Zita Velkey - Academia.edu (original) (raw)

Papers by Zita Velkey

Research paper thumbnail of The 2020 reform of the employment status of Hungarian health workers: Will it eliminate informal payments and separate the public and private sectors from each other?

Health policy, Jul 1, 2021

Hungary, like many countries, features a complex mix of the public and private sector in the fina... more Hungary, like many countries, features a complex mix of the public and private sector in the financing and provision of health care services. At the same time, the health system also faces challenges related to shortages of health professionals, low public financing, and informal payments. With the added pressure from the COVID-19 pandemic, Hungarian policymakers acted rapidly to pass a sweeping regulation aimed at these issues. Over two days, the Hungarian parliament introduced and unanimously approved a new regulation, Act C of 2020 on the Employment Status of Health Workers, that replaces the existing public employment relationship between health professionals, public providers and their controlling authorities. The Act, passed on 6 October 2020, brings the employment of health workers under strict central control by introducing a new employment status similar to that of the armed forces. The Act also provides doctors with an unprecedented 120% salary increase and criminalizes informal payments. The reception has been overwhelmingly negative, with thousands of health professionals indicating that they would not sign the new contracts, and the policy also contains serious technical and feasibility concerns. Although the first statistics show that only about 3-5% of the active workforce did not sign the contract by 1 March 2021, the implementation of the reform still faces serious challenges.

Research paper thumbnail of Hospital reforms in 11 Central and Eastern European countries between 2008 and 2019: a comparative analysis

Health Policy, 2020

; (2) compare recent (2008-2019) hospital reforms in these countries; and (3) identify common tre... more ; (2) compare recent (2008-2019) hospital reforms in these countries; and (3) identify common trends, success factors and challenges for reforms. Methods applied involved five stages: (1) a theoretical framework of hospital sector reforms was developed; (2) basic quantitative data characterizing hospital sectors were compared; (3) a scoping review was performed to identify an initial list of reforms per country; (4) the list was sent to national researchers who described the top three reforms based on a standardized questionnaire; (5) received questionnaires were analysed and validated with available literature. Results indicate that the scope of conducted reforms is very broad. Yet, reforms related to hospital sector governance and changes in purchasing and payment systems are much more frequent than reforms concerning relations with other providers. Most governance reforms aimed at transforming hospital infrastructure, improving financial management and/or improving quality of care, while purchasing and payment reforms focused on limiting hospital activities and/or on incentivising a shift to ambulatory/day care. Three common challenges included the lack of a comprehensive approach; unclear outcomes; and political influence. Given similar reform areas across countries, there is considerable potential for shared learning.

Research paper thumbnail of Jó ötlet-e a paraszolvencia kriminalizálása?

Orvosi Hetilap

Az egészségügyi szolgálati jogviszonyról szóló törvény a köz- és magánellátás szétválasztásával, ... more Az egészségügyi szolgálati jogviszonyról szóló törvény a köz- és magánellátás szétválasztásával, az orvosbérek jelentős megemelésével és a pénzadás kriminalizálásával igyekszik megszüntetni a paraszolvenciát Magyarországon. Korábbi munkáinkra, a nemzetközi szakirodalom feldolgozására, a releváns jogszabályok, illetve bírói gyakorlat elemzésére, valamint egy, a szülészetre fókuszáló, internetes kutatásra építve azt vizsgáltuk, hogy a választott eszközök valóban alkalmasak-e a cél elérésére, szükséges-e a módosításuk, és ha igen, hogyan. Az elméleti megfontolások és az empirikus bizonyítékok is arra utalnak, hogy a törvény megközelítése hibás, mert a betegek többsége nem az orvosok alacsony fizetése miatt ad pénzt, hanem azért, mert csak így látja biztosítottnak, hogy megfelelő egészségügyi ellátáshoz jut. Ez a „díjtétel típusú” paraszolvencia nem korrupció, az egészségügyi hiányhelyzetből ered, amellyel a törvény által előirányzott intézkedések érdemben nem foglalkoznak, inkább súlyo...

Research paper thumbnail of The 2020 reform of the employment status of Hungarian health workers: Will it eliminate informal payments and separate the public and private sectors from each other?

Health policy, 2021

Hungary, like many countries, features a complex mix of the public and private sector in the fina... more Hungary, like many countries, features a complex mix of the public and private sector in the financing and provision of health care services. At the same time, the health system also faces challenges related to shortages of health professionals, low public financing, and informal payments. With the added pressure from the COVID-19 pandemic, Hungarian policymakers acted rapidly to pass a sweeping regulation aimed at these issues. Over two days, the Hungarian parliament introduced and unanimously approved a new regulation, Act C of 2020 on the Employment Status of Health Workers, that replaces the existing public employment relationship between health professionals, public providers and their controlling authorities. The Act, passed on 6 October 2020, brings the employment of health workers under strict central control by introducing a new employment status similar to that of the armed forces. The Act also provides doctors with an unprecedented 120% salary increase and criminalizes in...

