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District hospitals under the magnifying glass of the NIK. Couldn't be worse?

MedExpress Team

Published Aug. 30, 2023 08:43

District hospitals under the magnifying glass of the NIK. Couldn't be worse? - Header image
As many as 217 audit conclusions and almost PLN 500 million in financial consequences of irregularities - these are the results of an NIK audit of the operation of district hospitals in 2020-2022. The district hospitals audited had problems with balancing their operations. And this is just the tip of the iceberg.

As of mid-2022, there were 313 county hospitals providing health care services financed by the National Health Fund. The number of county hospitals located in the country varies widely: the smallest are in Lubuskie Voivodeship (8), and the largest in Mazowieckie Voivodeship (44).

According to the NIK, the main problem hindering the operation of district hospitals is their deteriorating financial situation, manifested, among other things, in rising debt. According to data from the Ministry of Health, in 2019-2021, the total liabilities of district hospitals steadily increased and amounted to more than PLN 6 billion, nearly PLN 6.9 billion and less than PLN 7.3 billion, respectively. At the same time, the maturing liabilities of county hospitals over these years amounted to - respectively - about PLN 803 million, PLN 724 million and almost PLN 602 million. As of June 30, 2022, the total liabilities of county hospitals exceeded PLN 7.3 billion, including maturing liabilities of nearly PLN 777 million.

Finance on target

Due to the declaration of an epidemic state, the way hospitals are financed has changed, which has helped improve the financial performance of district hospitals. In 2019-2021, the total revenues of the hospitals audited by the NIK gradually increased and amounted to more than PLN 1.6 billion, PLN 1.9 billion, almost PLN 2.4 billion (an increase of more than 46%), respectively, and at the end of the first half of 2022 exceeded PLN 1.1, billion. While in 2019 only eight of the audited hospitals achieved a positive financial result, in 2020 there were already 13, and in 2021. - 16. The most profitable organizational units of the audited hospitals were departments established in connection with the COVID-19 epidemic state. At the same time, a negative phenomenon related to the COVID-19 epidemic was noted: in 2020, compared to 2019, the total number of inpatients and the total number of outpatients decreased (by 37.5% and 23.5%, respectively).

In contrast, already after the first half of 2022, only three audited hospitals recorded a net profit, while 19 incurred a net loss. According to the NIK, the financial problems of district hospitals will further worsen in response to mandatory salary increases for medical staff.

Order of access to benefits according to clear rules - up to 4 years in the queue

The audited hospitals determined the order of patients' access to medical services based on clear and transparent rules, in accordance with the Law on Patients' Rights. The largest number of people in stable condition waited for services in outpatient specialized care (AOS) to outpatient ...

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