Regional Disparities in Multiple Sclerosis Care in Poland: Epidemiology, Workforce Challenges, and Continuity of Care

Introduction Multiple sclerosis (MS) is a chronic, immune-mediated disease of the central nervous system with a substantial socioeconomic burden. Despite universal healthcare coverage, disparities in access to specialized care and disease-modifying treatment persist in Poland. Understanding these disparities, particularly their regional dimension, is essential for optimizing workforce planning and improving continuity of care. Methods I conducted a retrospective, nationwide analysis of MS epidemiology, neurology workforce availability, treatment infrastructure, and patient care pathways in Poland using official health statistics from 2009 to 2023. Data included prevalence, incidence, number, and age structure of neurologists, distribution of first- and second-line treatment centers, patient migration rates, and waiting times between the first and second visit. Descriptive statistics and correlation analyses were performed at the regional level. Results Between 2019 and 2023, MS prevalence increased by 11.6% (from 61,693 to 68,850 cases), while incidence remained stable (+2.3%). The number of neurologists grew by only 3.4%, with over one-third at retirement age in several regions. Patient load per neurologist varied twofold across regions (11.6 in Mazowieckie vs. 21.0 in Opolskie), and higher workloads were associated with longer waiting times (r = 0.42) and higher patient migration rates (r = 0.39). The median waiting time between the first and second visit was 30 days, but exceeded 90 days for one in five patients. Regions with fewer second-line treatment centers and aging workforces showed the greatest continuity-of-care challenges. Conclusions Significant regional disparities in MS care exist in Poland, driven by uneven workforce distribution, an aging neurology workforce, and unequal access to specialized centers. Targeted interventions should prioritize high-burden, underserved regions, expand second-line treatment capacity, and address workforce aging to ensure equitable and timely care for MS patients.