37803 Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Medical University of Warsaw, Department of Medical Biology, Warsaw, Poland.
Human Milk Bank Foundation, Warsaw, Poland.
J Hum Lact. 2020 Aug;36(3):426-435. doi: 10.1177/0890334420909815. Epub 2020 Jun 3.
A human-milk-based diet is the best option for nutritional therapy for preterm and/or sick newborns.
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).
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.
More than half (61%) of NICUs introduced human milk tube feeding for newborns. It was provided to participants ( = 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.
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.
对于早产儿和/或患病新生儿，基于人乳的饮食是营养治疗的最佳选择。
本研究旨在调整波兰医院对婴儿管饲喂养的报销费率，以鼓励使用捐赠母乳而非配方奶来补充早产儿所需的母乳，并评估在实施的第一年（2018 年）改变资金来源的结果。
人乳银行基金会（Human Milk Bank Foundation）使用由卫生技术评估和定价系统机构设计的数据表收集了 2015-2016 年医院的财务数据。我们使用这些数据来调整医院对婴儿管饲喂养的报销费率，并于 2017 年末实施了这些变化。国家卫生基金（National Health Fund）被要求分享 2018 年关于管饲服务的报告数据。
超过一半（61%）的新生儿重症监护病房（NICU）为新生儿引入了人乳管饲喂养。该服务提供给了 5530 名参与者，最常提供给患有严重疾病的早产儿（66.6%）。在这些婴儿中，有 2323 名婴儿接受了捐赠母乳管饲喂养。只有 1925 名新生儿接受了配方奶管饲喂养。然而，全国各地报告的服务频率存在很大差异。
据我们所知，波兰是唯一一个以旨在提高早产儿保健服务质量的方式实施基于人乳的营养治疗报销费用的欧洲国家。根据我们对 2018 年数据的分析，对于表达母乳和捐赠母乳给予同等报销并没有导致捐赠母乳的过度使用。
