Assessment of the dynamics of inpatient health care delivery in Poland before and throughout the COVID-19 pandemic.

A situation of emergency involving the whole population introduces changes in the dynamics of the health services that are provided. The magnitude of these shifts should be also linked to the medical speciality within which the health benefits are delivered. The aim of the paper was to identify changes in tendencies in inpatient medical service delivery during the COVID-19 pandemic by medical specialties. On the basis of a database extracted for in-patient treatment received from the public payer, a retrospective analysis was carried out. Comparing the values of the dynamics of the services provided in each medical speciality, the period before the COVID-19 pandemic was collated to the years of the pandemic (2020-2021). In the period before COVID-19, positive patient dynamics were observed in more than half of the specialities. Between 2020 and 2021, virtually all specialties reversed the trend and negative dynamics were recorded. The dynamics in 2021 indicate a process of return to the values from 2015 to 2019. Emergency situation has affected the dynamics of healthcare provision in different specialities to various extent. The most resistant to the negative impulses of the state of emergency were the areas that are strictly organisationally and financially defined (e.g. the group of "therapeutic and drug programmes").

Production function for modeling hospital activities. The case of Polish county hospitals.

The aim of the article is to present the use of production function as a source of knowledge for managers of county hospitals to make rational decisions so as to achieve economic efficiency, including naturally the financial efficiency. The healthcare sector in each country differs from other sectors of the economy. The economically effective operation of county hospitals in Poland is very difficult due to all their determinants. Therefore, all economic analyses should be used to help hospital managers achieve this goal, and production function remains underestimated as a source of knowledge. The Cobb-Douglas and translog production functions were used as sources of knowledge for decision-making by county hospitals. Total number of patient-days was a dependent variable; and the total number of beds, the number of doctors and nurses (in full time equivalents, FTEs) and costs (of materials, electricity, services) were a set of explanatory variables. The significance of explanatory variables most often appeared in models accounting for the workload of nurses. On the other hand, the greatest fit measured with the residual standard error was characterised by models accounting for the number of beds. For each type of production function, the diversified results obtained show the properties of production function. This kind of knowledge is not provided by analyses which are not based on production functions.

Macroeconomic and Social Indicators to Launch the PM-Based VBHC Model in the Healthcare System in Poland.

Global health systems face shortages of resources and, above all, money, with a simultaneous increase in health spending, as well as doubts about their effectiveness. In addition, there is a growing sense of greater achievement of the essential goal of clinical effectiveness. In the face of these problems, many centres are working on a new system of financing healthcare providers, primarily hospitals, which provide the most expensive medical services. In the opinion of the authors, an essential element for the implementation of VBHC is a comprehensive knowledge of hospitals, health care, the economy, public finances and the behaviour of members of society, based on KPIs. The work on these is not well advanced, and it seems that without the knowledge of economic and social determinants, it will not be possible to implement an affective VBHC model. Therefore, in the present article, after presenting the current state of research regarding the VBHC, personalised medicine as a prerequisite for achieving clinical effectiveness, and KPIs as a prerequisite for achieving economic efficiency, the authors focus on economic and sociological KPIs. The knowledge gained from this study is necessary to make effective decisions for the appropriate operation of healthcare as a system, and of hospitals in particular.

Economic situation and occupational accidents in Poland: 2002-2014 panel data regional study.

OBJECTIVES: Occupational accidents constitute a substantial health and economic burden for societies around the world and a variety of factors determine the frequency of accidents at work. The aim of this paper is to investigate the relationship between the economic situation and the rate of occupational accidents in Poland. MATERIAL AND METHODS: The analysis comprised data for 66 Polish sub-regions taken from the Central Statistical Office's Local Data Bank. The regression analysis with panel data for period 2002-2014 was applied to identify the relationships involved. Four measures of accidents were used: the rates of total occupational accidents, accidents among men and women separately as well as days of incapacity to work due to accidents at work per employee. Four alternative measures assessed the economic situation: gross domestic product (GDP) per capita, average remuneration, the unemployment rate and number of dwelling permits. The confounding variables included were: employment in hazardous conditions and the size of enterprises. RESULTS: The results of the regression estimates show that the number of occupational accidents in Poland exhibits procyclical behavior, which means that more accidents are observed during the times of economic expansion. Stronger relationships were observed in the equations explaining men's accident rates as well as total rates. A weaker and not always statistically significant impact of economic situation was identified for women's accident rates and days of incapacity to work. CONCLUSIONS: The results have important implications for occupational health and safety actions. In the periods of higher work intensity employers should focus on appropriate training and supervision of inexperienced workers as well as on ensuring enough time for already experienced employees to recuperate. In terms of public health actions, policy makers should focus on scrutinizing working conditions, educating employers and counteracting possible discrimination of injured employees. Int J Occup Med Environ Health 2018;31(2):151-164.

Productivity losses and public finance burden attributable to breast cancer in Poland, 2010-2014.

BACKGROUND: Apart from the health and social burden of the disease, breast cancer (BC) has important economic implications for the sick, health system and whole economy. There has been a growing interest in the economic aspects of breast cancer and analyses of the disease costs seem to be the most explored topic. However, the results from these studies are hardly comparable. With this study we aim to contribute to the field by providing estimates of productivity losses and public finance burden attributable to BC in Poland. METHODS: We used retrospective prevalence-based top-down approach to estimate the productivity losses (indirect costs) of BC in Poland in the period 2010-2014. Human capital method (HCM) and societal perspective were used to estimate the costs of: absenteeism of the sick and caregivers, presenteeism of the sick and caregivers, disability, and premature mortality. We also used figures illustrating public finance burden attributable to the disease. Deterministic sensitivity analysis was performed to assess the stability of the estimates. A variety of data sources were used with the social insurance system and Polish National Cancer Registry being the most important ones. RESULTS: Productivity losses associated with BC in Poland were €583.7 million in 2010 and they increased to €699.7 million in 2014. Throughout the period these costs accounted for 0.162-0.171% of GDP, an equivalent of 62,531-65,816 per capita GDP. Losses attributable to disability and premature mortality proved to be the major cost drivers with 27.6%-30.6% and 22.0%-24.6% of the total costs respectively. The costs due to caregivers' presenteeism were negligible (0.1% of total costs). Public finance expenditure for social insurance benefits to BC sufferers ranged from €50.2 million (2010) to €56.6 million (2014), an equivalent of 0.72-0.79% of expenditures for all diseases. Potential losses in public finance revenues accounted for €173.9 million in 2010 and €211.0 million in 2014. Sensitivity analysis showed that the results were robust to changes in the model parameters. CONCLUSIONS: The productivity losses attributable to BC in Poland were a sizable burden for the society. They contributed both to decreased economy output and to public finance deficit.