Publications by authors named "Gaal P"

Central and Eastern European (CEE) countries have recently implemented reforms to health care provider payment systems, which include changing payment methods and related systems such as contracting, management information systems, and accountability mechanisms. This study examines factors influencing provider payment reforms implemented since 2010 in Bulgaria, Croatia, Czechia, Estonia, Latvia, Lithuania, Hungary, Poland, and Romania. A four-stage mixed methods approach was used: developing a theoretical framework and data collection form using existing literature, mapping payment reforms, consulting with national health policy experts, and conducting a comparative analysis.

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Chimeric antigen receptor T-cell therapies (CAR-T therapies) are a type of advanced therapy medicinal product (ATMP) that belong to a new generation of personalised cancer immunotherapies. This paper compares the approval, availability and financing of CAR-T cell therapies in ten countries. It also examines the implementation of this type of ATMP within the health care system, describing the organizational elements of CAR-T therapy delivery and the challenges of ensuring equitable access to all those in need, taking a more systems-oriented view.

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Most research on health care equity focuses on accessing services, with less attention given to how revenue is collected to pay for a country's health care bill. This article examines the progressivity of revenue collection among publicly funded sources: income taxes, social insurance (often in the form of payroll) taxes, and consumption taxes (e.g.

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Background And Objectives: Without strategic actions in its support, the translation of scientific research evidence into health policy is often absent or delayed. This review systematically maps and assesses national-level strategic documents in the field of knowledge translation (KT) for health policy, and develops a practical template that can support Evidence-informed Policy Network (EVIPNet) Europe countries in producing national strategies for evidence-informed policy-making.

Methods: Websites of organizations with strategic responsibilities in KT were electronically searched, on the basis of pre-defined criteria, in July-August 2017, and an updated search was carried out in April-June 2021.

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Background: Postoperative pain management is an important part of surgical care, where Acute Pain Service offers added value in terms of patient outcomes and costs. The technology, however, has hardly been adopted in Hungary, with only two hospitals operating Acute Pain Service and whose performance has not been evaluated yet. This research compared pain management outcomes of surgical, orthopedic, and traumatology patients in Hungarian hospitals with and without Acute Pain Service.

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We present a full performance characterization of a solid state pulse picker for hard x-ray pulses at synchrotrons. The device is called WaveGate. Specifically, we quantify its efficiency (>30 %), timing capabilities (switching times between 100 ns and ms), on-off contrast (>10) and influence on the coherence properties of the incident x-ray beam.

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Introduction: Policies that reduce tobacco retail density to decrease tobacco use among the youth are critical for the tobacco endgame. This paper reviews a Hungarian tobacco regulatory measure, which, since 2013, has confined the sale of tobacco products exclusively to so-called National Tobacco Shops, summarises the changes in the national tobacco retail marketplace and reports on analyses of the impact of this intervention on illegal sales to minors and adolescent smoking behaviour.

Methods: We reviewed the available national statistical data on the structure and dynamics of the tobacco retail market.

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Femtosecond (fs) time-resolved magneto-optics is applied to investigate laser-excited ultrafast dynamics of one-dimensional nickel gratings on fused silica and silicon substrates for a wide range of periodicities Λ = 400-1500 nm. Multiple surface acoustic modes with frequencies up to a few tens of GHz are generated. Nanoscale acoustic wavelengths Λ/ have been identified as -spatial harmonics of Rayleigh surface acoustic wave (SAW) and surface skimming longitudinal wave (SSLW), with acoustic frequencies and lifetimes being in agreement with theoretical calculations.

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During cooling, conventional martensitic transformation can only be realized from austenite to martensite. Recently, a so-called reentrant martensitic transformation attracted much interest due to an additional transformation from martensite to austenite during further cooling. Obviously, materials with this reentrant transformation will increase the number of physical effects and possible applications.

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Introduction: Access to innovative pharmaceuticals is thought to be associated with several exogenous factors related to the local legal or financial framework of pharmaceutical reimbursement. Our aim was to describe the association between the outcome of the reimbursement procedure on innovative pharmaceutical submissions in Hungary and several potential explanatory variables related to the legal or financial framework of reimbursement procedures, such as the submission implying a need for a legal act to conclude on a positive decision; having a risk-sharing agreement (RSA) in place at the time of submission; the aim of the submission and expenditure on individual funding requests.

Methods: Publicly available administrative announcements of the Hungarian National Health Insurance Fund Manager were used to construct the analysis dataset including all concluded procedures between 1 January 2018 and 7 June 2021, complemented with information on the overall aim of the submission (new compound or new indication).

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Article Synopsis
  • Central and Eastern Europe (CEE) has younger populations, but faces a growing issue with chronic conditions and multi-morbidity as these populations age.
  • The text highlights key initiatives in countries like Czechia, Hungary, Poland, and Slovakia aimed at improving care coordination for complex patients, though some efforts have not been successfully implemented.
  • Recent commitments to enhance care coordination and strengthen health systems post-COVID-19 present an opportunity for these countries to learn from past experiences and drive future progress in healthcare.
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Background: Pain management is a key issue in health care. Providers adopt promising technological developments, like Acute Pain Service, at differing speeds, with countries, such as the USA and Germany taking the lead. Where Hungary stands is unknown, as the practice of pain management has not yet been comprehensively reviewed in that country.

