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EN
The aim of the article is to assess the access to health services in light of European Union regulatory changes, with particular emphasis on cataract procedures implemented in Poland during the years 2015–2017. Statistical data from the National Health Fund for the years 2015–2017 was analyzed by means of statistical description, graphical and table presentation. For parametric queues, a Student's t-test (α = 0.05) was used. For the number of submitted and paid applications under the directive, the linear trend model and the significance of the directional coefficient (α = 0.05) were used. The waiting queue for cataract surgery from the second quarter of 2015 to the fourth quarter of 2016 had an upward trend. In 2017, a drop in the number of waiting patients was observed, with a simultaneous increase in the number of applications submitted under the directive. At the same time, contract growth was observed, which translated into a decrease in the number of patients waiting for surgery in Poland. Nevertheless, no decreasing trend in the number of patients treated under the cross-border directive was observed.
PL
Celem pracy jest ocena dostępu do świadczeń zdrowotnych w świetle zmian regulacyjnych w Unii Europejskiej, ze szczególnym uwzględnieniem postępowania w zaćmie w Polsce w latach 2015–2017. Dane statystyczne Narodowego Funduszu Zdrowia za lata 2015–2017 przeanalizowano za pomocą opisu statystycznego. Dla kolejek parametrycznych zastosowano test t-Studenta (α = 0,05). Dla liczby złożonych i sfinansowanych wniosków w ramach dyrektywy zastosowano model trendu liniowego oraz istotność współczynnika kierunkowego (α = 0,05). Kolejka oczekujących na operację zaćmy od drugiego kwartału 2015 r. do czwartego kwartału 2016 r. miała tendencję zwyżkową. W 2017 r. zaobserwowano zmniejszenie liczby osób oczekujących na zabieg przy jednoczesnym wzroście liczby wniosków składanych w ramach dyrektywy. W analogicznym okresie nastąpiło zwiększanie kontraktów, co przełożyło się na spadek liczby pacjentów oczekujących na operację w Polsce. Nie zaobserwowano jednak tendencji spadkowej w liczbie pacjentów leczonych w ramach dyrektywy transgranicznej.
EN
The goal of this article is to provide an in-depth review of rare disease policies and the reimbursement of ODs in 3 European countries, two EU members (Poland, the Netherlands) and a non-EU one (Russia). A review of publicly available information on rare disorder policies and HTA processes was performed. Experts were consulted for unclear or scarce information. Russia has a five times higher frequency threshold for its rare disease definition than Poland and the Netherlands (both using the EU definition). The Netherlands has vastly increased its disease registries by instituting 300 expert centres via its National Plan, in Poland there are only 6 registries while in Russia one central registry exists. All 3 countries have an HTA process in place, however, the Russian one is relatively undeveloped. The access to ODs in the Netherlands is the broadest with 80 out of 83 EMA approved ODs reimbursed in 2015; Poland reimbursed 49, whereas Russia reimbursed 4 on the federal level and 43 in Moscow region. In all countries new rare disease policies are under development. The availability of healthcare systems solutions and the reimbursement of ODs differs greatly in all 3 countries, mainly in Russia. Even though both states are EU member with common regulations and access to EMA approved drugs, marked differences between Poland and the Netherlands in the range of policies, access to treatments and screening programs exist.
EN
Introduction: The use of cochlear implants (CI) has been a remarkable success in reducing disabilities in patients with impaired hearing. The definition of success for those patients means improvement of hearing ability for adults, possibility to develop speech and language for children, quality of life improvement and satisfaction with the whole CI implantation procedure. The aim: To examine patient satisfaction, determined by their place of residence, with all activities in progress during CI implantation including care in subsequent years. Material and methods: The study was conducted prospectively. Online surveys were sent to 1,906 CI patients, with the response rate reaching 33%; thus 630 surveys were analyzed. Demographic data of the respondents were collected: gender, age of implantation, one- or two-sided implantation, place of residence and implanting clinic. A detailed statistical analysis of the obtained data was performed. Results: One of the problems observed was the aspect of waiting time for qualification, implantation and replacement of the speech processor. The second problem was the travel time to the CI center and that was strictly connected with the place of the residence of a patient. Patients’ satisfaction with the control visit was high for majority of them. Conclusions: This research highlighted the limitations of the current CI service delivery. Significant differences concerning the CI pathway were found for particular regions of Poland. One of the future goals for healthcare providers should be to level out the differences in access to CI services between different regions of Poland.
EN
Introduction: The use of cochlear implants (CI) has been a remarkable success in reducing disabilities in patients with impaired hearing. The definition of success for those patients means improvement of hearing ability for adults, possibility to develop speech and language for children, quality of life improvement and satisfaction with the whole CI implantation procedure. The aim: To examine patient satisfaction, determined by their place of residence, with all activities in progress during CI implantation including care in subsequent years. Material and methods: The study was conducted prospectively. Online surveys were sent to 1,906 CI patients, with the response rate reaching 33%; thus 630 surveys were analyzed. Demographic data of the respondents were collected: gender, age of implantation, one- or two-sided implantation, place of residence and implanting clinic. A detailed statistical analysis of the obtained data was performed. Results: One of the problems observed was the aspect of waiting time for qualification, implantation and replacement of the speech processor. The second problem was the travel time to the CI center and that was strictly connected with the place of the residence of a patient. Patients’ satisfaction with the control visit was high for majority of them. Conclusions: This research highlighted the limitations of the current CI service delivery. Significant differences concerning the CI pathway were found for particular regions of Poland. One of the future goals for healthcare providers should be to level out the differences in access to CI services between different regions of Poland.
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