Narodowy Fundusz Zdrowia

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Narodowy Fundusz Zdrowia

Poland

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Kozierkiewicz A.,Osrodek Analiz Uniwersyteckich sp. z o.o | Sliwczynski A.,Narodowy Fundusz Zdrowia | Jassem J.,Medical University of Gdańsk | Topor-Madry R.,Jagiellonian University | Paszkiewicz J.,Narodowy Fundusz Zdrowia
Nowotwory | Year: 2012

Introduction. Breast cancer is one of the most important oncological problems in Poland, and epidemiological trends suggest is increasing in magnitude. Outcomes of breast cancer control depend mainly on efficacy of diagnostic and treatment processes. Only few treatment patterns of care studies on breast cancer are available in Poland, probably due to difficulties in collecting reliable data. This article for the first time presents information on the national breast cancer treatment patterns based upon the database of the National Health Fund (NHF). Materials and methods. This study is based on the NHF data available in the Register of Diseases' Treatment system. The analysis included 104,000 cases of patients treated for breast cancer between 2004 and 2010, which constituted the entire population of breast cancer patients identified as "confirmed" in the NHF system during this period. A comparative analysis of frequency of certain types of health interventions (i.e., surgery, chemo- and radiotherapy for curative and palliative care) between regions and over time has been performed. Results. Frequency of application of different types of intervention has been a subject of substantial changes in the period analysed. The changes may have been partially attributed to incentives within the health insurance system. There have been also regional differences which might have been due to regional availability of certain therapies, and also deviations from widely accepted therapeutic standards. Conclusions. These data suggest substantial differences in breast cancer treatment patterns in Poland. Some of these differences are independent of professional community strategies; whereas others reflect the preferences of various centres and groups of breast cancer specialists. Assuming that a set of optimal methods of breast cancer treatment can be defined, stronger emphasis should be put on their wide application. Current levels of differences and periodic fluctuations in treatment patterns suggests a lack of implementation of the national strategy in clinical practice. © Polskie Towarzystwo Onkologiczne.


Grant
Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: HEALTH-2007-3.2-8 | Award Amount: 3.70M | Year: 2009

Payment systems are fundamental to any health care system, introducing powerful incentives and fierce technical design complexities. DRG-systems aim at fairly assessing the costs of patient treatment, taking into account measurable patient characteristics such as diagnosis or comorbidity but to a varying degree also interventions chosen. Using a representative sample of inpatient data on 10-12 care episodes (representing different medical specialties, diagnostic/ therapeutic procedures, usage of innovative devices & drugs) from hospitals in 10 EU countries (AUT, ENG, EST, FIN, FRA, GER, NET, POL, SPA, SWE), the EuroDRG Project aims at studying the importance of structural factors such as wage levels vis--vis established patient variables and medical decision variables (procedures or using new and emerging technologies) to explain variation in costs within and between European countries. This will allow fair efficiency comparisons among EU hospitals to ensure that DRG-systems provide the intended incentives. A second objective is to investigate the role the quality of care plays to explain costs, an area with practically no European studies but potentially important policy implications. To achieve its objectives, the project is organised in phases: 1. Analysis of national DRG-systems and development of a methodology for trans-national analysis; 2. Trans-national DRG issues - hospital cost functions, efficiency and quality; 3. Translation into practice, synthesis and recommendation. To achieve a high scientific quality and a high policy impact, the strategy involves (based on the successful FP6 HealthBASKET project): encouraging partners to publish in peer-reviewed journals; using excellent links to major international organisations; establishing an EU-wide hospital benchmarking club; organising seminars at major conferences; a final conference with invited experts; involving representatives from countries with emerging DRG-systems (Bulgaria, China, India).


Sliwczynski A.,Narodowy Fundusz Zdrowia | Tkacz A.,BioMedical IT | Charlinski G.,Medical University of Warsaw | Piyush V.,Medical University of Warsaw | And 4 more authors.
Nowotwory | Year: 2012

