Over the past twenty years, the Polishhealth system has undergone several deep systemic changes.Poland spends more of its healthcare budget on inpatienthospital care than comparable countries, signaling an areaof inefficiency that requires reform ahead of demographictrends. Ownership of public hospital facilities isfragmented between different levels of government, leadingto multiple stakeholders and a lack of accountability.Poland has made significant progress in rationalizing itshospital system and reducing the number of beds, but thereform agenda remains unfinished as evidenced by thecontinuing debt issue. This note outlines a path toimproving the financial sustainability of the hospitalsector in Poland. The anatomy of the debt problem isexamined and major obstacles to financial health aresystematically reviewed. The root causes of barriers areanalyzed from a managerial as well as a health systemperspective, including the role of regulatory and financingconstraints. In making the case for change, the report alsodiscusses how secular trends, for instance in populationhealth and service delivery, need to be taken into accountas plans to reshape the hospital system are beingformulated. Preliminary recommendations are madedistinguishing: (i) system-level changes which will requirenational-level policy interventions, and (ii) options forVoivodships and facility managers to work better within theexisting system and enhance the chances of selecting noregret move investments.
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