Development of Scenarios for Health Expenditure in the New EU Member States: Bulgaria, Estonia, Hungary, Poland and Slovakia

The report is a result of the Ageing, Health Status and Determinants of Health Expenditure (AHEAD) project within the EC 6th Framework programme. The objective of the research was to present the model of future health care system revenues and expenditures in selected Central and Eastern European countries (CEE) which are now the New EU Member States, and to discuss projection assumptions and results. Selected countries include Bulgaria, Estonia, Hungary, Poland and Slovakia. The projections are based on methodology adopted in the International Labour Organization (ILO) Social Budget model. The projection examines impact of demographic changes and changes in health status on future (up to 2050) health expenditures. Next to it, future changes in the labour market participation and their imact on the health care system revenues are examined. Results indicate that due to demographic pressures health expenditures will increase in the next 40 years and health care systems in the NMS will face deficit. Moreover, health revenues, expenditures and deficit/surplus are slightly sensitive to possible labour market changes. Health care system reforms are required in order to balance the disequilibrium of revenues and expenditures caused by external factors (demographic and economic), and decrease the premium needed to cover expenditures. Such reforms should lead, on the one hand, to the rationing of medical services covered by public resources, and on the other, to more effective governance and management of the sector and within the sector.health care system, demographic projection, health care system revenues and expenditures projection, CEE, NMS

Health Expenditure Scenarios in the New Member States: Country Report on Poland. ENEPRI Research Reports No. 47, 19 December 2007

The objective of this report is to present the model of future health care system revenues and expenditures in Poland, and to discuss assumptions for the projection and projection results. Expenditure analysis is based on ILO social budget model, part of which is health budget model. The model takes into account the revenue side of health care system as well, which is consistent with the above-mentioned discussion on health care system funding and its sustainability. The first part of the Report is dedicated to social, and especially health-related, expenditure models and projections applied in Poland. Following, detailed description of data and information used in the current projection is presented. Baseline projections of main demographic and macro-economic variables and indicators used in the model are shown, and the assumptions for the development of these indicators and their inter-relations are discussed. Three scenarios are presented: the baseline scenario, death-related costs scenario, and the scenario with different longevity improvements. Projection results cover both the revenue and the expenditure side of health care system. Finally, conclusions are made and policy recommendations are formulated, based on projection results

Health Expenditure Scenarios in the New Member States – Comparative Report on Bulgaria, Estonia, Hungary, Poland and Slovakia. ENEPRI Research Reports No. 43, 19 December 2007

The objective of this comparative report is to present the model of future health care system revenues and expenditures in selected Central and Eastern European countries which are now the new EU member states, and to discuss projection assumptions and results. Health expenditure analysis and projections are based on the ILO social budget model, a part of which is the health budget model. The model covers health care system revenues and expenditures. It is suitable for the analysis of impact exerted by demography (especially ageing) on health care system revenues and expenditures. The objective of AHEAD project is to examine those factors. Up to date, data and information sources in new member states that could be used for the long-term comparative projections have been limited

Scenarios For Health Expenditure in Poland

The report is a result of the Ageing, Health Status and Determinants of Health Expenditure (AHEAD) project within the EC 6th Framework programme. The objective of the research was to present the model of future health care system revenues and expenditures in Poland and to discuss projection assumptions and results. The projections are based on methodology adopted in the International Labour Organization (ILO) Social Budget model. The projection examines impact of demographic changes and changes in health status on future (up to 2050) health expenditures. Next to it, future changes in the labour market participation and their impact on the health care system revenues are examined. Impact of demography on the health care system financial balanced is examined in four different scenarios: baseline scenario, death-related costs scenario, different longevity scenario and diversified employment rates scenario. Results indicate dynamic and systematic increase of the health expenditures in the next 30 years. Afterwards the dynamics of this process is foreseen to slow down. Despite the increase of the revenues of the health care system, the system will face deficit in the close future. This holds for each scenario, however the size of the deficit differs depending on longevity and labour market participation assumptions. Results lead to a discussion on possible reforms of the health care system.health care system, demographic projection, health care system revenues and expenditures projection, Poland

Programy lekowe w onkologii. Jak optymalnie wykorzystać ich możliwości?

Wstęp. Finansowanie wysokokosztowych metod leczenia jest możliwe głównie w ramach programów lekowych. Proces tworzenia programów lekowych uwzględnia potrzebę udostępnienia chorym nowoczesnych metod leczenia i jednocześnie możliwości finansowania z budżetu Narodowego Funduszu Zdrowia. Dla lekarza, oprócz wiedzy medycznej, niezbędne są również zrozumienie ogólnych zasad działania programów lekowych, znajomość źródeł informacji, wiedza o ośrodkach prowadzących programy oraz świadomość możliwych do wykorzystania szans i zagrożeń, jakie mogą pojawić się na ścieżce chorego. Materiał i metody. Przeprowadzono strategiczną analizę aktualnych onkologicznych programów lekowych w celu identyfikacji ich silnych i słabych stron oraz szans i zagrożeń. W analizie zachowano perspektywę lekarzy zajmujących się chorymi z podejrzeniem lub rozpoznaniem choroby nowotworowej. Wyniki. Dostęp do nowoczesnych leków zbliża możliwości polskich lekarzy do światowych standardów oraz poszerza możliwości leczenia chorych w Polsce w zakresie niezwykle kosztownych metod. Kryteria kwalifikowania do programów wykluczają niestety część chorych, chociaż zastosowanie terapii byłoby uzasadnione na podstawie obecnego stanu wiedzy. Realizacja programów w niewłaściwych ośrodkach onkologicznych i jednoczesny brak kompleksowości postępowania oraz niedostateczna współpraca między ośrodkami mogą powodować wydłużenie czasu oczekiwania na rozpoczęcie leczenia. Dodatkowo obciążenie zadaniami sprawozdawczymi i obawy przed penalizacją za niespełnienie rygorystycznych wymogów grożą spadkiem motywacji do kontraktowania i realizacji programów oraz kwalifikowaniem chorych do innego — często suboptymalnego — leczenia. Wnioski. Lekarze mogą ograniczać zagrożenia i wykorzystywać szanse w niektórych obszarach funkcjonowania programów lekowych. Działania te są kluczem do pełnego wykorzystania ich potencjału. Motywacja i wiedza na temat możliwości terapeutycznych, kryteriów kwalifikacji do programów, zasobów ośrodków je prowadzących dają możliwości optymalnego wykorzystania zalet programów lekowych mimo ich wad

Investing in Health Institutions in Transition Countries

This study presents an overview of the health care systems in postcommunist countries with its resources and operations, in addition to proposing steps that should be taken in order to overcome the health crisis associated with transition and increase the effectiveness and efficiency of health care systems. At the beginning of the 90's, the crisis of transition had a significant impact on the low level of funding in health care, declining in proportion to the fall of GDP or even faster. The continued crisis and slow recovery also affect the low political preference for funding the health care sector during the GDP allocation process. There is excessive competition from other important socio-economic goals and health care frequently loses the battle.transition economies, health status, health care system reforms, health care funding, financing methods of health care, health sector resources