How much does care in palliative care wards cost in Poland?

INTRODUCTION: The main task of palliative care units is to provide a dignified life for people with advanced progressive chronic disease through appropriate symptom management, communication between medical specialists and the patient and his family, as well as the coordination of care. Many palliative care units struggle with low incomes from the National Health Fund (NHF), which causes serious economic problems. The aim of the study was to estimate of direct and administrative costs of care and the actual cost per patient per day in selected palliative care units and comparison of the results to the valuation of the NHF. MATERIAL AND METHODS: The study of the costs of hospitalization of 175 patients was conducted prospectively in five palliative care units (PCUs). The costs directly associated with care were recorded on the specially prepared forms in each unit and also personnel and administrative costs provided by the accounting departments. RESULTS: The total costs of analyzed units amounted to 209 002 EUR (898 712 PLN), while the payment for palliative care services from the NHF amounted to 126 010 EUR (541 844 PLN), which accounted for only 60% of the costs incurred by the units. The average cost per person per day of hospitalization, calculated according to the actual duration of hospitalization in the unit, was 83 EUR (357 PLN), and the average payment from the NHF was 52.8 EUR (227 PLN). Underpayment per person per day was approximately 29.2 EUR (125 PLN). CONCLUSIONS: The study showed a significant difference between the actual cost of palliative care units and the level of refund from the NHF. Based on the analysis of costs, the application has been submitted to the NHF to change the reimbursement amount of palliative care services in 2013.

[Pericarditis and cardiac tamponade in patient with pulmonary embolism]. / Wysiekowe zapalenie osierdzia powiklane tamponada serca u pacjenta z przewlekla zatorowoscia plucna.

We present the case of co-existing pericarditis, cardiac tamponade and pulmonary embolism in a 60-year-old man treated with COPD. Cardiac tamponade as well as pulmonary embolism constitute a direct danger to life and the recovery depends on fast and proper treatment. Cardiac tamponade which co-exists with COPD is a pathology which is especially difficult to be diagnosed due to similar clinical symptoms. The necessity of pericardiocentesis in acute cardiac tamponade may limit the treatment of the coexisting pulmonary embolism.