Much Ado about nothing? The responsiveness of the healthcare system in Poland through patients’ eyes

• Published in: Health policy (Amsterdam) 2019-12, Vol.123 (12), p.1259-1266
• Main Authors: Polak, Paulina, Świątkiewicz-Mośny, Maria, Wagner, Aleksandra
• Format: Article
• Language: English
• Subjects: Health administration; Health care; Health care policy; Health services; Healthcare reform; Illnesses; Institutional change; Mass media; Medical personnel; Patient satisfaction; Patients; Reforms; Responsiveness; Satisfaction; Waiting lists; Waiting times
• ISSN: 0168-8510; 1872-6054
• DOI: 10.1016/j.healthpol.2019.09.011

•Healthcare reforms have been based on political agenda and lacked continuity•Reforms have not succeeded in reducing waiting times•Patient satisfaction has not increased despite reform efforts•Insufficient number of trained health professionals decreases patient satisfaction with healthcare This article analyzes the outcomes of the key healthcare reforms undertaken in Poland and assesses how successful they have been. Contrary to the governmental perspective on success, understood in terms of economic efficiency, we define it in terms of patient satisfaction. As such, health policy is treated as a political system’s response to the problems emerging in the public agenda. The analysis therefore focuses on the responsiveness of the healthcare system through patients’ eyes. This analysis takes three main reforms undertaken in post-1989 Poland as reference points. These were: Regional Sickness Funds (Kasy Chorych, 1999); the National Health Fund (Narodowy Fundusz Zdrowia, 2003/2004); and the waiting lists package and the oncological package (pakiet kolejkowy and pakiet onkologiczny, 2015). Each introduced key institutional changes, but also sparked media interest, public attention, and mass discourse. The article presents the main goals and the most important consequences of the reforms for patients. For the purposes of the analysis, the following patient-oriented indicators of reform success were chosen: (1) public satisfaction with healthcare, (2) waiting times, (3) number of health professionals. The assembled data from national and international databases leads to the conclusion that the reforms have not succeeded.