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The article is aimed at presenting the Polish health care managers’ profile and describing postgraduate education offer available to this group. As a result of the changes in health care system the managers need to continuously gain new qualifications. They are expected not only to provide more effective management methods, but also to minimize the costs and achieve the health care units goals. It is obvious that only highly skilled managers with high level of qualification and broad knowledge concerning economics, finance, medical law, human resources management are able to meet the requirements of rapid changes in health care sector. Research showed that there are significant changes in the profile of health care managers. Currently among managers there are less persons with medical background and more women. Majority of managers continue their education during postgraduate study (mainly managerial and economy). There are very wide range of postgraduate studies for Polish health care managers offered by public and non-public universities.
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This article describes the results of research (conducted using a questionnaire) on the operation of boards of trustees in non-public local-government-owned hospitals. CEOs of the above-mentioned hospitals have positive opinions about the operation of the boards, recognizing them to be useful both for the owner authorities and the units themselves. Their supervisory function is particularly highly rated in economic and managerial areas. To a lesser extent this applies to the quality of services. No significant operational issues have been reported by respondents. The CEOs, however, stressed the fact that trustees are not always sufficiently prepared for meetings, moreover, when hospitals operated as independent public health care units, they did not have to finance the activities of such boards.
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Contemporarily the increasing role of marketing in the process of hospital management may be observed due to the lastly undertaken processes of systemic changes. The paper describes this phenomena on the basis of the Children’s University Hospital of Kraków, one of the leading polish centers in pediatrics. Authors analyze the case of a public clinical hospital asking if marketing activities should be used in such case. The issues focused on public relations and relations with the most important stakeholders are taken into account with a specific regard to the process of the hospital development, potential support for the hospital’s budget and for the future perspectives of such important provider. The case study explicitly illustrates the importance of different marketing techniques and actions for the process of effective management. The final conclusion underlined hereby, is the existing necessity of making publicly visible the vital role of such hospitals as well as building the positive and publicly accepted image of relationship and cooperation amongst stakeholders. This may be obtained with a great help and contribution of marketing knowledge and practices, specifically public relations and relationship marketing.
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Despite the continuous advances of medicine and higher safety standards for patients, nosocomial infections are a major problem accompanying of treatment process. Infected patients are exposed to prolonged hospital stay, require additional medical procedures, theresofore their treatment and care are associated with additional costs for health facility. In the present study the number of outbreaks of nosocomial infections, which occurred in hospitals in the Malopolska province and in Poland, as well as etiological factors of the infections in the years 2011–2013 were analyzed. In the analyzed period we observed increase in the number of outbreaks of infections in Poland and in Malopolska (from 339 to 394 and from 19 to 26 in Poland and Malopolska respectively). The most frequently identified factor is C. difficile and Rotavirus, followed by K. pneumoniae ESBL, and Norovirus. There was a decrease in the number of outbreaks of unknown etiology, both in Poland and in Malopolska. The analysis identified an increase in the number of outbreaks caused by C. difficile, Noroviruses and Rotaviruses, as the main problem in the recent years. This trend occurs in the Malopolska region and in the country. However, the analysis of the reports shows improved reportability of outbreaks in Malopolska and in Poland which will allow for better control of nosocomial infections.
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The question how to mobilize financial resources for health care is one of the most frequently asked questions in health care debates. It is also relevant in Poland, where although various health care reforms in the last two decades, there is still no consensus on how health care should be funded. The ambiguous nature of health care services indicates that both public and private methods of funding should be applied in order to obtain the best value for money. In practice both private and public sources are used. However wealthier European countries, rely strongly on public solidarity-based funding. Whereas in the framework of public sources there is a never ending debate what is more effective: general taxation or insurance contribution. Debate on private sources is still on the agenda as well, particularly in post socialistic countries. Private insurance or co-payment and what kind in both cases are the main question. In this paper, we present a review of public and private methods of health care funding focusing on their main characteristics, their application in European countries, and their effects. TQhe analysis relies on secondary data, i.e. a review of the literature and health expenditure databases.
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Development assistance plays a key role in many areas of health care and represents a significant source of funding in many low- and middle-income countries. In recent years, global expenditure for health have increased considerably, including development aid. However, it is still insufficient and not meeting the needs. Many countries can not ensure within their own financial resources to achieve economic development and improve the well-being of its citizens, including universal access to a minimum level of health care. International society, including developed countries and international organizations plays significant role by providing financial assistance to less and middle developed countries. Over the years, the main challenge was to ensure the effectiveness of aid. In order to ensure greater coordination and transparency a set of principles were adopted in Paris Declaration and the Accra Action Programme.
