Worsening trends: Wider gap emerges between public and private healthcare in Hungary
The gap between public and private specialist care in Hungary has widened, according to a nationwide survey. While both sectors face challenges, one in five Hungarians now opts for private care—primarily due to shorter waiting times, better facilities, and more advanced equipment.
Public health services are showing concerning trends, with longer waits and fewer care centres. However, the private sector—despite being perceived as higher quality—also faces criticism: many patients report declining standards in doctors’ attitudes and professionalism.
These findings come from a representative national survey (1*) used to calculate the latest Premium Outpatient Care Quality Index (Prémium Járóbetegellátás Minőségi Index, PJMI). Now in its third year, the index measures satisfaction among those who use specialist care services. This year, respondents were asked not only about their most recent visit to a specialist, but also about their experiences over the past year.
Why do people still choose public healthcare?
According to the survey by Prémium Egészségpénztár, Hungarians continue to turn to private providers for specialist care: nearly 20% of such visits over the past three years were paid for privately. Around half of the respondents said they chose private care due to higher-quality services and faster access. In contrast, nearly as many people opted for public care simply because it is free of charge.
Based on patient ratings of their most recent visit, private care services received 83 out of a possible 100 points on the PJMI scale, compared to just 66 for public healthcare. The 17-point gap between the two systems has increased from 15 points last year, largely due to improved ratings for private care.
“With regular contributions to a healthcare savings account—especially when supplemented by employer contributions—people can prepare for future medical expenses. Many still do not realise that paying through a health fund can reduce the cost of private care, as users may receive a 20% tax refund on deposits, up to HUF 150,000 annually,” said Dr Péter Váradi, Chief Strategic Adviser at Prémium Egészségpénztár. “So far this year, our members have reclaimed nearly HUF 6 billion in personal income tax, and membership could reach 400,000 by the end of the year.”
Private providers offer faster, more accurate and comfortable service
The most significant differences between public and private care were observed in on-site waiting times, ease of scheduling, equipment quality, and overall comfort.
The on-site waiting time scored just 37 points for public care, compared to 72 for private. Timeliness of appointments also showed a wide gap—67 points for public, 85 for private. Comfort factors—including clinic design and ambience—scored highly in private clinics (86 points), but only 50 in public ones. Similarly, the quality of equipment and technology earned private providers 86 points, versus 54 for public institutions, based on patient impressions.
Women and young adults prefer private care
Preferences varied considerably by gender and age. Women were more likely than men to choose private care, and the highest usage was reported among 18 to 29-year-olds—39% of whom had visited a private specialist. In contrast, only 11% of adults over 60 had done so. Other demographic differences were minor: for instance, people in smaller towns were just as likely to use private care as those in larger cities or the capital.
Private care remains dominant in gynaecology: 26% of female respondents said their most recent specialist visit was for this purpose. Rheumatology (8%) and dermatology (7%) followed. Among men, the most frequent was urology (14%), followed by cardiology (12%) and ophthalmology (9%).
Appointment scheduling is key, but not always effective
Today, pre-booking is virtually mandatory for specialist health care: in 2024, 88% of respondents said they were only able to see a doctor via a scheduled appointment. Phone remains the most common booking method, followed by online platforms. Here too, convenience favours private providers: two-thirds of private patients booked by phone, and almost one-third online. In contrast, only 57% of public patients booked via phone, and just 14% used online systems—many still rely on in-person scheduling, whether out of habit or necessity.
While 60% of respondents found the timing of their most recent appointment acceptable, 66% had previously been unable to attend a needed specialist visit. Reasons included failed booking attempts, a lack of available slots, or appointments being scheduled too far in the future or at inconvenient times, prompting many to seek alternative solutions.
Although both systems now largely require appointments, punctuality remains problematic. Among private health care patients, 58% were seen almost immediately, and 32% waited no more than 30 minutes. In public health care, only 21% were seen right away, another 38% within half an hour—but one in five had to wait over an hour, even with a scheduled appointment.
(1*) NRC Omnibus Survey
The online survey targeted Hungarian adults who had received specialist care in the six months prior. The sample included 1,000 individuals and is representative by gender, age, education level, settlement size, and region.
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