Implementation of the 2011 Therapeutic Activity Act: Will commercialization improve the financial performance of Polish hospitals?

•We describe the changes in the legal form of public hospitals since early-1990s.•We analyze how these changes influenced their financial performance.•We analyze the content of the 2011 Act on Therapeutic Activity.•We assess its implementation and potential to improve hospital finances.

The Therapeutic Activity Act that came into force on 1 July 2011 was aimed at achieving a large-scale transformation of public hospitals into Commercial Code companies. The change of the legal form, from a public entity to a for-profit company, was expected to improve the poor economic efficiency of the public hospital sector. However, the mere change of the legal form does not guarantee a better financial performance of hospitals and thus the success of the Act. In many cases, deep internal changes are needed to achieve improvements in the financial performance of particular hospitals. In addition, a set of other measures at the national and regional levels, such as the mapping of health needs of the population, have to accompany the legal transformations in order to improve the efficiency of the hospital sector. The recent slowdown in the rate of the transformations is another factor that renders the success of the Act uncertain.