How much can we learn from each other? Polish and Hungarian good practices in financing ophthalmology care as a proposal for implementation in Ukraine

TL;DR

This paper compares ophthalmology care financing in Hungary, Poland, and Ukraine to find good practices that Ukraine can adopt during its healthcare reforms.

Contribution

The study identifies specific financing practices for eye treatments that could be implemented in Ukraine based on Hungarian and Polish models.

Findings

Hungary and Poland use DRG-based systems but differ in ophthalmology care delivery and financing.

Financing schemes influence treatment volumes and access to care, with Poland focusing on hospital care and Hungary on ambulatory care.

Ukraine can benefit from adopting incentivized quality improvements and flexible reimbursement strategies observed in the other two countries.

Abstract

The article aims to compare payment schemes for cataract, glaucoma, vitrectomy, cornea transplantations, DME, and AMD across Hungary, Poland, and Ukraine, and to identify implementable practices in Ukraine within the context of ongoing healthcare reforms.

Researchers used mixed-method research–with legal documents and data analysis on utilisation of ophthalmology services between 2010 and 2019 and in-depth semi structured interviews with fifteen health experts from Hungary, Poland, and Ukraine. Interviewees, five from each country, were representatives from healthcare providers and payers with at least 10 years’ experience in ophthalmology care and knowledge about financing schemes in each country of residence.

We identified significant differences in healthcare delivery and financing of ophthalmology services between Hungary and Poland, despite both countries rely on Diagnosis-Related Group (DRG) based systems for hospital care. Good practices for financing specific eye treatments like cataract, glaucoma, age-related macular degeneration (AMD), diabetic macular edema (DME), cornea transplantations, and vitrectomy are identified. The financing scheme, including financial products and incentives, can influence the volume of treatments. Access to ophthalmic care is a key concern, with differences in treatment schemes between Hungary (ambulatory care) and Poland (hospital care), leading to higher costs and the need for centralization of complex procedures like cornea transplantations.

The article highlights the importance of incentivizing quality improvements and removing financial barriers in Poland, while Hungary should focus on continuous monitoring of treatment methods and flexibility in reimbursement. For Ukraine, the research findings are significant due to ongoing healthcare reform, and the country seeks optimal practices while considering the experiences of other countries.