Course: Reimbursement systems
Reimbursement systems constitute an important element of contemporary health care systems and a significant economical, social and political factor in each country. However, the structure of the reimbursement system and its place in the health care system vary between countries. Differences are related to reimbursement, management of conflicts of interests, and decision-making authorities. In each system there are particular problems associated with recommendations, regulations, reimbursement decisions and types of institutions, procedures and documents.
Knowledge concerning systems introduced in other countries allows for better understanding of the Polish reimbursement system and prediction of its development.
Knowledge concerning the role of HTA in Poland and the national HTA agency (the AHTAPol), the structure of Polish reimbursement lists and procedures of appeal from reimbursement decisions is essential for maximum efficacy of activities aimed at obtaining reimbursement and avoiding problems in the context of current Polish legislation.
Intended participants
Representatives of public institutions responsible for health protection.
Key abilities
After completing this course, the participant will be able to:
- describe the specificity of reimbursement systems in various countries and the structure, rules of financing, various methods of settlement and affluence of a specific system,
- compare the reimbursement systems in selected countries with Polish solutions,
- define basic criteria of reimbursement and pricing in selected countries, with respect to both outpatient and inpatient care,
- present the role of health technology assessment from the perspective of the payer, the patient and the drug manufacturer,
- describe changes in the reimbursement procedure introduced by the ?package act?,
- use the knowledge concerning requirements and necessary procedures to develop a reimbursement application having a maximum chance of success and conforming to legal acts remaining in force,
- learn the course of assessment of a specific report by the AHTAPol, know its legal consequences and appeal from the decision.