PUBLIC-PRIVATE MIX AND PERFORMANCE OF HEALTH CARE SYSTEMS IN CEE AND CIS COUNTRIES

The role of the public and private sector in health care systems remains one of the crucial problems of these systems' operation. The purpose of this research is to identify the relationships between the performance of health systems in CEE and CIS (Central and Eastern Europe and Commonwealth of Independent State) countries, and the mix of public-private sector in the health care of these countries. The study uses a zero unitarization method to construct three measures of health system performance in the following areas: (1) resources; (2) services; and (3) health status. The values of these measures are correlated with the share of public financing that represents the public-private mix in the health systems. The data used is from World Health Organization’s Health for All Database for 23 CEE and CIS countries and comprises the year 2010. The results show that the performance of health systems in the countries investigated is positively associated with a higher proportion of public financing. The strongest relationship links public financing with performance in the area of services production. For policy makers, these results imply that health systems in post-communist transition economies could be susceptible to a decreasing role of the state and that growing reliance on the market mechanism in health care can deteriorate the operation of these systems

The effect of health care model on health systems' responses to economic crises

Motivation: The paper is concerned with relationships between model of health care and the responses of health systems to economic crises in OECD countries (1970–2013). The institutional arrangements are considered to affect the operation and performance of health systems in several ways; however, so far the topic has not been investigated in the economic crises context.Aim: This research attempts to bridge this gap by comparing the dynamics of health systems measures (male and female life expectancy; health expenditure; and doctors’ density) during years of recession with the average annual growth rate of the same measures for the countries clustered in four model groups.Results: The results show that the health care model applied is related with the systems’ responses to economic downturns. The Bismarck-type countries perform poorly in terms of health improvement and are incapable of containing costs during recessions. The Beveridge-type countries perform better in health improvement during stagnation; they also have effective cost-containment policies but they provide less security in terms of human resources for health than the Bismarck-type states. The market-oriented countries are in a superior position in health improvement when economies collapse; however, they fail to restrict health expenditure increase and to sustain the dynamics of doctors’ availability. The systems in transitions are characterized by a relatively low performance in female health improvement during recessions, a moderate situation in securing access to physicians and the greatest possibilities of containing costs. For the policymakers, the results imply that there is no universally superior model of health care organization

MARKET CONCENTRATION AND PERFORMANCE OF GENERAL HOSPITALS IN POLAND

        Theories of the hospital market view hospitals as competing for patients, physicians and third-party payers simultaneously. The competition involves such elements as price, quality, convenience, technology and innovation and the effects of the competition in the market affect the quality of care, clinical outcomes, cost of services, access as well as patient satisfaction.        The purpose of the paper is to shed some light on the impact of competition on the performance of general hospitals in Poland. Due to the unavailability of micro-level data, territorial concentration based on regional data is used as a proxy for the scope of competition. Therefore, the territorial concentration of hospital beds is measured with the use of the Herfindahl-Hirschman index (HHI) for each of the 16 provinces of Poland and for the four-year period of 2008-2011. In the second stage, the values of the concentration index are correlated with a set of variables describing the performance of hospitals.        The results show that the concentration of hospital beds in the regions is uneven. The regions with the most concentrated markets (zachodniopomorskie, łódzkie, podlaskie and mazowieckie) are characterized by four times higher values of the HHI than the one with the least concentrated market (śląskie). The results suggest that a higher concentration in the hospital market correlates with a larger number of patients treated and an increase in the cost of services

MARKET CONCENTRATION AND PERFORMANCE OF GENERAL HOSPITALS IN POLAND

Theories of the hospital market view hospitals as competing for patients, physicians and third-party payers simultaneously. The competition involves such elements as price, quality, convenience, technology and innovation and the effects of the competition in the market affect the quality of care, clinical outcomes, cost of services, access as well as patient satisfaction. The purpose of the paper is to shed some light on the impact of competition on the performance of general hospitals in Poland. Due to the unavailability of micro-level data, territorial concentration based on regional data is used as a proxy for the scope of competition. Therefore, the territorial concentration of hospital beds is measured with the use of the Herfindahl-Hirschman index (HHI) for each of the 16 provinces of Poland and for the four-year period of 2008-2011. In the second stage, the values of the concentration index are correlated with a set of variables describing the performance of hospitals. The results show that the concentration of hospital beds in the regions is uneven. The regions with the most concentrated markets (zachodniopomorskie, łódzkie, podlaskie and mazowieckie) are characterized by four times higher values of the HHI than the one with the least concentrated market (śląskie). The results suggest that a higher concentration in the hospital market correlates with a larger number of patients treated and an increase in the cost of services

