News - 4 January 2022

Hospitals in Central Europe severely affected by COVID-19 pandemic

In all of the countries of Central Europe analysed by PMR – Hungary, the Czech Republic and Slovakia – the situation on the hospital market in 2020-2021 was one of the most serious in Europe. Johns Hopkins University & Medicine data suggest that Hungary was the fourth most severely affected country in the world in terms of COVID-19 deaths per 100,000 citizens, with a figure of 384. The Czech Republic and Slovakia were also high in the ranking, according to 21 December 2021 data, with 330 and 294 deaths respectively (placing them in 9th and 12th place). The economies of the countries in question were weakened, and this has had adverse consequences for inpatient care. Further problems will arise because of the growing number of other ailments, caused by postponed diagnosis and operations.

Reforms in Hungary have adverse consequences

In general, the healthcare system in Hungary has many shortcomings, and this has led to a high incidence of COVID-19. The difficulties include recent reforms such as nationalisation, poor conditions at hospitals, shortages of sanitation supplies and personal protective equipment for health staff and patients, an insufficient number of single-bed rooms for the isolation of people with suspected or confirmed infections, insufficient microbiological testing, and a lack of reliable data and statistics on hospital-acquired infections, not least those resulting in deaths.


In all, COVID-19 caused a sharp fall in the total number of patients admitted and discharged in 2020 (of 22% year on year), along with same-day interventions (29%), in the wake of the temporary suspension of some procedures prompted by the pandemic. This has led to financial instability at many facilities. In 2021 the overall level of insufficiency continued. One reason was the fact that, at the beginning of March 2021, the Human Resources Minister, Miklos Kasler, ordered the immediate suspension of same-day operations in Hungary. Earlier, in March 2020, the minister had also ordered the suspension of all non-urgent operations, including same-day surgery. This stipulation was suspended in part in May and completely in June 2020. However, during the second wave, in November 2020, the minister ordered another suspension, with the exemption of certain institutions. This was lifted in February 2021.

Economic difficulties have knock-on effect on healthcare in CE countries

The Hungarian economy has also suffered, with possible adverse indirect consequences for public healthcare and restrictions on more expensive procedures. The Covid-19 pandemic contributed to a significant reduction in Hungarian economic output in 2020. The real GDP figure fell by 5.0% year on year, in contrast to a 4.6% increase in 2019. The decline mostly reflected a slump in private consumption (in the wake of the introduction of the lockdown: e.g. by restraining the activities of some industries and limiting household spending), along with constrained investments (private and public alike).


The economy of the Czech Republic was also significantly affected by the spread of the global pandemic in 2020. Czech Statistics Office estimates suggest that the real change in GDP came to approximately -6% year on year. The decline principally reflected a reduction in private consumption, a fall in investment and also a downturn in exports.


Because of the pandemic, 2020 saw a significant slowdown in Slovak economic output – real GDP dwindled by 4.8%, year on year, in contrast to a 2.5% rise in 2019. This was caused by the prevailing coronavirus pandemic, which also significantly affected the health of the population. The coronavirus became the third most common cause of death in Slovakia in 2020, and its share as a proportion of all deaths reached almost 6.8%. This situation has had a severe effect on the functioning of hospitals, which have, in many cases, limited their activities to urgent cases and have been heavily involved in the fight against the pandemic. Hospitalisations in Slovakia fell by as much as 17% overall in 2020. Furthermore, data from the health insurance funds show that, in the last three months of 2020, when the epidemiological situation worsened significantly, 43,000 fewer operations were carried out at Slovak hospitals year on year.

Czech hospitals experience considerable pressure

The Czech Republic has been one of the countries most severely affected by the pandemic, not least in early 2021. Many regional hospitals were overwhelmed by the influx of COVID-19 cases. As the pandemic gained in prominence, capacities were stretched thin all across the country. In addition, a shortage of medical staff also posed a serious problem. In March 2021, when a record number of COVID-19 patients were reported at intensive care units in the country, the first patient was moved abroad and transported to Poland, with other countries also taking in Czech patients.


A number of measures were adopted to help to increase capacity for acute inpatient care, including intensive care facilities for patients with COVID-19. This included restrictions on the activities of hospitals by means of a temporary ban on the admission of new patients for planned procedures.

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Marta Marszałek

Senior Pharma & Healthcare Market Analyst