Analysis of health care resources concentration in Poland
The aim of this study is to measure the concentration level of health care resources such as the doctors, nurses with midwives, outpatient entities and general hospital beds in Poland. It will also allow to identify inequities to access to these resources and thus also to health care services. The Herfindahl-Hirschman Index (HHI) was employed to measure the concentration level of the health care resources in Poland. The data for these health care resources spanning all Poland for the period of 2013-2017 were collected. The concentration of health care resources was measured in each of the 16 voivodeships in Poland based on the aggregated data at the powiat level. This approach arises from the limitation in the availability of data, which was collected from the public statistical system. The HHI indices support the assertion that in the period of analysis the entire general hospital beds, doctors and nurses with midwives sectors in Poland have been at average moderately concentrated and thus moderately competitive with the growing tendency to higher concentration and less competitive. The sector of outpatients entities appeared to be mainly unconcentrated. Moreover, the concentration of all health care resources is diversified across the voivodeships of Poland and it is quite uneven, which can limit the access to health care services.
Triotree. 2019. http://triotree.com/blog/healthcare-primary-secondary-and-tertiary-brief-description/ accessed on 01/12/19)
WHO. 1948. Constitution of WHO Available online: http://apps.who.int/gb/bd/PDF/bd47/EN/constitution-en.pdf?ua=1 (accessed on 12/28/18)
WHO. Making fair choices on the path to universal health coverage. Final report of the WHO Consultative Group on Equity and Universal Health Coverage, World Health Organisation 2014.
WHO. Universal Health Coverage. Available online: https://www.who.int/health systems/universal_health_coverage/en/ (accessed on 12/10/18)
Rój J., Znaczenie czynnika finansowego w rozwoju technologii medycznych w klinice uniwersyteckiej (Wydawnictwo UEP, 2011).
Culyer, A.J., Newhouse, J.P. The human capital model Michael Grossman, Handbook of Health Economics. Elsevier: 2005 348-408.
PBMCHHEALTH (2018). The Difference Between Inpatient and Outpatient Care, Available online:
https://www.pbmchealth.org/blog/difference-between-inpatient-and-outpatient-care/ (accessed on 12/21/18)
MZ. 2018. Ministry of Health. Available online: https://www.gov.pl/web/zdrowie; (accessed on 12/10/18).
Kaczmarek T., Marcinkowski J.T., Żyznarska M., Maksymiuk T., Majewicz A., Nierówności społeczne w dostępie do zdrowia, Probl. Hig Epidemiol., 88(3), 2007, 259-266
WHO. Universal Health Coverage. Available online: https://www.who.int/healthsystems/universal_health_coverage/en/ (accessed on 12/10/18).
Rój J., The Cost Efficiency of Hospitals in Poland in Zoe Boutsioli (ed),Themes on Health Care: Challenges and Future Actions, Athens: ATINER, 2009, 306-320.
Statistic Poland (2013-2017). Polish Statistical Yearbook. Available online: https://stat.gov.pl/obszary-tematyczne/ludnosc/powierzchnia-i-ludnosc-w-przekroju-terytorialnym-w-2018-roku,7,15.html. (accessed on 12/10/18)
Rój J. Relationship between Funding Mechanism and Service Effectiveness of Hospital. In:J. N. Yfantopoulos (ed), The economics of health reforms, Athens: ATINER. 2004, 507-518.
Rój J. , The Cost Efficiency of Hospitals in Poland in Zoe Boutsioli (ed),Themes on Health Care: Challenges and Future Actions, Athens: ATINER. 2009, 306-320.
Mossialos E., Health Systems in Transition Vol.13 No. 8; Poland. Health system review. European Observatory on Health Systems and Policies. 2011, Available online: http://www.euro.who.int/__data/assets/pdf_file/0018/163053/e96443.pdf (accessed on 12/22/18);
Kuszewski K., Gericke Ch., Health systems In transitions Poland, WHO 2005. 130.
Balázs N., Improving the allocation of health care resources in Poland. Available online:
ua=1; (accessed on 12/10/18)
Sagan A., Sobczak A. (2014). Implementation of the 2011 Therapeutic Activity Act: Will commercialization improve the financial performance of Polish hospitals?, Health Policy, 118 (2), 153-158.
Siedlecki R., Bem A., Prędkiewicz P., Ucieklak-Jeż P, Measures of hospital’s financial condition – empirical study. Strategica. Local versus global. International academic conference. 2015, 666-675.
Gaynor M, Town RJ., Competition in Health Care Markets. In: Pauly MV, Mcguire TG, Barro PP, eds. Handbook of Health Economics. Vol 2. Elsevier;: 2011, 499-637.
Schmid A., Ulrich V., Consolidation and concentration in the German hospital market: The two sides of the coin, Health Policy 109. 2013, 301-10.
Ucieklak-Jeż P., Bem A., Siedlecki R., Prędkiewicz P. , Concentration of Hospital Infrastructural Resources as a Source of Inequalities in Access to Health Care Benefits in Poland. In: Bem A., Daszyńska-Żygadło K., Hajdíková T., Juhász P. (eds)
Finance and Sustainability. Springer Proceedings in Business and Economics. Springer, 2018, 1-10.
Statistics Poland. Local Data Bank . Available online; http://stat.gov.pl/bdlen/app/dane_podgrup.hier? p_id=25991&p_token=2128957222 (access: 1/20/19).
Tiemann O., Schreyögg J.,Effects of ownership on hospital efficiency in Germany. Business Research; 2(2). 2009, 115-145
Pan J., Qin X., Li Q., Messina J.P., Delamater P.L., Does hospital competition improve health care delivery in China? China Economic Review 33. 2015, 179-199.
Hirschman A.O. The paternity of an index, American Economic Review 54 1964.
Herfindahl O.C. Comment on Rosenbluth’s measures of concentration, in: Business Concentration and Price Policy, G. Stigler, ed., Princeton University Press, Princeton 1955.
Ucieklak-Jeż P. , Income and education as a source of health inequality. New UE Countires Case. Prace Naukowe Uniwersytetu Ekonomicznego we Wrocławiu. Research Papers of Wrocław University of Economics nr 510. 2018. 181-192.
Rój J., Competition measurement of hospitals in Poland: the Herfindahl-Hirschman index approach, Ekonomika Vol. 95 Iss.1, 2016, 166-181.
Rhoades S.A. The Herfindahl-Hirschman Index, Federal Reserve Bulletin, Vol.79, No.3 . 1993, 188-189.
Baker L.C. , Measuring Competition in Health Care Markets, Health Services Research, 36(1), 2001, Part II.223-51.
Copyright (c) 2019 EPH - International Journal of Medical and Health Science (ISSN: 2456 - 6063)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
- All contributor(s) agree to transfer the copyright of this article to EPH Journal.
- EPH Journal will have all the rights to distribute, share, sell, modify this research article with proper reference of the contributors.
- EPH Journal will have the right to edit or completely remove the published article on any misconduct happening.