Ten-year retrospective comparative analysis of inpatient and outpatient care utilization patterns in Polish healthcare
Abstract
Introduction and purpose: Ambulatory healthcare plays a crucial role in the overall healthcare system,
providing a range of services that are designed to be delivered on an outpatient basis. Offering preventive
care, health education, managing chronic diseases and non-life-threatening urgent situations may alleviate
the burden on hospitals and provide high-quality, time- and cost-effective healthcare system. In this study
authors conduct a retrospective comparative analysis of inpatient and outpatient healthcare trends based
on data provided by the Central Statistics Office of Poland for a ten-year period between 2012 and 2022
Material and methods: This retrospective study was conducted using publicly available healthcare data
sourced from databases provided by the Central Statistics Office of Poland.
Results: The analysis revealed a significant increase in the average annual number of outpatient visits per
person (6.69 ± 0.39 vs. 7,70 ± 0.56; p < 0.001) and a decrease in annual hospitalizations per person
(0.20 ± 0.02 vs. 0.18 ± 0.02; p < 0.001) during the past decade. In addition, significant increase in the
annual number of visits per person to both specialists (2.66 ± 0.36 vs. 2.99 ± 0.55; p < 0.001) and general
practitioners (4.04 ± 0.26 vs. 4.71 ± 0.34; p < 0.001) were noted. Noteworthy, in Mazowieckie Province
data revealed a distinct healthcare service utilization pattern with more frequent specialist care and less
frequent primary care outpatient visits in comparison with other Polish provinces. During the COVID-19
pandemic, a substantial decrease in both hospitalization rates (0.19 ± 0.02 vs. 0.15 ± 0.01; p < 0.001) and
outpatient visits (4.57 ± 0.25 vs. 4.13 ± 0.26; p < 0.001) per person has been noted across whole country.
Conclusions: This study indicates a significant shift in healthcare utilization patterns towards outpatient
services, and a corresponding decline in hospitalization rates during the past ten years across Poland.
Keywords: public healthambulatory healthcarehealthcare utilization patternPolish healthcare
References
- Schuettig W, Sundmacher L. The impact of ambulatory care spending, continuity and processes of care on ambulatory care sensitive hospitalizations. Eur J Health Econ. 2022; 23(8): 1329–1340.
- Talbird SE, Carrico J, La EM, et al. Impact of Routine Childhood Immunization in Reducing Vaccine-Preventable Diseases in the United States. Pediatrics. 2022; 150(3): e2021056013.
- Yedlapati SH, Khan SU, Talluri S, et al. Effects of Influenza Vaccine on Mortality and Cardiovascular Outcomes in Patients With Cardiovascular Disease: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2021; 10(6): e019636.
- Laditka JN, Laditka SB, Probst JC. More may be better: evidence of a negative relationship between physician supply and hospitalization for ambulatory care sensitive conditions. Health Serv Res. 2005; 40(4): 1148–1166.
- Preitschopf A, Holstege M, Ligthart A, et al. Effectiveness of outpatient geriatric rehabilitation after inpatient geriatric rehabilitation or hospitalisation: a systematic review and meta-analysis. Age Ageing. 2023; 52(1): afac300.
- Soucier RJ, Miller PE, Ingrassia JJ, et al. Essential Elements of Early Post Discharge Care of Patients with Heart Failure. Curr Heart Fail Rep. 2018; 15(3): 181–190.
- Reynolds R, Dennis S, Hasan I, et al. A systematic review of chronic disease management interventions in primary care. BMC Fam Pract. 2018; 19(1): 11.
- Randall S, Crawford T, Currie J, et al. Impact of community based nurse-led clinics on patient outcomes, patient satisfaction, patient access and cost effectiveness: A systematic review. Int J Nurs Stud. 2017; 73: 24–33.
- Heisler M, Lapidos A, Kieffer E, et al. Impact on Health Care Utilization and Costs of a Medicaid Community Health Worker Program in Detroit, 2018-2020: A Randomized Program Evaluation. Am J Public Health. 2022; 112(5): 766–775.
- Tan LF, Kreston J. Cost-effective ambulatory care for emergency department avoidance. J Urgent Care Med. 2022; 16(10): 25–32.
