Changes in the Relative Situation of District Hospitals in Poland after the Introduction of a System of Basic Hospital Service Provision in 2017

Abstract

The most recent big reform of the Polish health system took place in 2017 and introduced a basic hospital service provision system. Hospitals were able to be included in the network and receive flat-rate financing from the National Health Fund. The current paper aims to assess how the relative situation of hospitals changed between 2015 and 2018. This study is based on multicriteria rankings which take into account the values of profit/loss on sales, the contract with the NHF, the income from health services outside the NHF, the income from rental and lease, the employment of doctors, the employment of nurses, liabilities, operating costs, and interns and residents per hospital bed. The similarity of rankings constructed using different methods is shown. Based on the results of the Chi-squared test, it can be concluded that the inclusion in the network does not affect whether the relative situation of a hospital between 2015 and 2018 improved or not. In the regression analysis, the dummy variable for level 1 hospital was negatively related to the median rank; however, this impact was not statistically significant. (original abstract)