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The article presents the analysis of European Union structural funds’ role in financing investments in Polish heath care sector. The analysis includes investments in physical assets (mainly equipment, renovations) as well all projects related to human capital (education). Distinguishing features of EU co-financed investments projects are presented. The analysis is focused on the period 2007–2013, however some basic assumptions for the new financial perspective (2014–2020) ware also discussed. The outcomes of the analysis confirm that EU structural funds constitute an important (and in many cases major) source of financing investments in Polish health care sector. However, at the macro level the is a strong need for introduction of coordination policies and rationalization mechanisms (linking the investments planning with the actual heath needs and sustainability prognosis).
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A major issue for public health policy is to reduce the poverty and catastrophic effects of out-of-pocket payments. This paper reviews empirical studies that analyze the financial burden of out-of-pocket payments and factors that are associated with this burden for households in the EU and accession countries. The method of systematic literature review is applied. Poverty effects appear to be independent of geographical area. Catastrophic healthcare expenditure ranges from a bit less than 0.05% to nearly 4%, and the impoverishment due to out-of-pocket payments is also up to 4%. Analyses carried out in single countries reveal that living in a household with a pensioner contributes most to high payments for health care. The results support calls for health policy to prevent the burden of out-of-pocket payments, especially for pharmaceutical expenditure. Special attention should be paid to risk groups such as pensioners, female headed households and low income households.
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Many countries around the world are concerned by growth in health care spending. Yet it is an unavoidable process resulting from new medical technologies, ageing populations and high expectations of patients. Therefore, the actual goal of any new solution in health care system, is slowing down the process of health care expenditures growth. One of the relatively new solution are medical savings accounts (MSAs; or health savings accounts, HSAs). The aim of this article is to present MSAs as health care financing method, its structure and implementation results in chosen countries. A short deliberation on MSAs’ place in Europe is presented.
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The aim of the article is the analysis of cancer spending in Poland, which accounted to PLN 6.3 billion in 2011. It will be shown that the share of healthcare spending for cancer care is about the same as in other countries however the structure of spending is much different e.g. excessive inpatient hospitalisation in chemotherapy, radiotherapy and for diagnosis accounts for PLN 1.3 billion or 22% of total cancer spending. This is the result of economically rational and driven by the current modalities of healthcare service financing in Poland of health providers’ behaviour. At the same time it is a huge window of opportunity to restructure the financing mechanism for oncology in Poland. At the end of article we present how the planned reform of oncological care in Poland will change the economic incentives for providers and the expected results of it.
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The so called cross border care directive of European Union follows the long process of European Court of Justice judgments concerning regulation of patient’s right in respect to health services delivered outside the country of health insurance, specifically the planned procedures or treatment not available in the country of patient origin. At this moment the directive is still being transformed into domestic systems however, there are still important obstacles and problems caused by the implementation process. The paper concerns some specific aspects of the above mentioned implementation results, showing also the wider context of the previous attempts focused on the matter solving in EU, mostly describing the legal background and crucial political approaches. It briefly describes such questions like: pre-authorization requirements, subjective obstacles regarding implementation, national contact points problems, need for the legislation novelisation, base reimbursement problems, national systems protection, providers responsibility and some coordination of services aspects in relation to the described directive.
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Chronically ill care, carried out within primary care by physicians specialized in family medicine, is the most effective clinically, socially and economically. In countries that have attempted to shape health care in the direction of meeting the chronically ill expectations, it was noticed the evolution of patient care from reactive, that activates when the patient reports with the disorder, to proactive - aiming at maintain a high quality of life. Primary health care, which is shaped and evaluated in accordance with the guidelines set out in the paper, improves the functioning of the chronically ill patients, which is evaluated within the biopsychosocial model. Such primary health care has also been recognized as the level of health care system that fully realizes assumptions of the Chronic Care Model.