- GUS. https://bdl.stat.gov.pl/bdl/start (17.03.2024).
- van der Pol M, Olajide D, Dusheiko M, et al. The impact of quality and accessibility of primary care on emergency admissions for a range of chronic ambulatory care sensitive conditions (ACSCs) in Scotland: longitudinal analysis. BMC Fam Pract. 2019; 20(1): 32.
- Hodgson K, Deeny SR, Steventon A. Ambulatory care-sensitive conditions: their potential uses and limitations. BMJ Qual Saf. 2019; 28(6): 429–433.
- Phillips CD, Truong C, Kum HC, et al. The Effects of Chronic Disease on Ambulatory Care-Sensitive Hospitalizations for Children or Youth. Health Serv Insights. 2019; 12: 1178632919879422.
- Walewska-Zielecka B, Religioni U, Soszyński P, et al. Evidence-Based Care Reduces Unnecessary Medical Procedures and Healthcare Costs in the Outpatient Setting. Value Health Reg Issues. 2021; 25: 23–28.
- Birkmeyer JD, Barnato A, Birkmeyer N, et al. The Impact Of The COVID-19 Pandemic On Hospital Admissions In The United States. Health Aff (Millwood). 2020; 39(11): 2010–2017.
- DiFazio LT, Curran T, Bilaniuk JW, et al. The Impact of the COVID-19 Pandemic on Hospital Admissions for Trauma and Acute Care Surgery. Am Surg. 2020; 86(8): 901–903.
- Wells RD. Ambulatory care in interventional radiology: a framework for radiology day-case. Clin Radiol. 2022; 77(7): 489–495.
- Cruz L, Grullón-Rodríguez H, López-Bencosme Y, et al. Ambulatory Percutaneous Coronary Angioplasty: a safe resource for low income countries. Medical Research Archives. 2023; 11(10): 1–8.
- Nordin AB, Shah SR, Kenney BD. Ambulatory pediatric surgery. Semin Pediatr Surg. 2018; 27(2): 75–78.
- Shariat A, Marcus B, Latmore M. High turnover for ambulatory orthopedic surgery. Curr Opin Anaesthesiol. 2021; 34(5): 659–665.
- Skues M. Emergency ambulatory surgery: Can it work? Best Pract Res Clin Anaesthesiol. 2023; 37(3): 387–395.
- Kim K, Moody P. More resources better health? A cross-national perspective. Social Science & Medicine. 1992; 34(8): 837–842.
- Zimlichman E, Nicklin W, Aggarwal, R, et al. Health Care 2030: The Coming Transformation. Catalyst Non-Issue Content, 2(2). NEJM Catalyst. 2021.
- Jeong HKi, Park C, Henao R, et al. Deep Learning in Dermatology: A Systematic Review of Current Approaches, Outcomes, and Limitations. JID Innov. 2023; 3(1): 100150.
- Batsis JA, DiMilia PR, Seo LM, et al. Effectiveness of Ambulatory Telemedicine Care in Older Adults: A Systematic Review. J Am Geriatr Soc. 2019; 67(8): 1737–1749.
- Ruberti OM, Yugar-Toledo JC, Moreno H, et al. Hypertension telemonitoring and home-based physical training programs. Blood Press. 2021; 30(6): 428–438.
- Kennel PJ, Rosenblum H, Axsom KM, et al. Remote Cardiac Monitoring in Patients With Heart Failure: A Review. JAMA Cardiol. 2022; 7(5): 556–564.
- Wammes JJ, van der Wees PJ, Tanke MAC, et al. Systematic review of high-cost patients' characteristics and healthcare utilisation. BMJ Open. 2018; 8(9): e023113.
- Paul MC, Dik JWH, Hoekstra T, et al. Admissions for ambulatory care sensitive conditions: a national observational study in the general and COPD population. Eur J Public Health. 2019; 29(2): 213–219.
- Dantas I, Santana R, Sarmento J, et al. The impact of multiple chronic diseases on hospitalizations for ambulatory care sensitive conditions. BMC Health Serv Res. 2016; 16(a): 348.