The regulations appeared in the Official Gazette on Friday, more than three weeks after the Health Minister signed them. And from today - that is, Saturday 4 September - they come into force.
As the MZ informed, the pilot programme will be financed within the financial plan of the National Health Fund. The money will come from the sugar tax. The cost of the pilot programme is expected to be around PLN 70.8 million.
The pilot is expected to last two years and is expected to cover approximately 2 900 patients.
How much the facilities will get for organising comprehensive care for the patient - that is, the valuation was developed by the Agency for Health Technology Assessment and Tarification.
Key terms
1) the first stage of the organisation of the pilot programme concluded by the President of the National Health Fund with the signing of contracts with health facilities, which lasts 3 months from the date of entry into force of the Regulation;
(2) the stage of implementation during which healthcare services are provided under the pilot programme within 24 months of the signing of the contractswhereby treatment bariatric surgery is implemented no later than 12 months before the end of the implementation phase of the pilot programme;
3) Evaluation phase - 3 months after the end of the implementation phase.
From whom do you need to get a referral for bariatric surgery?
The pilot programme is aimed at adults, meaning you have to be at least 18 years old.
Eligibility for the programme and surgery will be on the basis of referral health insurance physician with ICD-10 diagnosis: E66.0 Obesity due to excessive energy intake, eligible for surgical treatment based on the clinical criteria set out.
Apart from age, what criteria do you have to meet to have bariatric surgery "on NFZ"? What BMI do you need to have?
The clinical eligibility criteria for patients to be included in the pilot programme are:
1) BMI ≥ 40 kg/m² in healthcare recipients aged 18 years and over with ICD-10 diagnosis: E66.0 Obesity due to excessive energy intake;
2) BMI of 35-40 kg/m² in recipients for whom surgically induced weight reduction has the potential to improve obesity-related diseases.
Who will be excluded? Can having certain diseases be treated with bariatric surgery? Is planned pregnancy or breastfeeding a contraindication to surgery?
Patients who, although meeting the criteria in terms of BMI, have the following contraindications are not eligible for the pilot programme:
1) incurable diseases leading to cachexia;
2) life-threatening diseases;
3) endocrine diseases providing a substrate for obesity;
4) heavy blood clotting disorders;
5) active alcohol or drug addiction;
6) mental illnesses uncontrollable despite treatment and pharmacotherapy;
7) mental retardation of a severe degree;
8) inability to participate in ongoing long-term follow-up after surgical treatment;
9. the period of 12 months preceding planned pregnancy and the period of pregnancy and breastfeeding;
10) lack of complete conviction about the right choice of surgical treatment;
11) a condition that prevents independent living when the family or social care unit is unable to provide adequate long-term supervision.
Co-ordinated care means that a patient who meets all the criteria will not only have an operation, for example a gastric reduction, but also care before and after. And this will be long-term, including help from a variety of specialists, including, among others, a dietician.
The pre-operative care itself is expected to last between three and six months, during which time a team of specialists in, among others, general surgery, internal medicine or diabetology, anaesthesiology, medical rehabilitation, as well as a physiotherapist, psychologist, dietician, nurse - are expected to prepare the patient for surgery.
What 'slimming' operations is the National Health Service funding under the pilot?
43.71 Partial gastrectomy with anastomosis to the jejunum by Roux-en gastric bypass,
- 43.72 Partial resection of the stomach with anastomosis to the jejunum using the Mini gastric bypass,
- 43.82 Sleeve gastrectomy,
- 44.95 Laparoscopic gastric volume-limiting surgery,
- 44.96 Laparoscopic repeat surgery for gastric restriction,
What about after the operation? How long does the care last?
Patients will also have a follow-up visit after bariatric surgery (7 to 14 days after discharge from hospital).
And they will receive bariatric specialist care (monitoring the effects of the operation) for a further year.
Source: cowzdrowiu.pl