Tag: Dominik Dziurda

Index assessment of outpatient physiotherapy financed from public funds at the disposal of the National Health Fund provided in 2017–2019 in Poland

Zbigniew Tytko, Dominik Dziurda, Dorota Mańkowska, Agata Bąk, Katarzyna Leoszkiewicz, Katarzyna Kędzior, Piotr Bednarski, Roman Topór-Mądry


Zbigniew Tytko, Dominik Dziurda, Dorota Mańkowska, Agata Bąk, Katarzyna Leoszkiewicz, Katarzyna Kędzior, Piotr Bednarski, Roman Topór-Mądry – Index assessment of outpatient physiotherapy financed from public funds at the disposal of the National Health Fund provided in 2017–2019 in Poland. Fizjoterapia Polska 2022; 22(1); 152-158

Abstract
Introduction. Our study aims to present the state of Polish outpatient physiotherapy covered by the National Health Fund (NHF) based on a set of original indices to parametrise the structure of services and the physiotherapy process.
Materials and methods. The study used the NHF reporting data on outpatient physiotherapy collected between January 2017 and October 2019. The analysis used a set of originally developed indices.
Results. Of all outpatient physiotherapy cycles, generally provided on consecutive working days, 70% lasted 10 days and 84% were provided to patients without a formal confirmation of severe disability. From the patient’s perspective, 41% of the time of services is provided in a one-on-one basis (index of the structure of services), while the kinesiotherapy accounted for 30% of total time of services. The dominant group of services, about 70% in quantitative terms, is physical therapy.
Conclusions. To satisfy the health needs of patients by publicly funded outpatient physiotherapy is still a challenge and creates a perspective to develop a new way of organising and financing outpatient physiotherapy. The proposed indices of service structure and process enable an accurate diagnosis of the current situation, development of optimal system solutions and monitoring their implementation.
Key words:
physiotherapy, index, population-based, real world data
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Conceptions of the provision of physiotherapy care financed with public funds of the National Health Fund in the perspective of demographic changes

Dominik Dziurda, Dorota Mańkowska,Zbigniew Tytko, Piotr Bednarski, Katarzyna Leoszkiewicz, Agata Bąk, Katarzyna Kędzior, Roman Topór-Mądry

Dominik Dziurda, Dorota Mańkowska,Zbigniew Tytko, Piotr Bednarski, Katarzyna Leoszkiewicz, Agata Bąk, Katarzyna Kędzior, Roman Topór-Mądry – Conceptions of the provision of physiotherapy care financed with public funds of the National Health Fund in the perspective of demographic changes. Fizjoterapia Polska 2021; 21(3); 52-67

Abstract
Introduction. In 2018, outpatient physiotherapy financed by the National Health Fund (pl. Narodowy Fundusz Zdrowia, NFZ) was provided to 2.6 million patients, i.e. approx. 6.8% of Poland’s population with 128 million services and expenditures amounting to PLN 937 million. The unmet demand for physiotherapy services expressed in terms of waiting times, given the pressure of the ongoing demographic changes, is becoming an increasingly serious challenge for the public healthcare system. International experience suggests that changing the organisation and functioning of physiotherapy could improve its efficiency.
Aim of the study. The study aims to outline the prospects for optimal physiotherapy care provision (organisational and financial framework) within the public funds at the disposal of the National Health Fund (NFZ).
Materials and methods. The sources of data for the analyses were: the database of NFZ services, demographic data and projections of Statistics Poland (pl. Główny Urzad Statystyczny, GUS), literature on the subject and reports concerning organisational solutions. Demographic projections for the country until 2030 (GUS) were used for estimating the demand for outpatient physiotherapy services
Results. Individuals aged 60 and older account for more than half of patients in outpatient physiotherapy (OP). In the perspective of the next decade, the proportion of patients aged ≥ 60 will increase by another 11%. The presented concept of Primary Physiotherapy Care (PPC) involves the cooperation of Primary Healthcare (PHC) with outpatient physiotherapy. PPC assumes the shift of the provided treatment from the provision of single treatments or cycles to physiotherapy care and a population-oriented approach.
Conclusions. The direction of physiotherapy care evolution should take into account different perspectives: (1) patient’s perspective: a) tailoring the therapeutic process to the patient’s condition, b) implementing the process in accordance with available scientific evidence and clinical guidelines,
c) patient’s share in the responsibility for his or her health condition; (2) healthcare provider’s perspective: a) orienting towards achieving therapeutic effect (value), instead of orientation towards the provision of treatment, b) increasing the independence of physiotherapists as therapy managers,
c) adapting human resources and premises to increased patient population and to the structure of treatments provided according to the guidelines,
d) using new forms of therapy: education, instruction, learning self-care at home; (3) payer’s perspective: a) departing from a fee-for-service system towards financing the therapy/care instead, b) introducing indicators for adjusting the amounts of financing from public funds depending on measurable therapeutic effects.
Key words:
primary physiotherapy care, outpatient physiotherapy
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