Towards Financial Sustainability of the Hospital Sector in Poland—A Post Hoc Evaluation of Policy Approaches

Abstract

In Poland, as well as in many other countries around the world, hospitals constitute the cornerstone of health care provision. In 2020, hospitals stand at the frontline of the fight with the coronavirus pandemic, and are facing huge pressures. The issue of supporting the financial sustainability of the hospital sector has become especially important. The objectives of this study were to: (1) Provide a retrospective evaluation of the reforms aimed at improving the financial sustainability of hospitals in Poland, adopted and implemented within the last two decades (2000–2019), and (2) identify the main drivers of hospitals’ financial standing. A longitudinal analysis (2003–2018) of the stock of public hospital debt in Poland was also conducted. Methods applied included statistical data analysis and literature review. Results indicate that diverse top-down approaches (debt-relief programs with restructuration or corporatization elements as well as hospital network reform) provided limited results in terms of the improvement of the individual hospitals’ financial standing. The reasons for the reforms’ failures were mixed. Public hospitals operate under a unique and complex system of regulations with diverse external stakeholders and/or determinants influencing hospital revenues and cost generation. A more comprehensive and evidence-based approach is needed in developing policies aimed at supporting hospitals’ financial sustainability in Poland.