Trends in Hospitalization Duration for Rare Diseases: A Retrospective Analysis of Sarcoidosis, Still's Disease, and Systemic Sclerosis in Poland (2009-2018).

BACKGROUND A rare disease is a health condition that rarely occurs in the population. It is estimated that up to 400 million people around the world suffer from a rare disease. This retrospective study aimed to investigate factors associated with length of hospitalization in 78 626 patients with sarcoidosis, 3294 patients with adults-onset Still's disease, and 35 549 patients with systemic sclerosis between 2009 and 2018 using data from the National Institute of Public Health in Poland. MATERIAL AND METHODS In this population-based study, we analyzed hospital discharge records of first-time and subsequent hospitalizations. To perform the statistical analyses, R software was used. RESULTS The average length of hospitalization over the selected period in the diseases was 5.39 days for sarcoidosis, 6.22 days for scleroderma, and 7.44 days for Still's disease, and was shorter for each of the diseases analyzed compared with the length of hospitalization for second and subsequent stays. There were no substantial differences in length of hospitalization between males and females. The average length of hospitalization increased with each additional comorbidity. CONCLUSIONS The study showed that hospitalizations for selected rare diseases do not cause a significant burden on the healthcare system. The results also showed that advanced age and comorbidities are important factors determining the length of hospitalization. The average length of hospital stay for selected rare diseases in Poland is not longer than the European Union (EU) average, so it can be assumed that the process of inpatient treatment in Poland is optimal.

Efficiency and Effectiveness of Patient Care Provided by Physicians in Rural and Urban Areas in Poland.

BACKGROUND The health sector in Poland is currently facing challenges such as limited financial resources, poor infrastructure, and insufficient human resources. To address these issues, increasing cost-effectiveness at the individual physician level has become essential. This study aimed to evaluate the efficiency and effectiveness of patient care at the level of individual primary health care physicians and to compare the performance of physicians working in urban and rural areas. MATERIAL AND METHODS Thirteen original effectiveness indicators were developed based on a literature review, expert consultations, and a pilot study at the Medical and Diagnostic Center in Siedlce. The indicators were used to evaluate the effectiveness of physicians and compare physicians' characteristics working in rural and urban areas. The study extracted data on physicians' characteristics and used the indicators to evaluate their effectiveness. RESULTS Physicians working in rural areas treated more patients due to staff shortages. However, physicians working in urban areas demonstrated greater effectiveness in performing routine and advanced health checks and mammograms. Despite this advantage, the average life expectancy of patients was higher among patients of physicians working in rural areas. CONCLUSIONS Five indicators developed in the study formed a scale, which is a step toward developing a uniform effectiveness indicator. Further research on consistently measuring effectiveness could significantly impact the development of sociometric research methodology. This study highlights the differences in efficiency and effectiveness of physicians working in rural vs urban areas and underscores the need for healthcare policymakers to consider these differences in addressing healthcare resource allocation.

Health Care Organization in Poland in Light of the Refugee Crisis Related to the Military Conflict in Ukraine.

BACKGROUND: Poland is witnessing a migration crisis caused by the ongoing military conflict in Ukraine. In addition to housing and necessities, 1.8 million Ukrainians that had taken refuge in Poland must have access to medical care. We aim to propose a strategy for implementing the changes in the Polish health care system in response to the Ukrainian refugee crisis. METHODS: A literature review on organizational changes in the functioning of health care systems during the migration crises worldwide in recent years and brainstorming in order to develop a strategy for implementing changes in the Polish health care system in response to the Ukrainian refugee crisis. RESULTS: The proposed strategy for implementing the changes in the Polish health care system is based on building health care resilience and adaptation to different crises. The operational objectives of organization-related activities are: (1) preparation of medical facilities to provide help for refugees, (2) development and implementation of the communication system, (3) implementation of available digital solutions, (4) organization of the diagnostic and medical services, (5) and implementation of changes in the management of medical facilities. CONCLUSIONS: Urgent reorganization is required to respond to an unavoidable increase in the demand for health care services.