Workforce Shortages and Self-diagnosis Among Health Trends

Analysis

Recent years have seen many changes in healthcare, driven by COVID-19, the energy crisis and accelerated digitalization. However, the most pressing issue is the growing workforce shortage. We look at some of the developing trends.

According to a recent European Commission report, the Hungarian healthcare system is one of the most understaffed in Europe, with a low number of nurses and doctors per 1,000 people. Digitalization and artificial intelligence are becoming more critical, but they will not solve the workforce shortage, as they will not be able to replace intuition and the role of direct doctor-patient relationships.

The demand for private healthcare has increased significantly in recent years. Whereas previously, it only attracted the top 10% of society, it is now being used by the middle and lower classes, particularly due to COVID-19 restrictions, reduced public capacity and the abolition of the gratuity system of all but institutionalized “tipping.” According to health fund Prémium Egészségpénztár, one in five visits to a specialist in 2022 were to a private healthcare provider.

The private market is seeing more new entrants, with practices opening up all the time despite the shortage of doctors and assistants to fill them. According to 2021 data from the Central Statistical Office (KSH), 96% of health worker positions were filled (for nursing posts, the figure is 97%; for doctors, it is 96%). To address the growing shortage of staff and to plan capacity adequately, there is an increasing need for a regulated coexistence between private and public healthcare, experts say.

According to László Babai, founding director of Prima Medica Health Centers, the energy crisis has spilled over into private healthcare, but the public sector is more affected because it cannot compensate for the energy expenditure on the revenue side.

The Bigger Picture

In contrast, the private health sector can pass on the increased costs to patients, meaning changes in human resources are a bigger problem for it than energy issues. The current increase in assistant salaries alone will entail a 15-20% increase in fees while maintaining professional standards, while energy has only brought about a maximum increase of 4-5%.

Technological innovation and AI are also playing an increasingly important role in healthcare. With the increasing use of templates in processes and care, many providerswant to reduce costs through fewer human resources and more routinization. This is, indeed, needed, but machines cannot entirely replace human interaction. Healthcare has always been primarily personalized, and this will not change in the future.

AI can help patients and professionals in many areas, including big data diagnostics, patient monitoring, medical imaging and improving the efficiency of healthcare systems. At the same time, the role of intuition based on deep professional knowledge remains vital, as doctors often need to call on their experience in addition to objective indicators.

AI has been used for years in mole screening, for example, but the focus remains on personal care, support and human relationships at Prima Medica, the company says, arguing that this is what sick people in precarious situations most need.

Patients’ expectations are constantly changing. While in the past, the patient craved detailed explanations and more human care, the focus is now on complementing public healthcare and increasing access to treatments. The demand for second, third and multiple consultations has increased, as has the prevalence of self-diagnosis, both at home and globally.

The Rise of Self-knowledge

People are collecting more of their own data through smart devices and thus have more information about their condition, leading to greater engagement. According to a 2022 survey by Semmelweis University (the largest provider of healthcare services in Hungary, according to its website), almost 75% of patients in Hungary believe that using digital devices improves the efficiency of care. There are many benefits to using them, but self-diagnosis online is often incorrect and can, therefore, put patients’ health and safety at risk.

With the development of digital technology, the use of online registration and telemedicine in the healthcare sector is becoming more prominent. Around 50-60% of check-ins are done online, while telemedicine is also on the rise.

While these solutions have many advantages, it is important to highlight their limitations. With online appointments, the rate of errors, where patients make the wrong appointment with the wrong doctor, has increased significantly. This is inconvenient for the patient who makes the mistake while depriving other patients of an appointment and wasting time and energy on all sides in an area with a fundamental lack of capacity for care.

A further problem is so-called “impulsive registrations,” often resulting in no-shows for booked consultations. The rate has risen to around 20%, which is becoming unmanageable and leading to a significant loss of revenue. In many places, therefore, part or all of the consultation must be paid in advance at the time of booking.

Telemedicine is becoming more widespread in Hungary, with 6.4% of patients having used teleconsultation, according to the Semmelweis survey. Teleconsultation can be very effective if both the patient and the doctor follow professional rules. It can be particularly beneficial in caring for pregnant women and those who already know their own illness.

This article was first published in the Budapest Business Journal print issue of September 22, 2023.

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