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Agency for Health Technology Assessment and Tariff System,Warsaw, Poland

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Finansowanie najdroższych terapii lekowych w Polsce a problemy w dostępie do nich. Analiza poziomu finansowania i opłacalności programów terapeutycznych

Magdalena Koperny

Public Health and Governance, Volume 9, Issue 2, 2011, pp. 97 - 104

https://doi.org/10.4467/20842627OZ.11.021.0558

One of the most discussed topics about organization of the Polish health care system is providing full accessibility to the financing of the latest drug therapies. According to the institutions implementing
the programs most serious causes of problems in access to innovative pharmacotherapy are too low level of funding programs and their low profitability, or even hospitals pay the extra to such benefits.
Due to the increasingly high cost of treatment of severe illnesses and ongoing development of new medical technologies, in choosing the method of treatment are taken into account the results of economic analyzes.
The authors, by analyzing the level of funding and implementation of treatment programs, have attempted to answer the question whether the claims are true, and health care providers and Polish patients have equal access to the most expensive drug therapies? To verify the above hypothesis also performed an cost analysis of selected therapeutic programs. Cost analysis conducted based on the identification and analysis of the costs of four therapeutic health programs indicated that the refund value of National Health Fund for providers implementing health programs may be substantially higher than the costs incurred by them.
The current way of financing most expensive innovation therapy has many weaknesses, but most frequently mentioned causes of the problems with the availability of treatment programs are not supported by actual data.

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Good practice for guidance development – review of consensus methods

Magdalena Koperny

Public Health and Governance, Volume 17, Issue 4, 2019, pp. 217 - 229

https://doi.org/10.4467/20842627OZ.19.023.12185

Introduction. The process of synthesizing scientific evidence and translating elaborate scientific research findings into recommendations for clinical practice is one of the most complex and significant initiatives in health care. In connection with the increasing number of recommendations, previously unformalised elements such as the process of consensus decision-making require developing a methodological approach. The use of consensus methods serves to reduce the impact of psychosocial factors in the formulation of recommendations and to increase the degree of process transparency. The aim of the publication is to present formal methods of achieving consensus used in the process of developing clinical practice guidelines.

Materials and methods. The review focuses on results of reports analyzing the procedure and methods of developing clinical recommendations, with particular emphasis on the identification of consensus methods.

Results. Many international and national organizations and institutions develop recommendations or adapt guidelines developed by others. They use both informal and formal instruments to deal with divergent expert opinions. The most popular formal methods of achieving consensus identified in the review are the Delphi method, the nominal group technique, the RAND/UCLA method, the consensus conference, and the combinations of individual approaches. Formal methods have been shown to lead to less biased and more reliable recommendations. Regardless of the method used, the guidelines should clearly define the quorum and document the process of agreeing a common standpoint on recommendations, guidelines and recommendations.

Conclusions. Clinical guidelines have become an important tool influencing clinical practice. The participation of many experts representing the opinions and interests of different groups makes it necessary to apply a methodological and structured approach so that all participants have the opportunity to voice their opinion and to ensure process transparency, deal with misunderstandings and achieve a consensual position. The consensus methods allow to provide a wide range of stakeholders clinicians, policy makers, patients – with agreed rules of conduct in a given topic. The formal consensus methods and recommendations based on these methods combine scientific evidence with the practice and experience of experts.

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Ogniska zakażeń szpitalnych w województwie małopolskim w latach 2011-2013

Magdalena Koperny

Public Health and Governance, Volume 12, Issue 2, 2014, pp. 175 - 182

https://doi.org/10.4467/20842627OZ.14.019.3111

Despite the continuous advances of medicine and higher safety standards for patients, nosocomial infections are a major problem accompanying of treatment process. Infected patients are exposed to prolonged hospital stay, require additional medical procedures, theresofore their treatment and care are associated with additional costs for health facility. In the present study the number of outbreaks of nosocomial infections, which occurred in hospitals in the Malopolska province and in Poland, as well as etiological factors of the infections in the years 2011–2013 were analyzed. In the analyzed period we observed increase in the number of outbreaks of infections in Poland and in Malopolska (from 339 to 394 and from 19 to 26 in Poland and Malopolska respectively). The most frequently identified factor is C. difficile and Rotavirus, followed by K. pneumoniae ESBL, and Norovirus. There was a decrease in the number of outbreaks of unknown etiology, both in Poland and in Malopolska. The analysis identified an increase in the number of outbreaks caused by C. difficile, Noroviruses and Rotaviruses, as the main problem in the recent years. This trend occurs in the Malopolska region and in the country. However, the analysis of the reports shows improved reportability of outbreaks in Malopolska and in Poland which will allow for better control of nosocomial infections.

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