In 2018, less than 5% of cataract operations in Poles were performed abroad under the cross-border directive. Will the abolition of limits for these procedures cause Poles to stop operating cataracts abroad?
Nearly 16,000 Poles operated on cataracts abroad
Cataract removal procedures are by far the most popular benefits provided by Poles under the so-called cross-border directive. In 2018, the National Health Fund (NFZ) reimbursed nearly 15,900 of such benefits (shown in 14,000 applications) for the total amount of PLN 30.6m. This constituted 87% of all applications with payment made and 91% of the refunded amount.
By comparison, in 2017 NFZ reimbursed 15,700 benefits, but the reimbursement amount was higher and amounted to PLN 33.7m. This represented 93% of the total amount paid. The average value of the reimbursed costs was PLN 2,190 in 2018 and PLN 2,140 in 2017. It is worth noting that since July 2018 the qualification visit, the cataract removal operation itself and the control specialist advice after 14 days from the surgery are subject to a separate valuation.
However, the scale of foreign operations is not as large as the one might think. The number of cataract surgeries performed in Poland in 2018 amounted to nearly 315,000. This means that foreign operations constitute less than 5% of all cataract surgeries.
Czech Republic is the most popular destination
NFZ data show that in 2018 as many as 86% of applications for which reimbursement was made concerned treatment in the Czech Republic. At the same time, more than 89% of the total costs incurred by NFZ for cross-border care included treatment in the Czech Republic. These data concern all services in total, but it is no secret that Poles in the Czech Republic carry out cataract surgery in the first place. Czech institutions not only organise transport of the patient abroad, but often also provide accommodation and meals. Some of them also employ Polish-speaking staff.
NFZ abolishes limits for cataract operations
As we have already informed, since April 2019 NFZ has abolished limits for cataract surgery. According to the fund, in the first two months after the new regulations came into force, the number of procedures performed in Poland increased by 11%. Therefore, we can expect that in 2019 the number of those who will go abroad for such operations will be lower than in 2018.
It should be remembered, however, that despite the abolition of cataract surgery limits, there are still problems in the Polish health care system which may prevent an increase in the number of services provided. It concerns mainly too small number of specialist doctors, both ophthalmologists and anaesthesiologists.