Experimental statistics

The Hungarian Myocardial Infarction Registry (hereinafter as HUMIR) started operating on 1 January 2010 and data reporting became mandatory for all healthcare providers from 1 January 2014. For the purposes of official statistics, HCSO takes over the data from the registry from 2020 onwards for the reference year. In Hungary, GOKVIAct XLVII of 1997 on the management and protection of health and related personal data, Decree 49/2018 (XII. 28.) of the Ministry of Health and Social Affairs on the scope of diseases of major public health importance or otherwise associated with a significant cost burden, on the designation of the body managing the disease register of diseases, and on the detailed rules for the notification and registration of these diseases and Decree 15/2014 (III. 10.) of the Ministry of Health and Social Affairs on the procedure for the notification and registration of diseases related to myocardial infarction.^[1] operates the HUMIR in accordance with the law, which provides a comprehensive picture of the epidemiology of myocardial infarction in Hungary. This register covers all patients treated for myocardial infarction in Hungary and all acute myocardial infarctions detected by all healthcare providers. The HUMIR records persons hospitalised in Hungary with symptoms of acute myocardial infarction (ICD-10: I21-I23), and includes patients’ demographic characteristics, medical history, treatment and late complications of the disease.

The following data from the register were used:

• personal data (demographic characteristics),

• admission data (onset of complaints, first healthcare provider, admitting hospital, mode and time of admission, weight, height),

• treatment data (PCI),

• discharge data (diagnosis, mode of discharge, place and time of discharge, other serious illnesses).

Based on the patient's social security number, the register data can be linked to the mortality database of HCSO and the tax and contribution declaration database of the NTCA, so in addition to mortality data, labour market correlations and changes in earnings after the occurrence of an infarction can also be analysed.

Studying the labour market situation of people treated for a myocardial infarction, we applied several approaches:

1. First, we examined the existence of a legal relationship presuming the employment of the patients, i.e. whether the given individual had any legal relationship involving the obligation to pay contributions, related to work, in the month before and after the myocardial infarction. For this question, we considered the month preceding the myocardial infarction as the basis of comparison.

2. The second criterion was the length of time that people with a legal relationship related to work were on sick absence after the myocardial infarction, and when they returned to work.

3. In the third question, we sought an answer to whether the affected people had the same working capacity after the myocardial infarction as before. To do this, we studied the change in aggregate earnings among employees in the post-infarction period compared to the month before.

Given that we were analysing the ability of patients with a myocardial infarction to return to the labour market, in this study period we excluded those individuals who had already reached the official working age, i.e. 65 years, at the time of the (first) hospital admission in 2023.

For each research question, we followed the life course of people who had suffered a myocardial infarction for 6 months, which was calculated from the date of hospital admission recorded at the first event in the case of multiple episodes of myocardial infarction in a given year.

The linking of the myocardial infarction registry and the contribution data shows that 77% of the studied population worked in the entire month prior to hospital admission, but this does not necessarily imply continuous employment for the rest of the year. Therefore, the post-infarction activity can only be assessed as a trend, as we do not know the type of contract under which the studied people were employed.

The employment relationship lasted for an entire month (in short: worked) if during this period the employer did not report any absence relevant for social security purposes (e.g. sick pay, inability to work without cash benefits, etc.). Absences not relevant for insurance purposes, typically shorter ones, such as sick leave, ordinary leave, etc. are not included in the contribution data, so these absences were not taken into account here either.

[1]:↑ Act XLVII of 1997 on the management and protection of health and related personal data, Decree 49/2018 (XII. 28.) of the Ministry of Health and Social Affairs on the scope of diseases of major public health importance or otherwise associated with a significant cost burden, on the designation of the body managing the disease register of diseases, and on the detailed rules for the notification and registration of these diseases and Decree 15/2014 (III. 10.) of the Ministry of Health and Social Affairs on the procedure for the notification and registration of diseases related to myocardial infarction.