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The hospital network has not improved patients’ access to medical services, according to a report by the Supreme Chamber of Control (NIK). The changes introduced were to ensure comprehensive and coordinated care at each stage of treatment, but this was only the case for some hospitalised patients.
Half of the patients did not receive outpatient or rehabilitation services
According to the NIK report, in the case of the institutions audited by the Chamber, nearly half of the patients (48.5%) had recommended hospitalisation services. They were to be provided within 30 days after the end of the hospitalization. In practice, only two-thirds of patients received such services. In addition, 45% of patients received recommended outpatient advice (or had a deadline for doing so). In the case of rehabilitation services, the same percentage was about 55%.
Hospitals have no resources to provide services
The reason for not providing the above mentioned services was most often the fact that patient did no show up. However, some of them were not implemented due to the lack of adequate resources on the part of the hospital. Six of the establishments controlled had hospital wards within the network for which the corresponding range of outpatient services was not provided. For example, in the Wojewodzki Szpital Zespolony in Bialystok (II degree) there were no specialist outpatient clinics with endocrinology, rheumatology, anaesthesiology and intensive therapy profiles. In the Wojewodzki Szpital Specjalistyczny in Wroclaw (III degree) there were no outpatient clinics corresponding to the general surgery and internal diseases profiles.
In addition, none of the hospitals inspected introduced organisational changes to adapt them to the functioning of the hospital network. As explained, there was no need for this. Only in eight hospitals (27.6% of the inspected entities) did the scope of hospital or outpatient services change. However, these changes were not always positive, as they also concerned the discontinuation of services in specific areas due to a lack of doctors. For example, the Szpital Czerniakowski in Warsaw ceased to provide services in allergological and vascular clinics. The Szpital Miedzyrzecki closed the paediatric nephrology outpatient clinic.
The NIK audit covered 29 units operating within the hospital network, including twelve 1st degree hospitals, twelve 2nd degree hospitals and five 3rd degree hospitals. In order to verify the comprehensiveness of services, a sample of 20 patients discharged from two hospital wards of each therapeutic entity (one conservative and one surgical) in November 2017 and April 2018 was examined (total of 80 patients). We have also written about the impact of the hospital network on the finances of the institutions here.