Outpatient Spine Surgery in Poland: A Survey on Popularity, Challenges, and Future Perspectives.

"Disclosure The authors report no conflicts of interest in this work."

"Public health care in Poland is financed primarily by the National Health Fund (NHF), which determines the amount of reimbursement of drugs, procedures, etc. and sets the conditions necessary to receive them and limits on the permissible number of procedures performed. Currently, the NHF does not reimburse spine surgeries performed in outpatient care and only allows reimbursement of treatment costs in the case of hospitalization lasting several days. Furthermore, by applying homogeneous patient groups, the system even stimulates hospitals to artificially prolong hospitalizations to achieve the highest reimbursement level. For instance, the performance of a decompressive spinal operation with a three-day hospitalization cost about 3000 euros, while additional single day in hospital increases the price to 4500 euros. These mechanisms may discourage further adoption of outpatient spine surgery in Poland."