In 1994, a second committee was convened with the aim of eliciting public preferences which up to that time were not reflected at all in the process. Therefore, these value assessment methodologies are inadequate and at best partial because the evaluation criteria used to assess evidence and determine value are incomplete. dialysis services or transplantation); different diseases (e.g. Some initiatives have invested in collecting and compiling regional and national data to enable better country contextualization of decisions.15,17 However, there has been less emphasis on local processes for collecting necessary data and for deriving and implementing decisions including health benefits packages, which comprise a set of selected essential services that is provided by partially or fully publicly subsidized funds.18 As a result, many technically-focused efforts at priority-setting carry the risk of imposing opportunity costs in the form of reductions in potential health.19,20 A recent WHO resolution21 supports local capacity strengthening and local determination of health priorities. Similarly, through waiting times or ability to pay, priorities can be implemented in an implicit and hence intrinsically unaccountable way. The European Journal of Health Economics. Glassman A, Sakuma Y, Vaca C. Priority-setting processes for expensive treatments in cardiometabolic diseases. Bulletin of the World Health Organization. London: Primary Care Trust Network, the NHS Confederation; 2007. However, recently more and more Polish citizens are employed on the basis of civil law contracts; in these contracts, for specific tasks and contracts of mandate, contributions are not paid. They need to outline the principles, such as equity, efficiency, financial protection and sustainability that are driving factors or products of UHC development. These efforts have mostly focused on technical ways of defining specific interventions or technologies as priorities for all to adopt or on developing whole lists or packages of recommended cost–effective interventions. Washington: World Bank; 1993. Health Care Philos. However, research on monitoring and evaluation of priority-setting processes is scarce. The intent of the process is to replace behind the scenes advocacy and lobbying with explicit analysis and strong governance. (ranked 17th) of the 26 Med. However, attention should be paid on the theoretical foundations of decision theory and particularly in the required properties the criteria need to possess in order for the analysis to be robust and results useful to decision‐makers (Angelis and Kanavos, 2016b; Del Rio Vilas et al., 2011; Keeney, 2002). The reforms of the healthcare system in Poland were initiated in 1989 along with the reforms of the national economy. It is also important that evidence generated is comparable across interventions. While different stakeholders may have contrasting capacities and therefore varying contributions at each stage of the process, experiences indicate that broad stakeholder participation, especially engaging civil society and the public, is important for long-term sustainability of the process.24, As countries’ health burdens evolve and new technologies are developed, identifying appropriate topics for consideration at the right time is crucial. This might be connected with the fact that Polish citizens drink more strong alcohols and beer than an average European and far less wine. (eds. Forthcoming. Aris Angelis is a Research Officer at the Medical Technology Research Group of LSE Health and a PhD candidate with the department of Social Policy. https://doi.org/10.1007/s10198-016-0831-0, DOI: https://doi.org/10.1007/s10198-016-0831-0, Over 10 million scientific documents at your fingertips, Not logged in While the global community has long recognized the importance of preferentially subsidizing cost–effective health interventions and products for UHC, there is still insufficient emphasis on building national capabilities that can set priorities. 2012 Sep-Oct;15(6):961–70. 41, 489–507 (2010), Article  This section briefly covers the practical steps for priority-setting, building on a guidebook currently being developed.18,22 Although these steps can be applied to many areas, to maintain the focus of priority-setting for UHC, the development of a benefits package will be used as an example. In order to take care of the patients that will not only ensure them treatment in accordance with laws of the medical profession but will also offer them access to novel technologies, latest therapies, modern medicaments and innovative ways of treatment, and proper resources are required, which, as it has already been presented, in Poland are very much limited. PubMed Google Scholar. Due to public dissatisfaction of the emerging services, however, the methodology was modified to include more broadly defined criteria. Forthcoming. Hospitals are heavily in debt; in the first quarter of 2014, the sum of public hospital debts amounted to PLN 9.924 billion (Central Statistical Office). Moreover, a specific model of human behavior and the current hierarchy system, so much suppressed or even misshaped in the second half of the 20th century in Poland, have resulted in numerous consequences in the areas such as professional ethics of doctors, mutual patient-doctor relationships, or widely understood sector management. The existence of one institution that finances health care services, which requires extensive knowledge on the scope of health needs of communities from various regions of the country and also the knowledge on supply capacity of the health care sector, appears to be a utopian idea to implement if the system is organized in this way. Identifying Key Factors Related to the Resource Allocation in the Health Sector of the Iranian Oil Industry: Application of DIMATEL Method. The groups responsible for generating the evidence should have academic integrity and limited conflicts of interest. There have been major global efforts to inform global and country decisions in health, including the World Health Organization’s (WHO’s) CHOICE initiative. It was only following the introduction of explicit efforts in other countries and particularly the New Zealand experience (which by some was perceived to be more suitable for the British environment due to its ‘pragmatic’ rather than ‘principle’ based approach), that the debate in the United Kingdom clearly leaned in favour of priority setting (Ham, 1996; Klein, 1995, 1998; McKee and Figueras, 1996; Turnberg et al., 1996). Furthermore, it has been claimed that the QALY is ‘beset by methodological problems about the valuation of different states of health, by lack of data about incomes, and by the problem of patient heterogeneity’ (Klein, 1993, p. 310). Despite constant growth of indexes reflecting the health status of Polish society, such as life expectancy, quality of life, or decreasing index of deaths at birth, just as in the majority of European countries, in Poland the society is growing older, which implies the necessity to reorganize the system. Puzzling out Priorities. A methodological approach is needed for allocating health care resources in an efficient and fair way that gives legitimacy to decisions. The report outlines ten priorities for commissioners to help them drive forward health care change. Rockefeller Foundation, New York, USA.d. Better priority-setting can constructively channel the many and growing competing demands and calls for action in health. Development of explicit criteria for nomination of topics can encourage stakeholder participation in the process. Commentary: An interactive decision-making framework (i-DMF) to scale up maternity continuity of carer models. Philos. However, it had been argued that the QALY is flawed as a way of priority setting in health care (Harris, 1987) and that it only partly reflects an individual's true preferences (Mehrez and Gafni, 1989). included the context data for other articles of a similar age. The scope for setting priorities is also an important factor. Some initiatives have invested in collecting and compiling regional and national data to enable better country contextualization of decisions. Many authorities assign a group of stakeholders to take part in making decisions. Trends in Polish healthcare 2017 We present key trends in Polish healthcare for 2017, along with our recommendations. Thinking about rationing. Youngkong S, Baltussen R, Tantivess S, Mohara A, Teerawattananon Y. Multicriteria decision analysis for including health interventions in the universal health coverage benefit package in Thailand. It is a way of eliciting preferences for a set of options which are characterised by varying levels of performance and with respect to a number of, often conflicting, objectives; it does so by disaggregating a complex problem into simpler components or objectives, measuring the performance of options against the objectives, weighting up these objectives according to their relative importance, and re‐assembling the components by aggregating scores and weights to show the overall picture (DCLG, 2009; Raiffa, 1968).