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The 2021 plan for hospital care centralization in Poland – When politics overwhelms the policy process

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  • Dubas-Jakóbczyk, Katarzyna
  • Domagała, Alicja
  • Zabdyr-Jamróz, Michał
  • Kowalska-Bobko, Iwona
  • Sowada, Christoph

Abstract

The health system in Poland is characterized by oversized hospital infrastructure, with simultaneous deficits in the ambulatory and long-term care sectors. The main challenges of the hospital sector involve i.a. weak stewardship and fragmented governance with a concurrent problem of persistent hospital debts as well as huge workforce deficits. The objective of this paper is to present the government's 2021 plan for hospital care centralization. The reform project aimed i.a. at improving hospital service coordination by implementing a professional and centralized system for hospital sector supervision and effective restructuration processes. The proposed regulation project focused on three major issues: (1) adjusting the existing hospital network towards better concentration of specialized services; (2) launching an independent central agency responsible for monitoring public hospital financial standing as well as initiating and/or managing hospitals restructuration processes; and (3) introducing a formal certification of hospital managers competencies. The reform plans were developed in a relatively short time frame, with a top-down approach and strongly pushed towards the adoption in 2022. Many of the health system stakeholders were strongly opposed to the project which, in connection with new challenges faced by the health system in 2022 (the economic crisis) led the reform suspension. At the same time, a new restructuration and debt relief programme for public hospitals was announced.

Suggested Citation

  • Dubas-Jakóbczyk, Katarzyna & Domagała, Alicja & Zabdyr-Jamróz, Michał & Kowalska-Bobko, Iwona & Sowada, Christoph, 2023. "The 2021 plan for hospital care centralization in Poland – When politics overwhelms the policy process," Health Policy, Elsevier, vol. 129(C).
    • Handle: RePEc:eee:hepoli:v:129:y:2023:i:c:s0168851023000027
    DOI: 10.1016/j.healthpol.2023.104707
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    References listed on IDEAS

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    1. Dubas-Jakóbczyk, Katarzyna & Kowalska-Bobko, Iwona & Sowada, Christoph, 2019. "The 2017 reform of the hospital sector in Poland – The challenge of consistent design," Health Policy, Elsevier, vol. 123(6), pages 538-543.
    2. Christiansen, Terkel & Vrangbæk, Karsten, 2018. "Hospital centralization and performance in Denmark—Ten years on," Health Policy, Elsevier, vol. 122(4), pages 321-328.
    3. Christiansen, Terkel, 2012. "Ten years of structural reforms in Danish healthcare," Health Policy, Elsevier, vol. 106(2), pages 114-119.
    4. Katarzyna Dubas‐Jakóbczyk & Alicja Domagała & Marcin Mikos, 2019. "Impact of the doctor deficit on hospital management in Poland: A mixed‐method study," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 187-195, January.
    5. Dubas-Jakóbczyk, K. & Albreht, T. & Behmane, D. & Bryndova, L. & Dimova, A. & Džakula, A. & Habicht, T. & Murauskiene, L. & Scîntee, S.G. & Smatana, M. & Velkey, Z. & Quentin, W., 2020. "Hospital reforms in 11 Central and Eastern European countries between 2008 and 2019: a comparative analysis," Health Policy, Elsevier, vol. 124(4), pages 368-379.
    6. Polin, Katherine & Hjortland, Maximilien & Maresso, Anna & van Ginneken, Ewout & Busse, Reinhard & Quentin, Wilm, 2021. "“Top-Three” health reforms in 31 high-income countries in 2018 and 2019: an expert informed overview," Health Policy, Elsevier, vol. 125(7), pages 815-832.
    7. Saltman, Richard B. & Bankauskaite, Vaida, 2006. "Conceptualizing decentralization in European health systems: a functional perspective," Health Economics, Policy and Law, Cambridge University Press, vol. 1(2), pages 127-147, April.
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    9. Katarzyna Dubas-Jakóbczyk & Anna Kozieł, 2020. "Towards Financial Sustainability of the Hospital Sector in Poland—A Post Hoc Evaluation of Policy Approaches," Sustainability, MDPI, vol. 12(12), pages 1-19, June.
    10. Katarzyna Dubas-Jakóbczyk & Ewa Kocot & Anna Kozieł, 2020. "Financial Performance of Public Hospitals: A Cross-Sectional Study among Polish Providers," IJERPH, MDPI, vol. 17(7), pages 1-14, March.
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