The effect of health care model on health systems' responses to economic crises

Motivation: The paper is concerned with relationships between model of health care and the responses of health systems to economic crises in OECD countries (1970–2013). The institutional arrangements are considered to affect the operation and performance of health systems in several ways; however, so far the topic has not been investigated in the economic crises context.Aim: This research attempts to bridge this gap by comparing the dynamics of health systems measures (male and female life expectancy; health expenditure; and doctors’ density) during years of recession with the average annual growth rate of the same measures for the countries clustered in four model groups.Results: The results show that the health care model applied is related with the systems’ responses to economic downturns. The Bismarck-type countries perform poorly in terms of health improvement and are incapable of containing costs during recessions. The Beveridge-type countries perform better in health improvement during stagnation; they also have effective cost-containment policies but they provide less security in terms of human resources for health than the Bismarck-type states. The market-oriented countries are in a superior position in health improvement when economies collapse; however, they fail to restrict health expenditure increase and to sustain the dynamics of doctors’ availability. The systems in transitions are characterized by a relatively low performance in female health improvement during recessions, a moderate situation in securing access to physicians and the greatest possibilities of containing costs. For the policymakers, the results imply that there is no universally superior model of health care organization.</p

Struktura własnościowa a efektywność świadczeniodawców

Ownership structure and provider efficiencyThe purpose of the paper is to investigate the relationship between ownership structure of health care providers and technical efficiency of health care in the regions of Poland. A model built with the use of data envelopment analysis methodology is used for the estimation of efficiency of the health care production process in the regions. The inputs of the process are densities of doctors and nurses as well as per capita expenditures for health care in each of the regions; the outputs are numbers of ambulatory and stationary care services produced. Generally, the results show that the regions with a higher proportion of non-public providers are characterized by a higher technical efficiency, however the results are not unambiguous. The correlation between efficiency and the development of the non-public sector is statistically significant only in the case of ambulatory care providers, while it is insignificant when the proportion of non-public hospitals is considered

Productivity losses from short-term work absence due to neoplasms in Poland

Abstract Previous evidence on productivity losses from neoplasms focuses mostly on the economic burden from mortality, covers single cancer diagnoses and neglects non-malignant neoplasms. This study aims to broaden this perspective by analysing losses resulting from work absence and all neoplasm diagnoses. The analysis applies the human capital method and social insurance data to estimate productivity losses attributable to neoplasm-related short-term work absence in Poland in the period 2012–2022. The productivity losses due to work absence attributable to all neoplasms in Poland were €583 million in 2012 (0.143% of gross domestic product) and they increased to €969 million in 2022 (0.164%). Around 60% of the losses were associated with cancers while the remaining part of the burden was due to non-malignant neoplasms. The neoplasms that led to the highest losses were benign neoplasms, breast cancer, colorectum cancer and prostate cancer. The cancer sites characterised by the greatest losses per absence episode were brain cancer, lung cancer and oesophageal cancer. For most of the neoplasms, we observed increasing losses in an 11-year period analysed. Investing in effective public health policies that tackle neoplasms has the potential to reduce both the health burden and economic losses resulting from these diseases

Czy wydajemy za mało? Poziom i dynamika wydatków na zdrowie w Polsce i innych krajach OECD

In contrast to highly developed countries, the level of health expenditure in Poland is often considered to be too low. The purpose of the paper is to empirically test if the expenditure for health in Poland is in fact too little. Using simple regression and dynamic analysis of health expenditure in the OECD countries, the arguments against the statement are indicated. The results suggest that the relatively low health expenditure is explained by low GDP and the position of Poland is not an exception. Moreover, Poland is one of the countries with the highest rate of health expenditure growth, even if compared to virtually all Central and Eastern Europe countries investigated

Struktura własnościowa a efektywność świadczeniodawców

Ownership structure and provider efficiencyThe purpose of the paper is to investigate the relationship between ownership structure of health care providers and technical efficiency of health care in the regions of Poland. A model built with the use of data envelopment analysis methodology is used for the estimation of efficiency of the health care production process in the regions. The inputs of the process are densities of doctors and nurses as well as per capita expenditures for health care in each of the regions; the outputs are numbers of ambulatory and stationary care services produced. Generally, the results show that the regions with a higher proportion of non-public providers are characterized by a higher technical efficiency, however the results are not unambiguous. The correlation between efficiency and the development of the non-public sector is statistically significant only in the case of ambulatory care providers, while it is insignificant when the proportion of non-public hospitals is considered