Implementation of the Reimbursement Cost of Human-Milk-Based Neonatal Therapy in Polish Health Care Service

Abstract

Background A human-milk-based diet is the best option for nutritional therapy for preterm and/or sick newborns. Research aim The study aims were to restructure the reimbursement rates to hospitals in Poland for infants’ tube feedings to favor the use of donor human milk over formula for newborns who required supplementation of expressed mother’s milk and evaluate the results of the financing change during the first year of implementation (2018). Methods Financial data from hospitals were collected (2015–2016) by the Human Milk Bank Foundation using a data sheet designed by the Agency for Health Technology Assessment and Tariff System. We used data to restructure the reimbursement rates to hospitals for infants’ tube feedings and implemented the changes in late 2017. The National Health Fund was requested to share reported data in 2018 concerning tube feeding services. Results More than half (61%) of NICUs introduced human milk tube feeding for newborns. It was provided to participants ( N = 5,530), most frequently to seriously ill preterm infants (66.6%). Of these infants, 2,323 were fed donor human milk. Only 1,925 newborns received formula tube feeding. However, there were large differences in frequency of services reported among various parts of the country. Conclusions Based on our knowledge, Poland is the only European country where the reimbursement cost for human-milk-based nutritional therapy has been implemented in a manner intended to increase the quality of health care services for preterm newborns. Equal reimbursement for expressed mother’s milk and donor milk did not appear to cause overuse of donor milk based on our analysis of the 2018 data.

Knowledge and Attitudes of Pregnant Women Towards Dietary Supplements and Alternative Medicine for the City of Mosul

“…The largest percentage was off the overweight reason due to the growth of the fetus and hormonal changes in the body, which led to an increase in the size of the breast and uterus and an increase in the volume of blood and amniotic fluid. A difference between these findings can only be attributable to those studies conducted by Wesołowska in Poland:(43%) for BMI (25-29.5) kg/2m,18% for BMI (25 -29.9) kg/2m and(39%) for BMI (30-39.9) kg/2m (15) .The current results demonstrated that based on a questionnaire about dietary supplements, the highest percentage of supplement use was according to recommendations( 49.2%) by family to use nutritional supplements. According to their experiences and beliefs (40.8), E. Luay, S. H. Almukhtar P J M H S Vol.…”

The legislative framework of donor human milk and human milk banking in Europe

“…Our data revealed that a third party payer reimburses those costs for the procurement of DHM in only three out of 10 countries (France, Austria, and Poland). However, actual costs may only be partially refunded to the facility responsible for milk bank operations (Wesolowska et al, 2020). Since we demonstrated that the overwhelming majority of European HMBs are operated by neonatal departments, our data indicate that the respective health care facility covers the costs of its DHM services and for establishing HM banks.…”

“…Our data revealed that a third party payer reimburses those costs for the procurement of DHM in only three out of 10 countries (France, Austria, and Poland). However, actual costs may only be partially refunded to the facility responsible for milk bank operations (Wesolowska et al, 2020). Since participating countries compared to the potential number of eligible infants.…”

Versorgungsstrukturen und Betreibermodelle: Chancen und Herausforderungen des Frauenmilchbankwesens in Deutschland

“…Die fehlende Kostenerstattung der Bereitstellung von Frauenmilch spiegelt sich in europäischen Nachbarländern wider 12 . Nach einer aktuellen Erhebung erfolgt eine anteilige Kostenerstattung nur in drei europäischen Ländern, entweder abhängig von der Zahl der versorgten Neugeborenen oder von der generierten Menge Frauenmilch 5 .…”