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The Ministry of Health wants to introduce new rules for the diagnosis and treatment of breast cancer. The procedure for granting rehabilitation to women who are struggling with this disease will also change. The list of medical specializations that entitle to referral has been shortened.
According to the Ministry of Health, the assumption of the new draft regulation is to increase the transparency of the current regulations and to eliminate interpretation doubts. The amendment is to improve access to rehabilitation as part of cooperation with the Breast Cancer Competence Center.
The Ministry of Health’s draft appeared in the Government Legislation Center and was sent for public consultation.
Changes in conditions, increased scope of benefits
What will change?
According to the amendment to the regulation, the malignant neoplasm was deleted from the list of diagnoses qualifying the patient for healthcare services without specifying its location, but two new points were added to it:
- other postoperative disorders of the circulatory system, not elsewhere classified,
- postoperative disorders of the circulatory system, unspecified,
A medical consultation and a physiotherapeutic visit were added to the scope of services.
Required clarified the type and scope of the referral. It was determined that the referral for rehabilitation in preparation for the treatment of upper limb lymphoedema or upper limb lymphoedema after breast cancer treatment concerns day, inpatient or outpatient conditions.
Specified minimum durations of physiotherapeutic procedures (15-20 min), the use of specialized kinesiotherapeutic methods and manual therapy, anti-edema prophylaxis and general conditioning exercises (treadmill, cycloergometer, stepper) were taken into account.
The draft regulation will change the time conditions for the performance of the benefit:
- the commencement of the provision of the benefit within a specified period results from the purpose of rehabilitation and the clinical condition of the recipient and takes place before the start of treatment or immediately after discharge, or within 21 days from discharge after surgical treatment in order to prevent the development of edema and restore the efficiency of the upper limb, body statics (chest and trunk),
- delivery time for each recipient is determined individually by a doctor or an authorized physiotherapist providing services in a day ward, inpatient department or outpatient physiotherapy,
- in the period before the commencement of surgical treatment, a series of treatments including up to 10 treatment days (once),
- in the early period after surgical treatment, a series of treatments including 10 – 20 days of treatment (once),
- in the late period after surgical treatment, a series of treatments covering 10 – 20 treatment days (once).
Certificates for physiotherapists, more equipment in rehabilitation rooms
The project also increased the requirements of medical personnel. Physiotherapists would have to have a certificate recognized by the Polish Society of Physiotherapy confirming their skills in the field of comprehensive anti-swelling therapy. The requirement to provide services by an occupational therapist was also reduced from ½ to ¼ of a full-time job.
From the list of doctors authorized to issue a referral for rehabilitation, the doctor of the internal medicine ward was removed.
In the draft regulation the list of medical devices has been clarifiedwhich rooms providing rehabilitation services should be equipped with. According to the new rules, they will include:
- kinesiotherapy devices – mirrors, mattresses, exercise sticks, light balls, high wedges, massage rollers, treadmill,
- equipment for edema therapy – device for intermittent pneumatic compression with pressure regulation to min. 150 mmHg and sets of multi-chamber cuffs,
- a table, a therapeutic couch or a bed for manual lymphatic drainage,
- a set of compression bandages of various sizes and materials (short stretch or long stretch) for compression together with equipment for multi-layer bandaging,
- a set of compression sleeves to be put on after the end of the therapy in order to maintain the effects of the therapy, only for demonstration.
Are you afraid of cancer? Take a blood test and discuss the results with your doctor: Cancer – risk assessment for women (Cała Polska)