The incidence of Hodgkin's lymphoma in Poland according to the National Cancer Registry appears to be lower than could be estimated based on American data according to SEER. Until recently there was no possibility to verify these data using other sources and Hodgkin's disease morbidity was completely unknown. The aim of this study was to determine the incidence and morbidity of Hodgkin's lymphoma in Poland on the basis of the data of Polish National Health Insurer for the years 2004-2010. Materials and methods. Reports of medical services for patients with Hodgkin's lymphoma submitted for reimbursement to the Polish National Health Insurer for the years 2004-2010 have been analyzed. Results. For the years 2006-2010 the mean annual number of the new patients (an index of the incidence) was 1131 ± 210 for women, and 1210 ± 223 for men. The entire yearly number of Hodgkin's disease patients (an index of morbidity) was 4555 ± 154 for women, and 4505 ± 221 for men. There was a bimodal age distribution for both genders for new Hodgkin's disease cases. The first peak of occurrence was at about 30-35 years of age and the second started at about 50 years of age and reached maximum values at about 70-75 years of age. Conclusions. The incidence of Hodgkin's lymphoma in Poland evaluated on the basis of the data of the Polish National Health insurer was higher than determined by National Cancer Registry and similar to that predicted using SEER data. The morbidity of Hodgkin's lymphoma in Poland (determined for the first time) was about 4 times higher than the incidence, that is probably due to chronic disease in these patients (about 20-30%) who are not cured by the first line treatment. Additionally, regarding age distribution, bimodality of the incidence found in other analyses was confirmed.


Kozierkiewicz A.,JASPERS | Jach R.,Katedra i Klinika Ginekologii | Basta T.,Katedra i Klinika Ginekologii | Sliwczynski A.,Narodowy Fundusz Zdrowia | And 2 more authors.
Ginekologia Polska | Year: 2015

Ovarian cancer (OC) affects over 3 000 women in Poland annually. The efficacy of the therapy remains relatively low due to challenges of systematic improvement in the early detection OC rates. International comparisons indicate a positive correlation between health expenditures and 5-year survival rates of cancer patients. To the best of our knowledge, our study has been the first to present a correlation between the 5-year survival rates (SRs) and the cost of ovarian cancer therapy in particular regions of Poland. Material and methods: The study was based on the National Health Fund (NHF) data, available in the Disease Treatment Registry. The analysis included approximately 13 000 OC patients who started their treatment between 2005 and 2008 to allow for the evaluation of long-term therapy results. The 5-year survival rates were analyzed in relation to average NHF expenditures in various regions of Poland, distinguishing the population of patients aged 45-64 years. Results: The 5-year survival rate in the cohorts diagnosed in 2005 and 2008 changed marginally, from 42% to 43%, maintaining relatively large differences between the regions (from 35% to 53% in patients diagnosed in 2008). The NHF expenditures in particular regions differed significantly: mean cost for the entire treatment cycle ranged from 31.600 PLN do 58.000 PLN per person among patients diagnosed in 2008. No significant correlation between the survival and the cost was found. Conclusions: SRs of OC patients in particular regions of Poland are not correlated with average treatment cost. Thus, the differences in SRs between various regions of Poland have their source in other factors, e.g. clinical stage at diagnosis, or prevailing treatment patterns in the given region. Further studies may decrease regional discrepancies in patient care and SRs in OC subjects. © Polskie Towarzystwo Ginekologiczne.


Kozierkiewicz A.,JASPERS | Topor-Madry R.,Jagiellonian University | Kowalczyk A.,Medical University of Gdańsk | Gilewski D.,Dane i analizy.pl Sp. Z O.o. | And 3 more authors.
Nowotwory | Year: 2015

Introduction: Rectal cancer is one of the most common malignancies in Poland and is increasing in incidence. International comparisons indicate a positive correlation between health expenditures and 5-year cancer survival rates. This study, for the first time in Poland, correlates 5-year survival rates with expenditures on rectal cancer therapy in various regions of Poland. Materials and methods: This study is based on the National Health Fund (NHF) data, available in the Diseases' Treatment Register system. The analysis included approximately 25,000 patients who started their treatment between 2005 and 2008. We analysed 5-year survival rates among these patients versus average expenditures of the NHF on their treatment in particular regions. Results: Observed 5-year survival rates between 2005 and 2008 were at a similar level (some 41% and 45% in men and women, respectively), with relatively large differences between regions (36% to 45% in men and 39% to 49% in women). The NHF expenditures in the various regions differed significantly. The average costs of an entire treatment cycle per person ranged from 32,300 PLN to 41,000 PLN in both men and women. For comparisons studied no association was found between mean expenditure for treatment and 5-year survival rates. Conclusions: Survival of rectal cancer patients in various regions does not correlate with the average expenditures on their treatment. The differences in survival rates between the Polish regions will be due to other factors, such as tumour stage at presentation or treatment patterns in the regions. A more thorough analysis of this may aid in decreasing regional discrepancies in care and inequalities in survival rates in rectal cancer patients. © Polskie Towarzystwo Onkologiczne.


