Iwona Kowalska-Bobko

Corruption is commonly defined as the abuse of entrusted power for private gain. It is estimated that over 500 USD billion are lost every year due to corruption and that a 1-point change in the control of corruption indicator measured by the World Bank increases life expectancy by 0.44 years and reduces under-five mortality by 4.6 per 1,000 infants. Despite its global prevalence and critical impact on public and private services, corruption in the healthcare sector remains understudied. The present report aims to expand the knowledge on the paramount need to tackle corruption in healthcare by identifying the actors in the health system at risk to involving in corrupt practices, followed by defining health corruption from the governmental, non-governmental organisations, and societal perspectives, together with describing relevant corruption indicators from countries from the WHO European region. To conclude, this report presents a set of proposals and recommendations to address corruption in the healthcare sector.

Activities of public health authorities to combat COVID-19 in selected European countries

The coronavirus pandemic has contributed to great changes in the functioning of modern societies, not just in the medical dimension. The percep­tion of the health care system and its employees has also changed.

The aim of the article is to analyze the approach of public authorities to combat the spread of SARS-CoV-2 virus in the following countries: Belgium, Bulgaria, Denmark, France, Germany, the Netherlands, Spain, the United Kingdom and Poland. The research material was information available on the website of the European Observatory of Health Systems and Policies (EOHSP) in a special section dedicated to issues related to the prevention of coronavirus pandemic (https://www.covid19healthsystem.org/mainpage.aspx).

The obtained results indicate that the crisis situation caused by the COVID-19 pandemic forced all countries to undertake diversified, non-standard efforts, i.e. the use of their own pharmaceutical sector for the production of disinfectants or acceleration of obtaining licenses by medical practition­ers. In terms of financing one of activity was generation of additional funds for healthcare systems that were financially heavily burdened in the pandemic era.

Identification of key actors involved in the implementation of a regional functional model for hospital evaluation

The concept of Hospital-Based Health Technology Assessment (HB-HTA) is conducive to the rationalization of decisions made by the hospital management regarding the implementation of innovative medical technologies in hospital units.

This type of HTA is a bottom-up hospital initiative, but usually it is also supported systemically and involves other entities, such as: the Agency for Health Technology Assessment and Tariff System, the payer, or regional authorities. Providing support to the hospital in making the final decision on the implementation of innovative medical technology may include such aspects as: obtaining necessary funding for the implementation of technology, identification of the competitive potential of the planned project, or following the HB-HTA methodology in reporting.

The process of decentralization of hospital management in Poland induces scholars to carry out research and draw conclusions about the involvement of regional authorities, mainly voivodeship offices and their departments responsible for health issues, in the HB-HTA process.

The primary objectives of this paper are to present the results of research and analysis of the development and popularization of HB-HTA in Poland. These will be discussed in relation to the implementation of a regional functional model for hospital evaluation of innovative medical technologies and the creation of rules of cooperation between important institutions of sectoral (health) policy to support and develop HB-HTA at the regional (voivodeship) level, as well as the dissemination of knowledge, popularization of HB-HTA, and promotion of good practices.

Mixed functional model HB-HTA with the coordinating role of the Regional Center for Investments supported by the Polish National Fund and Agency for Health Technology Assessment and Tariff System

The implementation of the strategic model for hospital health technology assessment in Poland requires the involvement of many stakeholders. HB-HTA fundamentally concerns hospitals and how they rationalize decision making in implementing innovative medical technologies. However, the need to obtain public funding after verifying the effectiveness of a given medical technology or to keep up with the evolving HB-HTA method­ology naturally requires the involvement of both the payer (NFZ) and the Agency for Health Technology Assessment and Tariff System in activities connected with the implementation and development of HB-HTA. An important aspect of the coordination of activities in relation to hospital HTA is also the support given to hospitals by regional authorities – competent health departments in voivodeship offices – by assessing HB-HTA reports prepared by the hospitals and indicating regional competitive potential of a given medical technology. This creates a hybrid/mixed system of insti­tutional support for innovative medical technologies implemented in hospitals.

This institutional plurality within HB-HTA is a clear asset, strengthening the hospital’s planned undertaking substantively and financially, especially when the assistance mechanisms undertaken are flexible, soft in nature, and allow hospital units to shape effective HB-HTA activities.