Możliwości i bariery wdrożenia systemu HB-HTA na podstawie modelu z koordynującą rolą szpitala

HB-HTA system implementation based on the model with the coordinating role of hospital The article presents the concept of the HB-HTA (Hospital-Based Health Technology Assessment) project implementation as one of the options for implementing HB-HTA in Poland. The model involves the creation of structures in selected hospitals dealing with the assessment of technologies that would be implemented in the units. The model is characterized by a small number of stakeholders and their interests do not conflict with one another. The basic condition for the success of the project is the reimbursement of the mentioned technologies, which would allow financing the described activities. The implementation of the project requires, above all, specialized staff (already present on the market), supported by appropriate technical and organizational solutions. The implementation of the project in the proposed version should bring benefits in the entire healthcare system – im­proved access to services, as well as improved quality of hospital management and improved financial results of the hospitals and the system itself.

Identyfikacja kluczowych podmiotów i ich ról oraz możliwości i barier dla wdrożenia koordynacji regionalnej procesu HB-HTA w Polsce

Identification of key actors involved in the implementation of a regional functional model for hospital evaluation The concept of Hospital-Based Health Technology Assessment (HB-HTA) is conducive to the rationalization of decisions made by the hospital management regarding the implementation of innovative medical technologies in hospital units. This type of HTA is a bottom-up hospital initiative, but usually it is also supported systemically and involves other entities, such as: the Agency for Health Technology Assessment and Tariff System, the payer, or regional authorities. Providing support to the hospital in making the final decision on the implementation of innovative medical technology may include such aspects as: obtaining necessary funding for the implementation of technology, identification of the competitive potential of the planned project, or following the HB-HTA methodology in reporting. The process of decentralization of hospital management in Poland induces scholars to carry out research and draw conclusions about the involvement of regional authorities, mainly voivodeship offices and their departments responsible for health issues, in the HB-HTA process. The primary objectives of this paper are to present the results of research and analysis of the development and popularization of HB-HTA in Poland. These will be discussed in relation to the implementation of a regional functional model for hospital evaluation of innovative medical technologies and the creation of rules of cooperation between important institutions of sectoral (health) policy to support and develop HB-HTA at the regional (voivodeship) level, as well as the dissemination of knowledge, popularization of HB-HTA, and promotion of good practices. Słowa kluczowe: HB-HTA, lecznictwo szpitalne, ocena technologii medycznych, szpital, szpitalna ocena technologii medycznych, technologia medyczna, zarządzanie ochroną zdrowia, health care management, health technology assessment, Hospital-Based Health Technology Assessment, health technology, hospital, hospital treatment

Stanowisko Komitetu Zdrowia Publicznego Polskiej Akademii Nauk w sprawie szczepień przeciw COVID-19

The Resolution of Public Health Committee Polish Academy of Science on Vaccination against COVID-19 Public health community worldwide encouraged by successes of former campaigns have always accepted vaccination as the most effective way to handle infectious diseases pandemics. Even before the outburst of SARS-CoV-2 pandemic in many countries mandatory vaccination against many diseases, especially child related had been implemented. From among 193 countries under study in as many as 105 (54%) such obligation existed and in 62 of them (59%) at least one form of punishment or harm for those opposing was involved. Following this sort of available solutions and facing COVID-19 pandemic disaster the authors on behalf of the Public Health Committee of the Polish Academy of Science recommend to the government implementation od mandatory vaccination against COVID-19 for all workers in sectors of health care, education and welfare.

Środki trwałe w publicznej i prywatnej ochronie zdrowia w latach 1999–2018

Fixed assets in public and private healthcare in 1999-2018 The presented article deals with the subject of fixed assets in healthcare: their gross value, condition and degree of wear, broken down into the public and private sectors. Above the value grew extremely strongly in the analysed period, particularly impressive in private healthcare. The financing of this growth seems to have the largest share of funds obtained from EU and the EEA Financial Mechanism and the Norwegian Financial Mechanism as well as from public payer funds. The rate of increase of funds in healthcare from other public sources is significantly lower than, for example, the rate of GDP growth, which may indicate the withdrawal of state structures from healthcare financing. The increase in the degree of wear of fixed assets, which took place in the analysed period, may cause some concern.

Strategiczny model funkcjonalny z koordynującą rolą Regionalnego Centrum Oceny Inwestycji wspartego przez Narodowy Fundusz Zdrowia oraz Agencję Oceny Technologii Medycznych i Taryfikacji – model mieszany

Mixed functional model HB-HTA with the coordinating role of the Regional Center for Investments supported by the Polish National Fund and Agency for Health Technology Assessment and Tariff System The implementation of the strategic model for hospital health technology assessment in Poland requires the involvement of many stakeholders. HB-HTA fundamentally concerns hospitals and how they rationalize decision making in implementing innovative medical technologies. However, the need to obtain public funding after verifying the effectiveness of a given medical technology or to keep up with the evolving HB-HTA method­ology naturally requires the involvement of both the payer (NFZ) and the Agency for Health Technology Assessment and Tariff System in activities connected with the implementation and development of HB-HTA. An important aspect of the coordination of activities in relation to hospital HTA is also the support given to hospitals by regional authorities – competent health departments in voivodeship offices – by assessing HB-HTA reports prepared by the hospitals and indicating regional competitive potential of a given medical technology. This creates a hybrid/mixed system of insti­tutional support for innovative medical technologies implemented in hospitals. This institutional plurality within HB-HTA is a clear asset, strengthening the hospital’s planned undertaking substantively and financially, especially when the assistance mechanisms undertaken are flexible, soft in nature, and allow hospital units to shape effective HB-HTA activities.

Czas oczekiwania na postawienie diagnozy i rozpoczęcie leczenia w przypadku złośliwego nowotworu piersi oraz wpływ pomiaru na poprawę standardu realizowanych świadczeń

Waiting Times for Diagnosis and Treatment in Breast Cancer and the Impact of Measurement on the Improvement of the Standard of Services Provided Mortality rates for malignant breast cancer are rising in Poland. This is a subject of growing concern and a focus of public debate about cancer care in Poland. The following paper presents a case study—an attempt to measure and analyze waiting times for diagnosis and treatment in breast cancer. The survey was carried out in one of the regional cancer care centers in Poland. The data were collected solely from hospital information systems. The overall waiting time (mammography to treatment) was median 35,5 days. Waiting time since diagnosis (results of core needle biopsy to treatment) was median 27,5 days. The analysis has been conducted twice. In between the center implemented several organizational changes. They resulted in shortening of waiting time for mammogram description—from 4 to 1 day (median) also the waiting times for core needle biopsy result has been shortened—from 6 to 4 days (median). However, the overall waiting time has not changed significantly.

Model funkcjonalny HB-HTA z koordynującą rolą Narodowego Funduszu Zdrowia

The functional model of Hospital-Based Health Technology Assessment with coordinating role of the Polish National Health Fund The article presents the concept and the conduct of the HB-HTA (Hospital-Based Health Technology Assessment) project implementation with coordi­nating role of the Polish National Health Fund. The main stakeholders of the HB-HTA process were identified, together with their interests and barriers in the area of the implementation of HB-HTA in Poland.