Searching for the Optimal Method of Financing Hospital Emergency Departments-Comparison of Polish and Selected European Solutions.

Anna Tyrańska-Fobke,Andrzej Basiński,Marlena Robakowska,Katarzyna Pogorzelczyk,Daniel Ślęzak

doi:10.3390/ijerph19031507

Abstract

Hospital emergency departments are units of the State Medical Rescue system in Poland, which was established to help people in a state of a health emergency. The aim of this study is to develop an optimal method of financing emergency departments in Poland. The study used Polish data from 2016–2019 on the financing of services at the Clinical Emergency Department of the University Clinical Center in Gdańsk. For benchmarking and mathematical modeling, data for the Czech Republic, Germany and Latvia was used. The results of the analysis shows significant differences, to the disadvantage of Clinical Emergency Department, between the potential contract values in the tested models and the actual amounts of funds transferred by the National Health Fund Pomeranian Voivodeship Branch for the activities of Clinical Emergency Department under the concluded contracts. The introduction of co-payment on the part of patients reporting to the emergency departments with minor ailments that do not require hospitalization generates financial revenues, but does not significantly improve the financial results of the analyzed ward. However, it may be educational for patients in terms of raising their awareness of the correct place to seek assistance in the event of a sudden illness.

Highlights

Accepted: 26 January 2022Hospital emergency departments (EDs) are units of the medical rescue system, which was established to help people in a state of sudden health emergency
It can be concluded that the change of the current method of financing the ED from a daily lump sum to the settlement based on individual services provided in the ED, similar to the German solutions, will result in a favorable change in the financial result of the examined CED, and an improvement in the financial result of the entire healthcare entity
In the light of the above, the only applicable model among those verified in this study is the proposed additional model assuming the current daily lump sum for the ED increased by the co-payment from patients reporting to the ED and not requiring hospitalization at the rate applied in the Czech Republic

Summary

Introduction

Hospital emergency departments (EDs) are units of the medical rescue system, which was established to help people in a state of sudden health emergency. In order to enable emergency departments to properly perform the tasks for which they have been established, it is important to have them properly and adequately financed and supported by state institutions. Staffing problems and difficult access to health care services at lower levels, i.e., in primary health care and outpatient specialist care, mean that patients who do not require immediate medical assistance due to health emergencies seek assistance from emergency departments. It is highly important to look for solutions aimed at improving the functioning and financing of EDs, so patients in health and life-threatening situations could benefit from professional help at these departments as soon as possible [1].

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Conclusion