Clinical and health care aspects of respiratory tract disorders in Poland

Krzysztof Kanecki 1  ,  
Department of Health Care, Medical University of Warsaw, Poland
Department of Family Medicine, Medical University of Warsaw, Poland
Ann Agric Environ Med 2016;23(1):125–128
Respiratory diseases constitute a public health priority worldwide. This is related to the increasing exposure to microorganisms, toxic factors, allergens, drugs and smoking, as the most important factors. Increasing costs of health promotion, prevention, diagnosis and treatment of respiratory tract diseases forces the search for effective strategies in the reduction of costs without making a significant impact of these activities on health results. Chronic obstructive pulmonary disease (COPD) is an example of these diseases with increasing incidence, which has few known modifiable factors and absorbs large medical and social costs.

The aim of this study is to present the conception of cost driver analysis that could be useful in constructing a good combination of the EBM-based treatment with cost reduction decisions.

Material and Methods:
Analysis of cost drivers was based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines and Polish recommendations of COPD diagnosis and treatment. The proposition of cost reduction strategy in COPD treatment was based on identification of cost drivers in value chain conception.

Results and Conclusions:
An increasing incidence and treatment costs of COPD force the search for methods of costs reduction in health care. Identifying, evaluating and modifying the cost drivers with use of the value chain conception could be an effective method in achieving these objectives.

Krzysztof Kanecki   
Department of Health Care, Medical University of Warsaw, Poland
1. ECHI Report. European Community Health Indicators. http://ec.europa.eu/health/major_chronic_diseases/indicators/index_en.htm (access: 2012.11.16).
2. Zieliński J, Bednarek M, Górecka D. National Program of Early Detection and Prevention of COPD in the years 2000–2002. Pneum Alerg Pol. 2005; 73 (2): 116–121.
3. Kuna P, Pierzchała W, Jankowski M. Astma i POChP w pytaniach i odpowiedziach. Kraków. Med Prakt. 2008.
4. Lopez AD, Shibuya K, Rao C, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J. 2006; 27: 397–412.
5. Matters CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006; 3:e442.
6. National Institute of Public Health – National Institute of Hygiene. The health status of the polish population. http://www.pzh.gov.pl/page/fileadmin/user_upload/PZH_Raport_2008.pdf (access: 2012.11.13).
7. Jahnz-Różyk K, Targowski T, From S. 2008. Porównanie kosztów leczenia umiarkowanych i ciężkich zaostrzeń przewlekłej obturacyjnej choroby Płuc w Polsce w warunkach ambulatoryjnych i szpitalnych. Pneumonol Alergol Pol. 2008; 76: 426.
8. Jahnz-Różyk K, Targowski T, From S, Faluta T, Borowiec Ł. Koszty leczenia zaostrzeń przewlekłej obturacyjnej choroby płuc w warunkach ambulatoryjnych i szpitalnych w roku 2007. Pol Merk Lek. 2009; 26: 208–14.
9. Andersson F, Borg S, Jansson S, et al. The cost of exacerbations in chronic obstructive pulmonary disease (COPD). Respir Med. 2002; 96: 700–8.
10. Global Initiative for Chronic Obstructive Lung Disease – GOLD. http://www.goldcopd.org/uploads/users/files/GOLD_Pocket_May2512.pdf (access: 2012.11.17).
11. Pierzchała W, Barczyk A, Górecka D, Śliwiński P, Zieliński J. Zalecenia Polskiego Towarzystwa Chorób Płuc rozpoznawania i leczenia przewlekłej obturacyjnej choroby płuc. Pneumonol Alergol Pol. 2010; 78, 5:318–347.
12. Rekomendacje postępowania w pozaszpitalnych zakażenia układu oddechowego. 2010. http://www.antybiotyki.edu.pl/pdf/RekomendacjeA42009.pdf (Access: 2012.10.23).
13. Jassem E, Batura-Gabryel H, Cofta S, Doboszyńska A, Farnik M, Górecka D, et al. 2012. Recommendation of Polish Respiratory Society for palliative care in chronic lung diseases. Pneumonol Alergol Pol. 2012; 80, 1: 41–64.
14. Zasady Interwencji Antytytoniowej. Kolegium Lekarzy Rodzinnych w Polsce. http://www.klrwp.pl/file/zasady_interwencji_antytytoniowej.pdf (access: 2012.11.1).
15. Halpern M, Mitchell K, Bakst A, Schmier J. The economic impact of acute exacerbations of chronic bronchitis in the United States and Canada: a literature review. J Manag Care Pharm. 2003; 9: 353–9.
16. Tyszko P. Cost drivers in primary care of patients with chronic diseases. Przew Lek. 2010; 2: 188–192.
17. Porter ME. Competitive Advantage: Creating and Sustaining Superior Performance. The Free Press, New York 1998; 33.
18. Vestbo J, Anderson W, Coxson H, Crim C, Dawber F, Edwards L, et al. Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE). Eur Respir J 2008; 31:869–873.
19. Monso E, Ruiz J, Rosell A, Manterola J, Fiz J, Morera J, et al. Bacterial infection in chronic obstructive pul monary disease: a study of stable and exacerbated outpatients using the protected specimen brush. Am J Respir Crit Care Med. 1995; 152: 1316–20.
20. Strauss M, Conrad D, LoGerfo J, Hudson L, Bergner M. Cost and outcome of care for patients with chronic obstructive lung disease: analysis by physician specialty. Med Care. 1986; 24: 915–24.
21. Anthonisen N., Skeans M, Wise R, Mafreda J, Kanner R, Connett J. Lung Health Study Research Group. The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med. 2005; 142: 233–239.
22. Seemungal T, Harper-Owen R, Bhowmik A, Moric I, Sanderson G, Message S, et al. Respiratory viruses, symptoms, and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001; 164: 1618–1623.
23. Voogd J, Wempe J, Koeter G, Postema K, Sonderen E, Ranchor A, et al. Depressive symptoms as predictors of mortality in patients with COPD. Chest, 2009; 135: 619–625.
24. Croft M. Palliative care in end-stage COPD. Br J of Gen Pract. 2005; 55: 234–235.
25. Miravitlles M, Sicras A, Crespo C, et al. Costs of Chronic Obstructive Pulmonary Disease in Relation to Compliance With Guidelines. Ther Adv Resp Dis. 2013;7(3):139–150.
26. Boulhol, H. et al. (2012), “Improving the Health-Care System in Poland”, OECD Economics Department Working Papers, No. 957, OECD Publishing. http://dx.doi.org/10.1787/5k9b7bn5qzvd-en (access: 2014.03.12).
27. Ruchlin HS, Dasbach EJ. An economic overview of chronic obstructive pulmonary disease. Pharmacoeconomics 2001; 19(6): 623–642.