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Background: In the twenty-first century, health systems have to cope with the challenges posed by their rapidly changing environment. Among these changes, the emergence of digital health solutions is an opportunity to make health systems better, but also a compelling force to change. Community dentistry is one area of health care, where the rapid technological development has the potential for substantial performance improvement benefitting dental patients in terms of access to care and conveniance.

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In Hungary, the new act on the employment status of health workers aims at the elimination of informal payments by the strict separation of public and private care, by a significant increase of the salary of medical doctors and with the criminalization of giving and accepting informal payments. In this study, which is based on our former research, an analysis of the Hungarian judicial practice and an internet research focused on obstetrics, we examine whether the chosen tools are appropriate to achieve this goal, and if not, how the provisions of law should be modified. Both the theoretical considerations and the empirical evidence suggest that the approach the act took is wrong, because the majority of patients are not paying to compensate the doctors for their low salary.

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Structural martensitic transformations enable various applications, which range from high stroke actuation and sensing to energy efficient magnetocaloric refrigeration and thermomagnetic energy harvesting. All these emerging applications benefit from a fast transformation, but up to now their speed limit has not been explored. Here, we demonstrate that a thermoelastic martensite to austenite transformation can be completed within 10 ns.

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Objectives: The reimbursement process for innovative health technologies in Hungary lacks any formalized assessment of clinical added benefit (CAB). The aim of this research is to present the development, retrospective testing, and implementation of a local assessment framework for determining the CAB of cancer treatments at the Department of Health Technology Assessment of the National Institute of Pharmacy and Nutrition in Hungary.

Methods: The assessment framework was drafted after screening existing methods and a retrospective comparison of local reimbursement dossiers to that of German and French methods.

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Background: Prolonged shedding of SARS-CoV-2 in immunocompromised patients has been described. Furthermore, an accumulation of mutations of the SARS-CoV-2 genome in these patients has been observed.

Methods: We describe the viral evolution, immunologic response and clinical course of a patient with a lymphoma in complete remission who had received therapy with rituximab and remained SARS-CoV-2 RT-qPCR positive for 161 days.

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Article Synopsis
  • - The study highlights that mental health issues are a significant public health concern for young people in Europe, with varying levels of resources allocated to tackle these problems across different countries.
  • - Data from 31 European countries reveals alarming statistics for mental disorders, substance use disorders, and self-harm, showing trends in disability and premature death over a 30-year period.
  • - The findings suggest that improving national policies on mental health is crucial, particularly for younger populations, to address the increasing burden of these conditions highlighted in the research.
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Article Synopsis
  • The GBD 2019 study systematically estimated the global cancer burden, providing data on incidence, mortality, and disability to help address cancer worldwide.
  • In 2019, an estimated 23.6 million new cancer cases and 10 million cancer deaths occurred globally, marking significant increases in rates since 2010, with cancer becoming a leading cause of both death and disability-adjusted life years (DALYs).
  • The impact of cancer varied across sociodemographic index (SDI) quintiles, with higher SDI areas seeing more new cases, while middle SDI areas experienced more deaths and DALYs, highlighting disparities in cancer burden.
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This paper analyses the health policy response to the COVID-19 pandemic in the four Visegrad countries - Czechia, Hungary, Poland, and Slovakia - in spring and summer 2020. The four countries implemented harsh transmission prevention measures at the beginning of the pandemic and managed to effectively avoid the first wave of infections during spring. Likewise, all four relaxed most of these measures during the summer and experienced uncontrolled growth of cases since September 2020.

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Background: Surgical procedures play an increasing role among health technologies to treat diseases. Pain often accompanies such diseases, both as a result of their pathology, but also as the side-effect of the intervention itself, and it is not only a burdensome subjective feeling, but adversely affects the recovery process, can induce complications and increases treatment costs. Acute Pain Service Teams are becoming increasingly widespread in hospitals to address post-operative pain, yet we have so far no data on how many hospitals have actually adopted this technology in Hungary.

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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.

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Mobile phones have been used to monitor mobility changes during the COVID-19 pandemic but surprisingly few studies addressed in detail the implementation of practical applications involving whole populations. We report a method of generating a "mobility-index" and a "stay-at-home/resting-index" based on aggregated anonymous Call Detail Records of almost all subscribers in Hungary, which tracks all phones, examining their strengths and weaknesses, comparing it with Community Mobility Reports from Google, limited to smartphone data. The impact of policy changes, such as school closures, could be identified with sufficient granularity to capture a rush to shops prior to imposition of restrictions.

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Since its emergence in China, the COVID-19 pandemic has become the number 1 health challenge in the world with all affected countries trying to learn from each other's experiences. When it comes to health services, dental care does not seem to be a priority area, despite the fact that it is among the highest risk medical specialisations in terms of spreading the infection. Using the Department of Community Dentistry of Semmelweis University as a case study, the objective of this paper is to introduce and analyze the system and organizational level measures, which have been implemented in dental care in Hungary during the first months of the COVID-19 outbreak.

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A new concept for temporal gating of synchrotron X-ray pulses based on laser-induced thermal transient gratings is presented. First experimental tests of the concept yield a diffraction efficiency of 0.18%; however, the calculations indicate a theoretical efficiency and contrast of >30% and 10, respectively.

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