The Ministry of Health is preparing changes to the hospital system. New rules for qualifying for the network and consolidation of medical entities

The amendment to the act on health care services financed from public funds and certain other acts is an element of the planned health ministry reform of the healthcare system, including hospitals.

The proposed solutions are to strengthen the hospital system. In the case of hospital networks (the system of basic hospital security of healthcare services, i.e. PSZ), the project assumes, among other things, abandoning qualification for individual security levels, in favor of qualifying all service providers with at least one so-called qualifying profile.

In the case of procedure profiles, an additional qualification criterion will be introduced. This will be a threshold share of procedure services in the adopted reference period. At the same time, in the case of the obstetrics and gynecology profile, the minimum number of deliveries in the same period will be decisive. The Ministry of Health initially predicts that this will be approximately 60 percent share of procedures and approximately 400 deliveries, respectively.

The Ministry of Health estimates that the effect will be the concentration of hospital surgical services in centers with greater experience and staff potential. This will allow for better use of limited resources. The number of hospitals maintaining constant readiness to provide acute care services will be reduced.

The Ministry of Health notes that currently staff, equipment and infrastructure are used inefficiently. Some hospitals maintain increased readiness under contracts in full hospitalization mode without a justified need, which causes excess costs. The Ministry of Health notes that the analysis of services under the general surgery profile in 24-hour departments showed that over 60% of hospitalizations could be settled as services under one-day surgery, i.e. without the need to provide 24-hour access to the operating theater.

In turn, the number of outpatient services in the years 2017-2023 increased by 8%, which the Ministry of Health considers an unsatisfactory result. The project also provides for the possibility of creating and running independent public health care facilities by associations of local government units, as founding entities.

The next solutions concern the creation and approval of recovery programs created by independent public healthcare facilities (SP ZOZs) that have a net loss. The preparation of the program is to be preceded by analyses covering the current activities of the SP ZOZ. The recovery program is to include, among others: assessment of the hospital's adaptation to regional and national health needsa proposal for cooperation with other hospitals to better utilize staff and other resources.

In July, at a meeting with hospital representatives, Health Minister Izabela Leszczyna presented a concept for healthcare system reform. It assumes deregulation, transformation and an inverted pyramid of benefits. The process is planned for 10 years.

The Ministry of Health proposes to create a map of benefits (MZS – map of hospital security), which will determine what benefits and to what extent should be secured in a given area. The map of benefits will be linked to the stream of financing health services, investments and aid instruments, including for indebted hospitals.