Concentration of Inpatient Health Care Providers in Poland

The purpose of this study is to measure the concentration level of inpatient health care providers such as general hospitals, psychiatric hospitals, chronic medical care home, nursing homes, hospices in Poland, which will allow to identify inequities to access to inpatient health care services. The Herfindahl-Hirschman Index (HHI) was used to investigate the concentration level of the inpatient health care providers sector in Poland, which is also treated in the literature as a proxy of competition. To understand how market of each particular inpatient health care providers has become structured and thus competitive the data for inpatient health care providers spanning all Poland for the period of 2010-2017 were collected. The concentration of inpatient health care providers was measured based on the aggregated data at the voivodeship level and for general hospitals, it was measured separately 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 Data are collected from the public statistical system. The HHI indices support the assertion that in the period of analysis the entire inpatient health care providers sector in Poland has not been at average concentrated – apart from the nursing homes where the moderate level of concentration was identified. Moreover, the increase of HHI in analyzed period in case of hospices and chronic medical care homes can be troublesome, because it can signal of growing concentration in the future and then getting also less competitive. However, concentration of general hospitals when analyzed at the lower level of hospital structure appeared uneven.