Zdrowie Publiczne 2008 118(4);487-492 Review Article
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The evolution of Contracting of Specialist Services in Poland in years 1999-2007
The main idea of the paper is to show the changes that were taking place for 9 years (1999-2007) in the process of contracting and conceptualization of the contracted product in the fi eld of out-patients department specifi c needs and the pricing of contract.
On the 1st January 1999 in Poland the reform of medical- health care system came into effect. It was based on the act of 6th February 1997 about common health-care insurance.
By virtue of the Act, 17 National Health Services were the executors of this reform and their functioning was to be monitored by Health Insurance Supervision Offi ce. The Act of Common Health Insurance made public and private subjects equal, giving them the opportunity of competing for contracts with National Health Services and then with National Health Fund.
The contracts were to be entered upon in negotiations and after the competition of offers had been realised. The competitions of offers were to result in real medical service market. In consequence it should have helped the best subjects to develop in the market and favour their stabilization. However the subjects that were not meeting patients’ and payer’s needs were to be eliminated from the market. Such stabilization could favour investments both in the capital of a given health care unit and in its human resources.
The method of contracting services in ambulatory specialist care and then in specialist ambulatory services was changing slightly at the time of the next medical-health-care reforms launching. Well-defi ned changes took place only in the conditions of offering service and the methods of advice qualifi cation. Despite of many errors, launching of health services contracting is a positive step on the way to better functioning of this area of health-care in our country.