Research paper thumbnail of The 2020 reform of the employment status of Hungarian health workers: Will it eliminate informal payments and separate the public and private sectors from each other?

Health policy, Jul 1, 2021

Hungary, like many countries, features a complex mix of the public and private sector in the fina... more Hungary, like many countries, features a complex mix of the public and private sector in the financing and provision of health care services. At the same time, the health system also faces challenges related to shortages of health professionals, low public financing, and informal payments. With the added pressure from the COVID-19 pandemic, Hungarian policymakers acted rapidly to pass a sweeping regulation aimed at these issues. Over two days, the Hungarian parliament introduced and unanimously approved a new regulation, Act C of 2020 on the Employment Status of Health Workers, that replaces the existing public employment relationship between health professionals, public providers and their controlling authorities. The Act, passed on 6 October 2020, brings the employment of health workers under strict central control by introducing a new employment status similar to that of the armed forces. The Act also provides doctors with an unprecedented 120% salary increase and criminalizes informal payments. The reception has been overwhelmingly negative, with thousands of health professionals indicating that they would not sign the new contracts, and the policy also contains serious technical and feasibility concerns. Although the first statistics show that only about 3-5% of the active workforce did not sign the contract by 1 March 2021, the implementation of the reform still faces serious challenges.

Research paper thumbnail of Hospital reforms in 11 Central and Eastern European countries between 2008 and 2019: a comparative analysis

Health Policy, 2020

; (2) compare recent (2008-2019) hospital reforms in these countries; and (3) identify common tre... more ; (2) compare recent (2008-2019) hospital reforms in these countries; and (3) identify common trends, success factors and challenges for reforms. Methods applied involved five stages: (1) a theoretical framework of hospital sector reforms was developed; (2) basic quantitative data characterizing hospital sectors were compared; (3) a scoping review was performed to identify an initial list of reforms per country; (4) the list was sent to national researchers who described the top three reforms based on a standardized questionnaire; (5) received questionnaires were analysed and validated with available literature. Results indicate that the scope of conducted reforms is very broad. Yet, reforms related to hospital sector governance and changes in purchasing and payment systems are much more frequent than reforms concerning relations with other providers. Most governance reforms aimed at transforming hospital infrastructure, improving financial management and/or improving quality of care, while purchasing and payment reforms focused on limiting hospital activities and/or on incentivising a shift to ambulatory/day care. Three common challenges included the lack of a comprehensive approach; unclear outcomes; and political influence. Given similar reform areas across countries, there is considerable potential for shared learning.

Research paper thumbnail of Jó ötlet-e a paraszolvencia kriminalizálása?

Orvosi Hetilap

Az egészségügyi szolgálati jogviszonyról szóló törvény a köz- és magánellátás szétválasztásával, ... more Az egészségügyi szolgálati jogviszonyról szóló törvény a köz- és magánellátás szétválasztásával, az orvosbérek jelentős megemelésével és a pénzadás kriminalizálásával igyekszik megszüntetni a paraszolvenciát Magyarországon. Korábbi munkáinkra, a nemzetközi szakirodalom feldolgozására, a releváns jogszabályok, illetve bírói gyakorlat elemzésére, valamint egy, a szülészetre fókuszáló, internetes kutatásra építve azt vizsgáltuk, hogy a választott eszközök valóban alkalmasak-e a cél elérésére, szükséges-e a módosításuk, és ha igen, hogyan. Az elméleti megfontolások és az empirikus bizonyítékok is arra utalnak, hogy a törvény megközelítése hibás, mert a betegek többsége nem az orvosok alacsony fizetése miatt ad pénzt, hanem azért, mert csak így látja biztosítottnak, hogy megfelelő egészségügyi ellátáshoz jut. Ez a „díjtétel típusú” paraszolvencia nem korrupció, az egészségügyi hiányhelyzetből ered, amellyel a törvény által előirányzott intézkedések érdemben nem foglalkoznak, inkább súlyo...

Research paper thumbnail of The 2020 reform of the employment status of Hungarian health workers: Will it eliminate informal payments and separate the public and private sectors from each other?

Health policy, 2021

Hungary, like many countries, features a complex mix of the public and private sector in the fina... more Hungary, like many countries, features a complex mix of the public and private sector in the financing and provision of health care services. At the same time, the health system also faces challenges related to shortages of health professionals, low public financing, and informal payments. With the added pressure from the COVID-19 pandemic, Hungarian policymakers acted rapidly to pass a sweeping regulation aimed at these issues. Over two days, the Hungarian parliament introduced and unanimously approved a new regulation, Act C of 2020 on the Employment Status of Health Workers, that replaces the existing public employment relationship between health professionals, public providers and their controlling authorities. The Act, passed on 6 October 2020, brings the employment of health workers under strict central control by introducing a new employment status similar to that of the armed forces. The Act also provides doctors with an unprecedented 120% salary increase and criminalizes in...