Financing of therapeutic rehabilitation in the context of other non-invasive medical treatment specialties

Abstract

Methods of financing health care services constantly undergo changes. These changes involve both the allocated financial resources and average prices received for person-day of treating patients in hospital departments of various specialties. Thus, a constant monitoring of financing levels and service pricing in particular types of health care services is indispensable, since these issues are directly associated with the development or stagnation observed in particular branches of medicine. This paper aimed at verifying the hypothesis that the pricing of person-day in the field of inpatient therapeutic rehabilitation, especially involving children, is under priced in relation to an average value of a person-day received in specialties providing non-invasive hospital treatment, and comparable as regards the costs of services. An analysis and comparison of costs and incomes for medical units providing health care services in selected areas of inpatient therapeutic rehabilitation for children and non-invasive hospital medical treatment have been attempted. This analysis has been carried out on the basis of data provided by the regional branches of the National Health Fund (NFZ). Generally available information concerning the terms and conditions of contracting services and agreements that NFZ has entered into with service providers has been also used. A comparison of the conditions for providing services that service providers should meet in order to obtain financing within the framework of NFZ, shows that personnel costs of a department of pulmonary rehabilitation and department of general rehabilitation are lower by approximately 15% than personnel costs of a department of pediatrics, and 9% lower than for a department of pediatric neurology. However, an average pricing of person-day received by rehabilitation departments is about 3-fold lower than that received by departments of pediatrics and pediatric neurology. Departments providing non-invasive medical treatment admit a large variety of patients. This diversification of patients only in part coincides with patients admitted to rehabilitation departments. Thus, additionally average pricings of person-day at departments providing non-invasive medical treatment and departments of general rehabilitation with respect to selected diagnosis related groups of patients who manifest diseases treated in both types of departments, have been compared. The obtained results have confirmed gross under financing of inpatient rehabilitative services. Inpatient rehabilitative services offered for children are particularly undervalued. In this instance, service providers bear higher costs, resulting from, among other considerations, a larger average number of physiotherapists necessary to conduct rehabilitation, the requirement of assuming the full legal responsibility for children which necessitates additional educational care and 24-hours medical care, not only in the case of neurological rehabilitation, as well as providing nutrition adequate for children's ages, including five high-quality meals daily. Consequently, it is necessary to increase the pricing of inpatient rehabilitative services provided for children.