The OECD experts appraise positively the progress in the form of increasing public expenditures on health, but they also point out several challenges related to the efficient use of these funds. Among them is the excessive focus on reparative medicine with negligible expenditure on prevention, as well as an oversupply of hospital beds that could be used to build a new strategy in long-term care. In this area, the OECD points to the need to build a long-term strategy that will help respond to the dynamically growing needs of the aging population. This also applies to building a workforce for the sector.
“Poland has made significant progress in terms of health outcomes. From 2000 to 2022, life expectancy increased by five years. People in Poland are living longer than ever before. However, life expectancy is still below the OECD average and below the levels achieved in some neighboring countries. There are also many negative health effects and diseases associated with cardiovascular diseases and malignant tumors. To some extent, they can be prevented and treated with the support of appropriate policies. Therefore, a greater emphasis should be placed on prevention and limiting behavioral risks among the population in Poland, such as alcohol consumption and smoking,” says Zuzana Smidova, senior economist at the OECD.
The report shows that almost half of all deaths are caused by cardiovascular diseases such as ischemic heart disease, hypertension, and stroke. They occur 50% more often than the average in OECD countries. Cancer is the cause of about one fifth of deaths, and the mortality rate from them is higher than for the entire group of OECD countries. Over two fifths of all deaths are linked to smoking, alcohol consumption, and low physical activity. The experts indicate that these risk factors can be reduced by actions for public health.
“We can also increase taxes on health-harming products such as alcohol and tobacco products. Another option is limiting the hours when these harmful products can be purchased. We should also continue preventive actions, informing society about the associated risks and health threats,” adds Zuzana Smidova.
The OECD report states that access to healthcare in Poland is good. The authors note that health services funded by public money are comprehensive, e.g., primary and specialized healthcare, emergency care, and palliative care. They also positively evaluate the availability of drugs.
“Expenditure on healthcare in Poland was previously low, but now we see their growth. A good news is the political agreement to increase public healthcare expenditure to 7% of GDP by 2027. It is a value similar to the OECD average and growth compared to 2023, when expenditure was almost 6% of GDP. It is important to efficiently use these funds,” says the OECD economist.
However, health care system specialists point out that the proportion of services related to reparative medicine is too high in comparison to expenditure on prevention. According to Eurostat, in our country only about 22 euros per person is earmarked for it, making it the lowest result in the European Union, almost ten times lower than the EU average. Meanwhile, well-organized prevention is necessary to early detect diseases and treat them effectively, as far as possible on an outpatient basis, rather than within hospitalization.
The OECD assesses that the Polish hospital sector, which plays a significant role in the health care system, is relatively large but inefficient. In public hospitals, which account for 2/3 of the sector and 90% of available beds, there were almost five beds per 1000 inhabitants and the occupancy rate was 71% (data for 2022), which is about 10 percentage points less than in countries such as Switzerland or the United Kingdom. In the opinion of experts, this indicates a significant oversupply of beds.
“We should take a closer look at the network of hospitals and how it relates to the needs for healthcare in different regions in order to use the oversupply of beds for long-term care purposes in Poland. We know that there are shortages in this area in Poland given the aging population. In addition, as society becomes wealthier, we see an increase in the use of health care services, including long-term care. Therefore, more such facilities will be needed. We suggest that Poland develop a more comprehensive network of long-term care that will cover both institutional and home care,” emphasizes Zuzana Smidova.
The OECD report shows that in 2021 Poland spent 0.5% of GDP on long-term care, one of the lowest scores in the organization, with the average for all countries being 1.7%. The supply of long-term health and social care services is low and unable to meet the existing demand. The OECD estimates that about 40% of older people have unmet needs in this area, more than in other EU countries. The number of beds in stationary long-term care facilities is about four times lower than the OECD average. This means that only 1% of older people are under the care of long-term care institutions compared to the OECD average of 11.5%.
“The development of long-term health care is important because the number of older people and life expectancy are increasing. Many people need care towards the end of their lives, so it is important to maintain an appropriate number of places, which Poland should address. We know that the Ministry of Health is already working on a relevant reform. Healthy ageing is also important. As life expectancy increases, prevention becomes more important to prevent diseases from developing at an early stage of life, thus generating higher costs at a later age,” says the expert.
The OECD report also notes the number of long-term care workers, which is five times smaller than in other countries, significantly limiting the availability of institutional and home care services. This in turn means that care for seniors is usually taken over by family members, mostly women. Availability of personnel is also a problem in other areas of the health care sector. In 2022 there were 3.5 practicing doctors per 1000 inhabitants, close to the OECD average, and 5.7 nurses, compared to an average of about 10. The numbers of dentists and pharmacists are also below average. At the same time, health care and social care staff worked longer hours than workers in these sectors in other OECD countries (39.1 hours per week, 4.5 hours more than average). Experts point out that increasing the number of medical personnel is one of the most serious challenges for the Polish health care sector. Especially as the demand for additional staff will grow dynamically (over three times faster than in EU countries).
