Polish hospital sector requires stronger stewardship, says World Bank

June 9, 2014

WARSAW, June 9, 2014 – A comprehensive set of reforms is required to sustainably improve the performance of Polish hospitals, argues a new World Bank Policy Note entitled Poland – improving the financial sustainability of the hospital sector: towards a systemic approach.

The Note finds that the Polish hospital system is oversized, and that it is organized, regulated, and funded in such a way that hospitals compete with each other in ways that do not benefit the patients.  The Note proposes a comprehensive diagnostic of the issues faced by the hospital sector, including in terms of financing. 

The Note recommends specific reforms to sustainably improve the efficiency of the hospital sector and to free up resources to better meet patients’ needs.  The 2011 Law on Therapeutic Services provides a good starting point, as it increases the financial accountability of hospital founders.  International experience suggests that additional reforms are needed, including:

- Fostering cooperation and networking (and not only competition) among hospitals.  This is about concentrating the delivery of highly specialized services and organizing an integrated system of care across facilities.  It has proven the most efficient way to avoid redundant investments and ensure the quality of services.  It will require: (i) designing and implementing “health maps”, to optimize the organization of care providers in a given area based on health needs of the local population; and (ii) putting in place strong incentives for hospital owners/founders to work together better.

- Organizing the purchasing of health services by the health insurance fund in such a way as to promote the reconfiguration of service delivery, and ensure that the prices of hospital services better reflect relative costs.

- Modernizing quality assurance mechanisms to put less emphasis on inputs, and measure quality in a more explicit and transparent way.  

To implement such a program, organizational reforms will be needed, in particular to provide the strong stewardship that is needed in a highly decentralized sector.  In the meantime, hospitals and regional authorities can make improvements, for instance, by producing and publishing hospital indicator dashboards, increasing management capacity and oversight, developing systematic evaluations and joint-learning, and designing mid- to long-term strategic frameworks.

“This Policy Note reflects on our policy dialogue with various stakeholders in Poland and proposes a way forward based on international best practice,” said, Xavier Devictor, World Bank Country Manager for Poland and the Baltic Countries.  “Much has been done, however, much remains to be done to improve the delivery of health services in Poland. The World Bank stands ready to support policy makers and share international experience with Poland.”

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