Bridging healthcare gaps through specialized mobile healthcare services to improve healthcare access and outcomes in rural Hungary

Abstract

Telemedicine offers promising solutions to healthcare challenges in underserved rural areas. This study evaluates a public insurance-based telemedicine system implemented in Hungary, where 12 Mobile Healthcare Service Centers (MHSCs) provided general and specialist care to over 21,000 residents across five rural districts. During the six-month study period, 1,889 individuals received medical care through 4,118 healthcare events. The intervention led to the identification of 105 new hypertension cases and 26 new diabetes cases. Patient feedback was overwhelmingly positive, with 96% willing to recommend the service, and nearly all doctors expressing a willingness to continue participation. A 10% reduction in relative referral rates was observed, suggesting that the system helped alleviate pressure on traditional healthcare providers. Additionally, 2,026 screenings, 1,572 chronic care visits, and 151 laboratory tests were conducted, demonstrating the broad utilization of the service. The estimated monthly operational cost of the telemedicine system was approximately $250,000, which exceeded the national primary healthcare funding of $160,000 per month, highlighting the financial implications of scaling similar programs. The findings indicate that mobile telemedicine services can improve healthcare accessibility in underserved areas and reduce healthcare disparities. Further research is needed to assess the long-term effects of such interventions.

Keywords: Mobile health clinics; Point-of-care technology; Rural healthcare access; Telemedicine; Telemedicine ecosystem; Underserved populations.

Fig. 1

Districts involved in the programme. This figure shows the five rural Hungarian districts involved in the telemedicine programme: Zalakomar, Hirics, Litke, Szalonna, and Nyirkata. The map highlights these areas where mobile healthcare service centers (MHSCs) were deployed to provide medical services to underserved populations.

Fig. 2

Mobile healthcare service center, developed and constructed in the programme. (A) Fiat Ducato 250 Max MHSC (B) main technical parameters of the vehicles (C) telemedicine and POCT devices applied on the MHSC.

Fig. 3

Educational status. educational status in the programme areas compared to national averages. This figure illustrates the differences in educational attainment between the Programme areas and the national averages in Hungary. The data highlight disparities across four educational categories (namely: Did not finish 8th grade, Maximum 8th grade qualification, Finished secondary school, and Tertiary education), showing a higher proportion of individuals with lower educational levels in the Programme areas compared to national figures.

Fig. 4

Healthcare Services provided in the Programme. The figure shows the types of healthcare services delivered during the intervention. The services are divided into categories such as screenings, chronic care, acute care, social consultation, referrals, laboratory diagnostics, and patient journey planning, highlighting the frequency of each type of service provided across the population.

Fig. 5

Utilization of Telemedicine Tools and POCTs in the Programme. (A) The use of various telemedicine tools throughout the Programme, including electronic stethoscopes, ECG devices, ankle-brachial index measurement tools, and otoscopes. The frequency of usage varied, with stethoscopes and ECGs being the most commonly applied devices. (B) The distribution of POCTs conducted during the intervention, including urine analysis, HbA1c, blood tests, CRP, INR, and Streptococci tests. POCTs were used in a smaller proportion of cases compared to telemedicine tools but played a key role in diagnostic support.

Fig. 6

Changes in relative referral rates in the intervention area. This figure illustrates the differences in referral rates between the intervention and control areas before and after the implementation of the Programme. Significant reductions in referral rates are marked with an asterisk, highlighting the potential impact of the intervention on decreasing the need for external healthcare referrals.