Kozierkiewicz Dr. A.,JASPERS | Topor-Madry R.,Zaklad Epidemiologii | Sliwczynski A.,Narodowy Fundusz Zdrowia | Pakulski M.,Narodowy Fundusz Zdrowia | Jassem J.,Medical University of Gdańsk
Nowotwory | Year: 2014

Introduction: Breast cancer is one of the most important oncological problems in Poland, and epidemiological trends suggest it is increasing in incidence. International comparisons indicate a positive correlation between health expenditures and 5 years survival rates in cancers. This article for the first time in Poland, correlates 5-year survival rates in with expenditures for breast cancer therapy in particular regions of Poland. Materials and methods: This study is based on the National Health Fund (NHF) data, available in the Register of Diseases' Treatment system. The analysis included approximately 59,000 cases of patients who started their treatment between 2004 and 2007. We analysed 5-year survival rates among these patients versus average expenditures of the NHF for their treatment in particular regions. Results: Five-year observed survival rates increased between 2004 and 2007 from 73.6% to 74.9%, with relatively large differences between regions (66% to 79% for 2007). The NHF expenditures in particular regions differed significantly. Among patients diagnosed in 2007 the average costs of treatment ranged from 23.600 PLN to 42.800 PLN per person (for the entire treatment cycle). No correlation between survival and expenditures was found, either positive nor negative. Conclusions: Survival rates of breast cancer patients in the regions studied are not correlated with the average expenditures for their treatment. The differences in survival rates between regions of Poland may be due to other factors, such as tumour stage at presentation, or the treatment pattern in the regions. Not all expenditures impact on treatment efficacy. A more thorough analysis of this WHF data may aid in determining why there are decreasing regional discrepancies in care and inequalities in survival rates of breast cancer patients. © Polskie Towarzystwo Onkologiczne.


Kozierkiewicz A.,Europejski Bank Inwestycyjny | Sliwczynski A.,Narodowy Fundusz Zdrowia | Pakulski M.,Narodowy Fundusz Zdrowia | Jassem J.,Medical University of Gdańsk
Nowotwory | Year: 2013

Introduction. Breast cancer is one of the major problems of cancer, althought it is increasingly a treatable disease. The fight against breast cancer should have an appropriate infrastructure and provide a clinically effective and cost effective method of treatment. In this case, the knowledge on expenditures is essential (from the perspective of the payer) and also costs of treatment (in terms of contractor services), so that decisions about expenditures on treating breast cancer have been burdened with the least possible risk. Whereas treatment decisions should be based on clinical evidence (evidence-based medicine), management should be based on evidence of an economic nature (evidence-based management). The current analysis contributes to the discussion on proper financial management in the treatment of breast cancer. Materials and methods. This analysis was based on the National Health Fund (NHF) data, available in the Register of Diseases' Treatment system. We analyzed data on about 104,000 patients treated in Poland for breast cancer in the years 2004-2010. That is, on all the patients identified as "confirmed" in the NHF system during this period. The entire expenditure on therapy of particular patients have been counted, including expenditure from the beginning of therapy to cure (or death). This analysis includes only NHF expenditure (the direct costs), and does not include costs incurred by patients. Results. Expenditure related to breast cancer treatment increased between 2004 and 2010 at a rate exceeding the rate of consumer inflation, and in 2010 reached about 500 million PLN. In 2010 expenditure per person averaged 32 thousand PLN, with significant differences between individual regions. Expenditure per capita decreased strongly with age - from about 67 thousand PLN in patients aged 30 years, to about 20 thousand PLN in those over 80 years old. Expenditure on people who have undergone a screening mammography were about 8-15% lower than in other patients. Conclusions. Our data illustrate the scale of the financial burden of treatment of breast cancer in Poland. Using data accumulated in the NHF it is possible to calculate the total expenditure, and to demonstrate the differences in spending between groups of patients differing in place of residence, age, date of commencement of treatment, or participation in screening. These data allow for more informed and safe designing of changes and modifications in the system of breast cancer management. © 2013, Polskie Towarzystwo Onkologiczne.

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