Analiza systemu wyceny usług ambulatoryjnej opieki specjalistycznej w Polsce po 2011 roku na tle rozwiązań zagraniczych i modeli teoretycznych
Analysis of the Pricing System of Specialist Ambulatory Health Services in Poland on the Background of Foreign Solutions for and Model Theory

Summary/Abstract: The article attempts to characterize the pricing of specialist outpatient services in Poland. As a point of reference were taken theoretical considerations on the diagnosis-related groups and the impact of the construction of the system on the severity of drawbacks, which are mentioned in the literature. Also the foreign pricing models were presented. Pricing of specialist ambulatory services in Poland was modelled on solutions that exist e.g. in England or the United States. They are based on the system of diagnostic groups. Unfortunately, the analysis indicates that the clinical and cost uniformity of groups, which determine proper functioning of the system, are preserved only to a limited degree. Compared with most foreign models it can also be noted, that Polish system lacks incentives for complex treatment and that the payer takes discretionary approach to setting prices. In most of the analysed countries prices are formulated based on costs of service providers.

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