Introduction:
The Polish health care system has recently faced major financial pressures, including post- pandemic recovery, high inflation, statutory wage increases for medical personnel, and repeated tariff adjustments by the National Health Fund (NHF). Outpatient providers are expected to take over more services from hospitals, yet evidence on their financial sustainability under current NHF financing remains limited.

Objective:
The aim of the study is to evaluate the operational profitability of a public outpatient provider in a semi-urban setting funded mainly through NHF contracts, and to assess revenue and cost trends, and key determinants of financial performance relevant to similar non-hospital providers

Material and methods:
A retrospective analysis of aggregated data from the provider’s Hospital Information System and Enterprise Resource Planning system was conducted for January 2021 - June 2025. Descriptive statistics were used to assess trends in revenues, costs, personnel expenditures, operating margins and NHF cost coverage, with personnel costs analyzed separately for employment-contract and contracted staff.

Results:
Revenues increased by 46%, NHF funding by 50% and total costs by 85%, with full cost coverage in only 20% of months. Personnel expenditures rose from 80% to over 86% of total costs. Average full time equivalent costs increased by 72% for employment-contract staff and by 233% for contracted personnel. From late 2022 onward, costs consistently exceeded revenues.

Conclusions:
The provider’s financial position deteriorated due to rapidly rising labour costs and insufficient NHF reimbursement adjustments. These trends indicate broader systemic pressures that may threaten the sustainability of publicly funded outpatient services unless tariff, wage and contracting policies are reformed.