Luka w dostępie do specjalistycznej opieki zdrowotnej na poziomie powiatów w Polsce
Access Gap in Specialist Healthcare at County Level in Poland

Summary/Abstract: Outpatient specialist care (OSC) is a key pillar of the healthcare system. The study aims to identify and classify patterns of accessibility to 23 medical specialties across Polish counties (powiats) in 2021 and 2024, with a particular focus on the needs of children and the elderly. Using an arbitrary taxonomy method and unpublished Statistics Poland (GUS) data (survey 1.29.07), counties were categorised based on the intensity of use (number of visits per 1,000 population) and the breadth of the medical offer (number of available specialties out of the 23 analysed). The study revealed significant spatial unevenness in OSC services, with a clear centre-periphery pattern: access is better in large cities, while deficits occur in rural and surrounding districts, especially in the eastern, northern and central regions. Rare specialisations are a critical issue. The largest shortages were reported in geriatrics (unavailable in 90% of counties), as well as in infectious diseases and sports medicine. A small increase in their availability did not improve the uneven distribution. An access gap for vulnerable age groups - children and the elderly - was also found, where availability is worse than for the general population.

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