Half of us are killed by cardiovascular disease. Meanwhile, the Ministry of Health wants to reduce funding for the treatment of heart attacks. Cardiac surgeons are outraged, and the department is defending itself and saying that it has the situation under control.
– Why is the ministry saving on Zawałówka? – with this question we turned to the belt spokesman of the ministry. We heard that it is not about saving, but about the sensible allocation of funds. It seems that the idea to save money on some cardiac surgery procedures did not come “out of space”. AOTMiT, i.e. the Agency for Health Technology Assessment, analyzed the data provided by 24 cardiology departments regarding the treatment of as many as 63 thousand five hundred invasive cardiology patients. This helped to calculate costs for doctors, nurses and other personnel, as well as for the maintenance of the required infrastructure in hospital departments. – Based on these calculations, a cost calculation was made – explains Milena Kruszewska, spokeswoman for the ministry. – These activities are to ensure an appropriate allocation of public funds allocated to medical care, proportionate to the scale and importance of health needs – he adds. And he also gives a detailed quote:
One day of a patient’s stay in the cardiology department costs PLN 420, and in intensive cardiology it costs about PLN 689. One hour of work of the hemodynamic laboratory is estimated at PLN 503. – The above calculations are currently the subject of further, in-depth analytical work and consultations conducted by the Minister of Health in order to develop an optimal model of financing cardiological care, including in particular services in the field of invasive cardiology – explains Milena Kruszewska.
What do the doctors say?
– Even if the valuation of some procedures could be reduced, the funds should be used for innovative methods of treatment in cardiology. In the current proposal, it is incomprehensible, for example, a slight increase in expenditure on diagnostics, and a reduction by several dozen percent for treatment! – says prof. dr hab. med. Janina Stępińska, head of the Intensive Cardiac Therapy Clinic at the Warsaw Institute of Cardiology.
After the Ministry of Health announced that it was going to cut funding for cardiological procedures by thirty to sixty percent, the environment of “heart” doctors was in a frenzy. – The proposal to drastically reduce the cost of many procedures by several dozen percent is grossly different from the actual costs of treatment reported by hospitals – says prof. Jacek Legutko from the Polish Society of Cardiology. Another problem is the form in which it takes place: – Changes should be agreed with our environment – adds Prof. Stepińska.
Normality after a heart attack
Mr. Jan from Olsztyn had a heart attack at the age of 40. – Very extensive. I was almost in that world. Doctors saved me. They made me by-passes. I work normally today. I’m a driver. I quit smoking, I can still enjoy life – he says. He adds that his father also had a heart attack at the age of 40, which he did not survive. – If then the doctors had such methods as today, probably my dad would still be alive – he says. – I am eight months after a severe heart attack, the so-called anterior wall, with damage to a third of the ventricle. I’ve got a stent. I returned to normal home activities, I work again, I lost 10 kg, I have cycled about 500 km since the surgery – says Wojtek, a XNUMX-year-old from Krakow.
Ms Ola had a heart attack at the age of 53, two years ago. – I had very unusual symptoms. I just felt stuffy so I wanted to downplay it. Fortunately, my daughter insisted on going to the hospital with me. Doctors saved my life. I am so grateful to them, this year I happily became a grandmother. How i live I am under cardiological control all the time, I control my blood pressure, I make a lipid profile, I take medications. Besides, I live a normal life – says Ms Aleksandra.
Life-saving intervention
A blood vessel in the heart is blocked during a heart attack. In order to locate this place, the so-called coronarography. A thin tube is inserted into the artery in the groin or wrist, which is moved inside the vessel to the heart and given a special contrast. The doctor, thanks to radiological devices, examines the vessels. The contrast filling them shows narrowed or clogged places. In the course of such an examination, a decision can be made on the treatment method, e.g. on angioplasty, i.e. widening of the narrowed area and possible stent placement – a spring supporting the vessel wall, or the necessity to implant the so-called by-passes, i.e. additional vessels bypassing the diseased place. If the infarction did not cause complications, the patient may be discharged home on the third, fourth and fifth day after such surgery.
The development of interventional cardiology in the last 15 years in Poland has reduced the number of deaths due to heart attacks by half. Polish doctors are now able to save most of the patients with a heart attack. This is because Poland has developed a model treatment system on a European and global scale based on a network of over 150 invasive cardiology centers with round-the-clock duty hours, which much richer countries today envy us so much. Thanks to this, a patient with a heart attack in any region of Poland can quickly go to a facility where a procedure to unblock a closed vessel leading blood to the heart will be performed.
Saving on Zawałówka
The valuation of life-saving procedures in interventional cardiology in Poland is lower compared to other European countries. In our country, the average cost of treating acute myocardial infarction is EUR 2395. For comparison, in Estonia twice as much, and in Austria almost five times as much. On the other hand, the treatment of a patient with myocardial infarction, heart failure and haemorrhagic complications is reimbursed in Poland at a rate twice lower than in the Netherlands, Sweden and Great Britain, and four times lower than in Ireland. In addition, there is not enough money for post-heart attack care and rehabilitation. According to prof. Janina Stępińska from the Institute of Cardiology in Warsaw, the outlays on cardiology should not be reduced, because cardiovascular diseases are still the main cause of death in Poles.
Meanwhile, modern treatment allows patients after a heart attack to return to work and normal life activities, and also contributes to the extension of life expectancy. But it costs money, especially maintaining modern treatment rooms, cardiac intensive care units and 24-hour readiness of highly specialized medical teams throughout the country.
– Do we really want to destroy this undoubted success of the Polish health service, which we managed to build with such difficulty and for which the whole of Europe still admires us? – asks prof. Legutko. – Restricting Polish patients’ access to effective treatment of heart attacks will reverse Polish cardiology by 20 years – warn doctors.
The heart attack attacks Poles twice as often as residents of other European Union countries. Much more often than patients from other countries, we die in the first year after a heart attack. On your own wish. Even after undergoing a costly state-funded operation, we do not change our lifestyle. For many patients, even a severe illness is not enough to motivate them to quit smoking, alcohol, change their diet and start playing sports.
Despite these difficulties, Polish cardiologists and cardiac surgeons managed to treat heart diseases at the best European level. Will it still be like this?