), pharmaceuticals (12.8 %) and outpatient care (4.2 %). Phlebitis and thrombophlebitis represent a significant burden with outstanding public health importance for the health insurance system and for the society. Frequency of the disease is higher both in outpatient and inpatient care for women. There is a significant difference (3.6 years) in the onset of the disease between women and men in outpatient.

PNS127 SECTOR-NEUTRAL REIMBURSEMENT OF HEALTH CARE SERVICES IN HUNGARY

The aim of our study is to describe the practice of sector-neutral reimbursement of health care in Hungary, and to assess the performance and reimbursement of the Hungarian curative-preventive health care providers according to ownership type. We analysed changes in the amount of financial units (weight number, german-point, capitation etc.) between 2000-2017. For comparability we used values of December 2000. for calculating fix-based index for each unit. We assessed four type of ownerships (central and local government, for-profit enterprises, non-profit providers) within the curative-preventive sector. Data were derived from the Hungarian National Health Insurance Fund Administration (NHIFA). Health care providers in Hungary can be contracted by the NHIFA regardless of ownership type since 1992 and can get reimbursement with the same conditions. As of 2017, most of providers were government bodies in: district nurse service (86.1%); outpatient care (82.5%); CT/MRI (84%); acute inpatient care (97.4%) and in chronic inpatient care (88.4%), while private sector dominated in general practitioner service (90.7%); dental care (81.8%); patient transportation (94%); home special nursing (95.9%) and dialysis (87.1%). We also analysed changes of certain financial units according to dominant ownership forms between 2000-2017. Since 2000. units of health care services provided by private bodies increased less (1.68 times more in 2017), than services where the majority of providers are governmental (2.01 times more). The difference between financial units can be explained with the income correction since 2016, where the promised increase is basically built in the values of these units. Overall, a health care system that not only operates, but contracts private providers for public funding can satisfy the needs of a nation’s population.

PIT5 NATIONWIDE HEALTH INSURANCE TREATMENT COST OF INTRACRANIAL INJURIES IN HUNGARY: COST OF ILLNESS STUDY BASED ON REAL WORLD DATA

Injuries are a major cause of morbidity and mortality in developing and in industrialized regions. The aim of our study was to calculate the annual health insurance treatment cost of intracranial injury in Hungary. The data were derived from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), the only health care financing agency in Hungary. We analyzed the number of patients and the health insurance treatment cost for the year 2017. The following cost categories were included into the study: out-patient care, laboratory diagnostics, medical imaging, acute in-patient care, chronic in-patient care and drugs. Patients with intracranial injury were identified with the following codes of the International Classification of Diseases 10threvision: S06. Number of patients admitted to in-patient hospital care was 17,643 (40.9 % women and 59.1 % men) with a mean age of 40.84 years (women: 41.57 years; men: 40.33 years). The number of patients underwent outpatient care was 41,453 (42.4 % women and 57.6 % men) with a mean age of 40.05 years (women: 41.98 years; men: 38.52 years). For the treatment of patients with intracranial injuries in 2017 the Hungarian National Health Insurance Fund Administration spent 8.942 billion Hungarian Forint (HUF) which equals 28.920 million Euros (EUR). Major cost drivers were acute inpatient care (95.6 % of total health insurance costs), chronic inpatient care (2.7 %) and outpatient care (1.3 %). Intracranial injuries represent a significant burden for the Hungarian health insurance system. The disease is more common in men (57-59 %) than women. There is no significant difference (1-3 years) in the onset of the disease between women and men.

PMS24 NATIONWIDE, REAL-WORLD HEALTH INSURANCE TREATMENT COST OF SCOLIOSIS IN HUNGARY: A COST OF ILLNESS STUDY

Scoliosis and related medical problems are of public health importance andgenerates a considerable economic burden. The aim of our study was to calculate the annual health insurance treatment cost of scoliosis in Hungary. The data were derived from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), the only health care financing agency in Hungary. We analyzed the number of patients and the health insurance treatment cost for the year 2017. The following cost categories were included into the study: out-patient care, laboratory diagnostics, medical imaging, acute in-patient care, chronic in-patient care and drugs. Patients with scoliosis were identified with the following codes of the International Classification of Diseases 10threvision: M41. The number of patients underwent outpatient care was 175,726 (68.1% women and 31.9% men) with a mean age of 42.26 years (women: 45.59 years; men: 35.33 years). Number of patients admitted to in-patient hospital care was 11,249 (76.9% women and 23.15% men) with a mean age of 60.4 years (women: 62.0 years; men: 55.07 years). For the treatment of patients with scoliosis in 2017 the Hungarian National Health Insurance Fund Administration spent 2.961 billion Hungarian Forint (HUF) which equals 9.576 million Euros (EUR). Major cost drivers were acute inpatient care (37.8% of total health insurance costs). out-patient care (37.4%) and chronic inpatient care (20.4%). Scoliosisrepresents a significant burden for the Hungarian health insurance system. The disease is more common in women (68-76 %) than men. There is a significant difference (7-10 years) in the onset of the disease between women and men.