One-day hospitals are appreciated by patients, because in comfortable conditions, without waiting, they can benefit from the highest quality medical services. However, today the future of many such institutions is in question.
The firsthospitals in one daywere established 10 years ago and fit well into thehe althcare system . But today it is not known what their future will be, because on November 3, 2011, the then minister of he alth signed a draft regulation changing the requirements that hospitals must meet in one day to apply for a contract withNFZ . In short, hospitals - largely private - have very high demands on equipment, the organization of operating theaters and the qualifications of their staff. Another blow for these institutions was the decision of the President of the National He alth Fund to suspend the implementation of contracts, including those signed before 2011, for several years.
One-day hospital - quick treatments without lying in the ward
One-day hospitals have modern equipment and employ carefully educated medical staff. - One-day hospitals have their own base and provide services every day, not from time to time - explains Andrzej Mądala, president of the management board of Mavit Medical Center. - The organizers, or rather the owners, take full responsibility for the quality of the service, and thus for the safety of patients - he adds. These hospitals do not perform all types of medical procedures, but that was the assumption when they were organized. The medical offer of hospitals in one day is rich. Some perform minor procedures, while others offer more serious ophthalmic surgery (e.g. cataract removal, retinal virectomy), oral surgery, ENT, orthopedics, cardiology, and organ surgery. Here you can operate on a hernia, varicose veins, gallbladder, remove tonsils and breast lumps. Usually these are treatments that are waiting for months or even years in state institutions. One-day operations are of great interest. A stay in a hospital that is not a pleasant experience, a long sick leave, is avoided. Such an operation does not interfere with life, there is no stress caused by separation from the family, which is especially important when the patient is a small child or a person inelderly.
One-day hospital - the myth of treating he althy patients
- One-day hospitals are accused of building their careers on easy patients, i.e. people who need to undergo a simple procedure that does not involve the risk of complications - says Andrzej Mądala. - Unfortunately, this view has many supporters, but it is far from the truth - he says. Before each procedure, tests are carried out to answer the question of whether a particular person - taking into account his general he alth condition, comorbidities, etc. - can undergo surgery during one day. If we suspect that there may be complications (for various reasons) and the patient will have to stay longer in the hospital, we refuse the procedure. It has nothing to do with our convenience. We are aware of the risk. We will not expose the patient to the deterioration of his he alth, and ourselves to the troubles that may result from it. There are treatments that, for medical reasons, should not be performed as part of one-day surgery. We stick to it and do not take unnecessary risks.
One day hospital - where a reliable economic bill
- The basis for the operation of one-day hospitals are contracts with the National He alth Fund - explains the president of CM Mavit. - On the fingers of one hand, you can count those that can survive without contracts. But these institutions are not treated in the same way as public institutions that carry out the same activities. This is an ongoing problem called subject equality. If a private one-day hospital signs a contract for PLN 1 million, the same state hospital will easily obtain an incomparably larger contract. In 2010, the National He alth Fund spent nearly PLN 26 billion on hospital treatment, of which a little over PLN 1.5 billion was allocated to the implementation of contracts with all types of private hospitals. 476 private hospitals signed contracts with the National He alth Fund. Only half of them had contracts in excess of PLN 1 million. - One-day hospitals operate cheaper and there are specific calculations for that - emphasizes Andrzej Mądala.
- A public hospital receives a few hundred zlotys more than a one-day operation for the same elective surgery, but when the patient is hospitalized for only 1-3 days - the value of the treatment is even higher. I believe that one-day hospitals should provide services that can be safely performed there. Public hospitals - poviat, voivodeship or university clinics - should offer a different range of medical services. I am thinking of complicated, difficult and high-risk operations. For their work, these hospitals should be paid high enough rates so that they do not seek benefits fromperforming minor procedures that do not require the involvement of intensive care units or the long stay of the patient in the hospital - emphasizes Andrzej Mądala.
One-day hospital - attention to quality
Private hospitals are an opportunity not only for patients, but also for young, though sufficiently experienced doctors, who can improve their skills here. What's more, it is often here that they learn proper management, proper management of the patient and the latest surgical techniques.
- I am opposed to hospitals that rely on occasional rented operating rooms in public hospitals, where patient care is questionable - he says Andrzej Wisala. - That blurs the responsibility. In our hospital, we can effectively take care of the sanitary regime, good equipment, and experienced specialists. If we are to improve the quality of services provided by medical entities, this rule should apply to all types of facilities. Meanwhile, the sanitary ordinance of November 2011 imposed strict requirements only on establishments providing one-day services. I am far from judging colleagues who run public hospitals. They do not have an easy life, but since we all care for the sick, the same rules should apply to us, also in terms of sanitary regulations, which should be met by all he alth care facilities.
One day hospital - uncertain future
The ordinances of the minister of he alth and the ordinance of the president of the National He alth Fund will probably contribute to the collapse of some private hospitals in one day. Not all owners will be able to build new operating blocks within a few months. Technically, it is possible, because there is a company that builds hospitals
from ready-made modules, but the construction costs are considerable. One-day hospitals are needed by patients and the he alth care system. They all have, or can have, significant benefits from their functioning. However, the game must be clean, because unfortunate administrative decisions will hit primarily patients, people who want to solve their he alth problems quickly, safely and in good conditions.