This paper is aimed at exploring the role of the HB-HTA ecosystem as an important pathway for popularizing the implementation of innovations in healthcare organizations. The scientific debate has largely been focused on the rising importance of HB-HTA and the principles guiding the process. Solutions implemented by individual countries differ, which may be rooted in historical, cultural, and institutional differences. Our understanding of the impact of individual countries’ healthcare systems on HB-HTA solutions and infrastructure still lacks a basis in interpretative studies. A conceptual framework is proposed to assess the aptness of the HB-HTA model designed for hospitals operating in a country or region, focused on the concepts of adaptiveness and responsiveness to features of the healthcare system present there. A tool is proposed for investigating factors that are likely to assist the successful implementation of the HB-HTA ecosystem. A dynamic SWOT analysis on the case of the HB-HTA model designed for Poland provides interesting insights into the building of the conceptual framework. The results of this study help explain how to create an HB-HTA model that is best adapted to the regional or national healthcare system, including potential risks and opportunities.

Background: Over 300,000 cataract operations are performed in Poland every year, and the most common, late complication of cataract removal surgery is posterior capsule opacification (PCO). The risk of PCO depends on the lens material. Hydrophobic acrylic lenses cause PCO less frequently as lymphatic endothelial cells show lower affinity for the surface of the lens made of silicone. The objective of this study is to assess the economic impact of using hydrophobic acrylic lenses compared to using hydrophilic acrylic lenses for cataract treatment in the Polish inpatient and outpatient settings.Methods: A budget impact analysis (BIA) compared the economic outcomes associated with using hydrophobic acrylic lenses versus using hydrophilic lenses for patients undergoing cataract surgery. The BIA predicted annual expenses in the following scenarios: performing Nd:YAG to treat PCO within 2 and 3 years after implantation of hydrophobic or hydrophilic acrylic lenses for different lens structure. Data used to assess the frequency of PCO was determined in systematic literature review. Costs of current and predicted interventions were estimated based on average data from 19 Polish hospitals. Prices of health services were taken from official public tariff lists.Results: The use of a hydrophobic lens significantly limits the number of complications after cataract surgery relative to a hydrophilic lens. As hydrophobic lenses have a higher unit price their use increases the cost of treatment which currently is not reflected by adequate difference in price of the service. Total annual National Health Fund (NHF) expenses for 3-year follow-up model range from 139.1 million EUR to 143.1 million EUR depending on the lens structure, due to the cost of complications.Conclusions: BIA indicates the possibility of introducing surcharge for the use of hydrophobic lenses, which could increase the frequency of their use and reduce the number of complications after cataract surgery. It was estimated that total NHF expenses reach the minimum value for the surcharge at the level of 9 EUR. The surcharge of 14 EUR is the maximum value that does not increase the initial NHF expenses.

The aim of this article is to assess the cost accounting solutions that are used currently in Polish hospitals. The evaluation covered three main areas that require cost data—management, external reporting and pricing of health services (performed by a regulatory body). The study concerned the costing model that was obligatory for Polish public hospitals in the years 1998–2011 (top-down micro-costing model) and has not yet been replaced by another solution. Different research methods have been used for each of the areas under research, inter alia surveys, direct interviews and case study methods. Empirical results indicate a limited usefulness of the researched costing model in all of the evaluated areas: management, financial reporting and pricing. First, the costing model is used moderately only for the most important management areas, such as planning, control and operational decision making. Second, it does not include the specifics of diagnosis-related groups (DRGs) (basic pricing object) and therefore does not allow for accurate determination of their costs. Third, due to lack of the complex costing methodology the model is used in an unstructured and incoherent manner.

The functional model of Hospital-Based Health Technology Assessment with coordinating role of the Polish National Health Fund The article presents the concept and the conduct of the HB-HTA (Hospital-Based Health Technology Assessment) project implementation with coordi­nating role of the Polish National Health Fund. The main stakeholders of the HB-HTA process were identified, together with their interests and barriers in the area of the implementation of HB-HTA in Poland.