Analysis of integrated healthcare activities into residential homes of elderly people in Hungary

Background: As a consequence of the Aging society, the elderly people have growing need for long-term care and often for special nursing in addition to the health care system. The focus of Hungarian health care system lacks basically the examination of health care provisions carried out in the social care system. The main objective of this study is to assess the health care needs within the residential social care institutions for elderly people and to follow the implemented capacity transfer from hospitals and nursing homes to social care residential homes.

 

Approach: Between March and October 2025, with the support of the Budapest Metropolitan Municipality as owner and operator, we conducted a comprehensive survey in 9 residential homes with a capacity of approximately 3,400. The main objective of the survey was to explore the healthcare needs of residents of long-term care facilities. The aim of the survey was to collect and systematize information on healthcare-related activities.

 

The method used was to conduct in-depth interviews with the general manager and the director of nursing of each home. Extensive information and data were also collected and systematically analyzed, such as the age distribution of residents, disease patterns, capacity (number of rooms, beds, medical offices, number of employees, etc.), equipment, occupancy rate, and the physical condition of the equipment.

 

Results: The results showed that the average age of residents of residential social institutions has increased by 3 ys compared to previous studies in 2015 (currently 79 years). Approximately 20-25% of residents of the homes require skilled nursing care, and the rate of moderate to severe dementia varies between 20-44%, depending on the type and location of the institutions.

Among the health activities, the managers of the homes reported a wide range of skilled nursing activities, with 4-5 specialists as medical consultants (internists, psychiatrists, neurologists, diabetologists, orthopedists).

 

 In addition to nurses, the nursing homes employ or contract 1-2 dieticians, physiotherapists and psychologists to support different diets, improve daily physical activities and prevent dementia, and maintain (partially improve) the cognitive abilities of the elderly. Other important activities of the management, requiring a great deal of organization and finance, include organizing patients’ pathways to secondary care including transport to specialist clinics, polyclinics, and emergency and other hospital departments.

 

Implications: In Hungary, the aging of the elderly population living in nursing homes is creating an increasing need for nursing and medical supervision, as well as a number of other health care-related activities. The solution requires a high level of integration of health care activities into the daily and weekly routines of the institutions. The method used in the study, the systematic mapping of a wide range of health care activities, offers a useful methodology for experts in other countries to design and conduct similar studies.