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Abstract 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.

Introduction: The new regulations called the “oncological package” were implemented in Poland on 1 January 2015. The issuance of the Diagnosis and Oncological Treatment Card initiates a path of rapid diagnosis and therapy. The new regulations also encompass the diagnostic process in suspected thyroid carcinoma, which is the leading endocrine gland cancer. In 2014, 162 new cases of thyroid cancer were noted in Świętokrzyskie Province in Poland. Before the rapid diagnostic procedure is implemented, the risk of malignancy must be evaluated, which is of particular importance in the case of suspected carcinoma of the thyroid gland due to the great prevalence of benign thyroid nodules. The risk of thyroid carcinoma is evaluated by the analysis of the medical history and proper interpretation of ultrasonographic images of focal lesions. Aim: The aim of this study was to analyse the knowledge of primary care physicians about clinical and ultrasonographic features of high-risk thyroid tumours and to assess whether the Diagnosis and Oncological Treatment Card is used correctly for initiation of a rapid diagnostic process in patients with suspected thyroid carcinoma. Material and methods: The analysis involved the results of thyroid ultrasound scans and medical history data collected during the first visit from all patients who, in the period from 1 January 2015 to 30 September 2016, were referred to the Department of Endocrinology of Świętokrzyskie Oncology Centre with the Diagnosis and Oncological Treatment Card issued by a primary care physician due to a suspicion of thyroid cancer. The authors evaluated the presence of clinical or ultrasonographic features of high-risk thyroid tumours. The analysis involved records of 95 patients. Results: None of the patients presented clinical features of thyroid carcinoma. The phenotype of focal lesions represented high-risk features in merely 21% of the patients; the most common ultrasonographic feature was hypoechogenicity (70% of patients). Oncological diagnostic procedures (fine-needle aspiration biopsy) confirmed a malignancy in only 1 case; it was a patient with high-risk ultrasonographic features (1/20 patients – 5%). None of the patients with a benign phenotype was diagnosed with thyroid carcinoma. Conclusions: 1) The Diagnosis and Oncological Treatment Card is not used properly by primary care physicians in the diagnosis of thyroid lesions. 2) When issuing the Diagnosis and Oncological Treatment Card, primary care physicians do not use the knowledge about clinical or ultrasonographic features that suggest a high risk of malignancy.

The aim of this report is to describe the series of training sessions for primary health care (PHC) physicians that concerned “oncological sensitivity” and were organized in the Holycross Cancer Center (HCC) in the first quarter of 2015. The purpose of the training sessions was to present the guidelines of the oncological fast-track system and the practical information with respect to disturbing symptoms of the disease and the necessary diagnostics directed at verifying the suspicion of various types of cancer. This knowledge allows the proper implementation of the tasks entrusted to the family doctor as part of the Oncological Package. Practical training (medical) was conducted by specialists working in several different clinics within the Holycross Cancer Center. The theme of the meetings covered all types of cancer, from solid tumors of various locations to tumors of the hematopoietic system.