Patients have been waiting for this refund for years. "Up to 3,000 women require surgery annually"
- In the new model, care for patients with endometriosis will be provided at two levels
- In advanced cases, women will be referred to specialist centres for free surgical procedures.
- - Up to about 40 percent of patients with endometriosis suffer from an advanced form of the disease, which means that every year 2.5 to even 3 thousand women require surgery - enumerates prof. Wender-Ożegowska in an interview with Rynek Zdrowia
- The expert hopes that the new model will also speed up the diagnosis of the disease. - The estimated waiting time for a diagnosis is currently 6 to 8 years from the first symptoms to appear - she calculates
Women suffering from endometriosis can count on free, comprehensive and specialist treatment from July this year. On Tuesday (July 1), the regulation of the Minister of Health in this matter came into force. It provides for a new model of free diagnostics and treatment of patients with this condition. It is to provide a full spectrum of therapy - from diagnostics, through conservative and surgical treatment, to rehabilitation and dietary advice.
It also introduces a new procedure to the list of guaranteed benefits in the scope of hospital treatment: excision of the intrauterine adenomyosis focus from the pouch of Douglas.
We discussed the changes being introduced, among others, during the June Women's Health Forum organized at the International Congress Center in Katowice. According to the national consultant in the field of obstetrics and gynecology , Prof. Ewa Wender-Ożegowska, this is a great progress in the care of patients with endometriosis.
- Endometriosis treatment was reimbursed, especially when it comes to initial diagnostics, but due to organizational issues, treatments for already developed endometriosis were often not performed in National Health Fund centers - explains the expert.
In the new model, patient care will be provided at two levels. In the first, pharmacological treatment will be provided by gynecological and obstetric clinics, and in cases of deep endometriosis, women will be referred for surgical procedures. Importantly, this will also apply to situations where the changes occur outside the reproductive system, e.g. in the intestines or urinary system.
The regulation coming into effect in July precisely specifies what standards regarding staffing and equipment the facilities will have to meet in order to provide comprehensive treatment of endometriosis, including its most advanced form, at the expense of the National Health Fund .
Patients with the most advanced stage of the disease have numerous and extensive endometrial changes and adhesions within the organs in the pelvis and beyond. According to the consultant, this form of the disease affects as many as 40% of patients, which means that as many as 2.5 to 3 thousand women a year require surgery.
The new model of care is also expected to speed up diagnosis of the disease, which currently leaves much to be desired.
- Unfortunately, the estimated waiting time for a diagnosis is 6 to 8 years from the first symptoms. This is due to various reasons, including the fact that endometriosis is an insidious disease. It does not cause one characteristic symptom. It is accompanied by pain, bloating, and there may be symptoms related to menstruation, spotting between periods, which is why many other causes are often sought. The worst thing is that endometriosis often affects young girls, in whom neither their parents nor their doctor suspect it at all - says Prof. Wender-Ożegowska.
The expert emphasizes that the centers that will enter the system will have appropriate diagnostic tools and personnel with certificates confirming their skills in both diagnostics and surgical treatment.
- This is a very narrow group of specialists, but I hope that thanks to the establishment of the centres, patients will have access to the best and most modern therapies. Not only in terms of surgical treatment, but they will also be provided with psychological and physiotherapy care and will receive recommendations for further treatment - says Prof. Wender-Ożegowska.
Medical entities that wish to treat patients with endometriosis within the model of comprehensive specialist care financed by the National Health Fund will have to submit documents confirming that the conditions specified in the regulation have been met to the provincial branch of the National Health Fund by 10 November each year . The Fund, in turn, will have until 10 December to confirm whether the facility meets the criteria.
Endometriosis is when the endometrium (the mucous membrane that naturally lines the uterine cavity) grows outside the uterine cavity, in the peritoneal cavity, ovaries, fallopian tubes, and sometimes also ureters. It is accompanied by pain in the lower abdomen, especially during menstruation, and fertility disorders. Symptoms also include: painful intercourse and digestive tract complaints (bloating, nausea, pain during defecation).
According to data from Jutro Medical, a network of primary care clinics, as many as 83% of patients with endometriosis are aged 19-35. In 76% of cases, the condition occurs as a comorbidity.
The Foundation "Pokonać Endometrióza" has been trying for years to introduce systemic solutions in Poland in the field of treating the disease. The breakthrough was the establishment of the European Endometriosis League in 2005, and the publication at the same time by the European Society of Human Reproduction and Embryology (ESHRE) of treatment recommendations for European gynecologists.
The latest version of the ESHRE recommendation was published in February 2022. Over time, this has had an impact on the situation in the country. The Polish Society of Gynecologists and Obstetricians has developed national standards that indicate the path of diagnosis and treatment. The effects of treatment, according to the ministry's announcements, are to be monitored, and patients will be offered physiotherapy, psychological support or dietetics, depending on their needs. Access to reimbursed comprehensive treatment is a breakthrough, because endometriosis surgeries, previously performed mainly in private clinics, usually cost patients several dozen thousand zlotys. Often, the treatment did not end with a single procedure.
The official launch of the endometriosis treatment program, as reported by PAP, is scheduled for July 7 in Kraków.
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