Poland: #31 in the 2024 World Index of Healthcare Innovation

Introduction

Poland ranked second to last in the World Index of Healthcare Innovation (31st) with an overall score of 37.18. It ranks 25th in Choice and is the lowest at 32nd in Science & Technology, attributed to inadequate patient-centered care, insufficient infrastructure, and minimal scientific contributions.

A notable aspect of Poland’s socialized healthcare system is its relative financial stability, ranked 13th in Fiscal Sustainability. The system’s stringent price controls and limited access help moderate spending growth, albeit at a significant expense to patient care.

Background

Poland’s healthcare system has undergone significant transformations over the past century, shaped by its geopolitical changes. Before World War II, much of what is now Poland was under German jurisdiction and followed the healthcare framework established by Otto von Bismarck in 1883, which was among the first to implement a social insurance-based system. Following the war, the shift in borders placed Poland under Soviet influence, leading to the adoption of the Soviet healthcare model. This system featured centralized and state-owned health insurance and healthcare services.

After the fall of communism in 1989, Poland initiated a series of reforms to decentralize and modernize its healthcare. While the government maintained ownership of most hospitals and clinics, management responsibilities were delegated to the regional level, known as voivodeships. The National Health Fund (Narodowy Fundusz Zdrowia, NFZ) was established and remains the sole payer within the government-run health insurance system, which is primarily funded through payroll and individual tax contributions.

Today, Poland employs a universal healthcare system primarily funded through the NFZ. The NFZ contracts with healthcare providers and sets the reimbursement rates for medical services, ensuring that all citizens have access to necessary healthcare services. Significant investments in healthcare infrastructure and technology have been made to improve efficiency and patient care.

Poland spends approximately 6.7 percent of its GDP on healthcare, which amounts to around $26 billion annually. The country has around 6.2 hospital beds per 1,000 inhabitants, higher than the EU average of 5.3. The healthcare workforce includes approximately 2.4 doctors and 5.1 nurses per 1,000 people, reflecting ongoing efforts to address workforce shortages and improve care delivery.

Recent reforms have further focused on enhancing primary care, preventative services, and digital health initiatives. For instance, e-prescriptions have been widely implemented, with over 90 percent of prescriptions now being issued electronically, improving efficiency and patient safety. These initiatives reflect Poland’s ongoing commitment to adapting to contemporary healthcare challenges and needs.

Dimension Performance

Quality

Poland ranks 26th in Quality. Poland’s quality rankings are driven lower by multiple elements, including measures of preventable disease (28th), infrastructure (25th), and pandemic preparedness and response (30th). However, Poland made significant strides in patient-centered care, rising to 13th from 31st in 2021. The boost in patient-centered care scores stemmed mainly from improvements in the time required to see a physician, patient safety, and transparency.

Choice

Poland’s healthcare system is ranked 25th for Choice. Although it boasts one of the lowest pre-subsidy health insurance costs globally, the system is structured around a single-payer model, which notably affects the quality and availability of care. Additionally, the options for choosing physicians are highly restricted; patients may only change their primary care physician once every six months. While the availability of innovative medicines is comparable to that in countries like Sweden and Australia, this advantage is undermined by limited access to more affordable biosimilar medications.

Science & Technology

At 32nd, Poland ranks at the bottom of the countries in the Index for Science and Technology. Development in medical and scientific innovation, particularly in the fields of medicine and biochemistry, is limited. Despite this, Poland fares somewhat better in medical advancements, ranked 22nd, largely due to a significant number of innovative drug approvals as a member country of the European Medicines Agency. However, it continues to be positioned at the bottom in the areas of scientific discoveries and health digitization, both ranked 32nd.

Fiscal Sustainability

Despite some shortcomings, Poland’s healthcare system is ranked 13th in the Index for Fiscal Sustainability. The country maintains a manageable national solvency, ranking 15th with a debt-to-GDP ratio of 53.7 percent. Over the past decade, Poland has also curtailed its public health spending, ranked 16th, alongside a reduction in the growth rate of this spending, now ranked 19th.