Introduction, purpose of the study: In Central Europe, in Hungary, the state guarantees
access to health care and basic health services partly through the Semmelweis Plan
adopted in 2011. The Health Plan aims to optimize and transform the health system.
The objectives of hospital integration, as set out in the Plan, started with the state
ownership of municipal hospitals in 2012, continued with the launch of integration
processes in 2012–2013 and culminated today. The transformation of a health system
can have an impact on health services and thus on meeting the needs of the population.
We aim to study the effectiveness of integration through access to CT diagnostic testing.
Our hypothesis is that integration has resulted in increased access to modern diagnostic
services. The specialty under study is computed tomography (CT) diagnostic care. Our
research shows that the number of people receiving CT diagnostic care has increased
significantly because of integration, which has also brought a number of positive
benefits, such as reduced health inequalities, reduced travel time, costs and waiting
lists. Test material and method: Our quantitative retrospective research was carried
out in the hospital of Kalocsa through document analysis. The research material was
comparing two time periods in the Kalocsa site of Bács-Kiskun County, Southern Hungary.
The number of patients attending CT examinations by area of duty of care according
to postal codes was collected: Pre-integration period 2014.01.01–2017.11.30. (Kalocsa
did not have CT equipment, so patients who appeared in Kecskemét Hospital but were
under the care of Kalocsa), post-integration period 2017.12.01–2019.12.31. (period
after the installation of CT in Kalocsa). The target group of the study consisted
of women and men together, aged 0–99 years, who appeared for a CT diagnostic examination.
The study sample size was 6721 persons. Linear regression statistics were used to
evaluate the results. Based on empirical experience, a SWOT analysis was carried out
to further investigate the effectiveness of integration. Results: As a result of the
integration, the CT scan machine purchased in the Kalocsa District Hospital has enabled
an average of 129.7 patients per month to receive CT scans on site without travelling.
The model used is significant, explaining 86% of the change in the number of patients
served (F = 43.535; p < 0.001, adjusted R2 = 0.860). The variable of integration in
the model is significant, with an average increase in the number of patients served
of 129.7 per month (t = 22.686; p < 0.001) following the introduction of CT due to
integration. None of the month variables representing seasonal effects were found
to be significant, with no seasonal effect on care. The SWOT analysis has clearly
identified the strengths, weaknesses, opportunities and threats related to the integration,
the main outcome of which is the acquisition of a CT diagnostic tool. Conclusions:
Although we only looked at one segment of the evidence for the effectiveness of hospital
integration, integration in the study area has had a positive impact on CT availability,
reducing disparities in care.