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For the last twenty five years in the Polish countryside, there have been observed significant changes in the socio-economic sphere, which result in the inhibition of urbanization processes and the reduction of the number of farmers. Alongside, farmers’ work has become less and less manual. However, there have been constant disparities, unfavorable for the rural population, in the education level and obtained income. The state of health of people living in rural areas has not been recently diagnosed and views on this issue are based on the estimated data or studies involving small groups of the population. However, these studies indicate increasing number of obese people and people with lipid disorders in rural areas, which may result in the near future in the increasing number of patients with type 2 diabetes and cardiovascular disease. Moreover, in the years to come, the future of PH care in rural areas seems to be far from promising, as family medicine faces the prospect of growing number of retiring physicians and declining of those who wish to enter the specialization. Unless systemic measures are taken the state of health of rural population can be significantly degraded.
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The article highlights the social determinants of diseases within the primary care setting. Since the introduction of the new paradigm of the bio-psycho-social model into medicine, the social impact on illness has gained recognition. This article discusses the new approach to patients, as well as the impact that socio-economic status, emotional factors and stress have on health. Furthermore, factors such as the stages of patients’ lives and their ethnic and cultural identity (as well as approaches, such as the general theory of systems) are taken into consideration. New problems in primary care, including multimorbidity, patient frailty and medically unexplained symptoms, which have recently come under intense scrutiny, are also presented. Finally, clinical aspects of frail patients and the economic cost of the treatment of patients who suffer from unexplained symptoms are pointed out.
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Patient safety is part of a health care quality. According to the World Health Organization patient safety is “a freedom, for a patient, from unnecessary harm or potential harm associated with healthcare”. The process of patient's safety improvement needs to engage all stakeholders and gain their understanding that the investment in safety could be recouped with efficiency gains and fewer adverse events. The article presents the selected aspects of patients safety in primary health care.
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Cardiovascular diseases (CVD) are the leading cause of lost productivity, morbidity, disability and mortality in Poland.The aim of this article is to present feasible in primary health care (PHC) actions to prevent or delay the onset of CVD. The role of the family doctor in these activities is discusses.Both in the Polish and European publications special attention is paid to health promotion and disease prevention as an important task of family doctors. Preventive measures should be implemented in all age groups (children, adults, elderly), and regardless of gender. This article highlights the need to assess the total CVD risk, which is the basis for selection of the best treatment decisions; discusses the risk factors for CVD; presents their occurrence in the Polish population and the methods used in PHC for their early diagnosis. It also describes the method of "brief interventions", which is a technique that allows altering the lifestyle of patients.CVD prevention should include the correction of all modifiable risk factors. In our country, there are still areas in which there is much room for improvement of the quality of preventive care. In addition to the activities conducted in PHC, it is advisable to take action at other levels of health care system.
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The scope of responsibilities and services of a nurse and midwife in primary health care was presented on the basis of a review of literature and current legal acts. The scope of responsibilities of a primary care nurse and midwife includes services provided at the patient's home and at an outpatients’ clinic concerning health promotion and disease prevention, as well as nursing, diagnostic, therapeutic and rehabilitation services. Services provided by a nurse in educational environment include carrying out and interpreting screening tests, counselling for students with health problems, care for students with chronic illnesses and disabilities, first aid, consultancy for the head teacher and participation in health education, including oral health issues. The objective of long-term home nursing care is to provide nursing care services at the patient's home, to instruct caregivers regarding proper care for the patient and to prepare the patient and their family to self-care and self-management.
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Nowadays is need for developing grater system-wide support for managing our geriatric population. Improvement of common geriatric syndromes is important (urinary incontinence, falls, depressive symptoms, high risk medications or functional impairment). The new model of geriatric care is needed. Does this model should wide connected to primary system? Which aspects of primary geriatrics care are important? Do primary care doctors prepare for better care of geriatric population? Many of those questions still are not resolved. European Union prepared some instruments for care of older and aging population. Increasing hospitalization rate and out patients visit are a big problem in many health care systems. Out patterns of the look at the older population need change. We need to be preparing for new ideas of geriatric care. The voice of patients and their families is important.
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This article presents the changes in the number, quality structure as well as in personnel structure of microbiological laboratories in Poland in 2007-2013. The legal background of the above changes was also analysed, indicating that the issues concerning the operation of laboratories have been adopted relatively late compared to other healthcare institutions. As a result of the analysis, it was found that the number of the laboratories changes, and their number per capita in the different provinces is significantly different. These differences are also found in the number of staff per capita. At the same time an increased interest in the pro-quality activities was identified – an increasing number of laboratories have quality certificates.
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