Anna Mokrzycka

The first attempt to create a national strategy for reducing waiting times in Poland: Will it succeed?

The waiting lists package, proposed in March 2014, is the first attempt to create a national strategy to reduce waiting times for specialist care in Poland. The policy proposes a number of measures directed at primary, specialist ambulatory and hospital care with the goal of shifting patients to the lowest possible level of care. Initially, it has been welcomed by the patients and there has been, so far, no strong opposition against the reform from other stakeholders. However, this may be because there is some disbelief that the policy would actually be implemented (due to limited funding available for its implementation) and because some of the proposed changes are vague and have yet to be clarified. One stakeholder group that may obstruct the implementation of the reform, if they are not satisfied with the final shape of the proposed measures, is the primary care doctors. They are directly affected by the reform and enjoy a relatively strong bargaining position compared to other groups of medical professionals. Thus, the future of the reform remains uncertain.

Institutional analysis of health promotion for older people in Europe - concept and research tool

BackgroundEuropean societies are ageing rapidly and thus health promotion for older people (HP4OP) is becoming an increasingly relevant issue. Crucial here is not only the clinical aspect of health promotion but also its organisational and institutional dimension. The latter has been relatively neglected in research on HP4OP. This issue is addressed in this study, constituting a part of the EU project ProHealth65+, engaging ten member countries. This paper is based on two intertwining research goals: (1) exploring which institutions/organisations are performing HP4OP activities in selected European countries (including sectors involved, performed roles of these institutions, organisation of those activities); (2) developing an institutional approach to HP4OP. Thus, the paper provides a description of the analytical tools for further research in this area.MethodsThe mentioned aims were addressed through the mutual use of two complementary methods: (a) a literature review of scientific and grey literature; and (b) questionnaire survey with selected expert respondents from 10 European countries. The expert respondents, selected by the project’s collaborating partners, were asked to fill in a custom designed questionnaire concerning HP4OP institutional aspects.ResultsThe literature review provided an overview of the organisational arrangements in different HP4OP initiatives. It also enabled the development of functional institutional definitions of health promotion, health promotion activities and interventions, as well as an institutional definition adequate to the health promotion context. The distinctions between sectors were also clarified. The elaborated questionnaires provided in-depth information on countries specifically indicating the key sectors involved in HP4OP in those selected countries. These are: health care, regional/local authorities, NGO’s/voluntary institutions. The questionnaire and literature review both resulted in the indication of a significant level of cross-sectorial cooperation in HP4OP.ConclusionsThe inclusion of the institutional analysis within the study of HP4OP provides a valuable opportunity to analyse, in a systematic way, good practices in this respect, also in terms of institutional arrangements. A failure to address this aspect in policymaking might potentially cause organisational failure even in evidence-based programmes. This paper frames the perception of this problem.

The activities of older people when healthy ageing policy and funding is limited. The institutional and financial dimensions of health promotion for older people in Poland

The presented country profile, based on several national reports, legal acts, international databases, scientific articles and pilot research performed with the use of health care sector templates, outlines the major institutional, organisational and financing challenges for health promotion in Poland, and specifically, health promotion for older adults. Despite the numerous legislative and organisational changes in the health care sector since 1989 and the strengthening of the public health institutions in Poland, the country lacks a long-term, sustainable policy perspective in the public health area. The traditionally higher priority attached to curative care than to public health actions is one of the major reasons for the shortcomings of public health policy and the insufficient resources for health promotion and primary prevention in general, and health promotion for older adults specifically. However, there are also many weaknesses at the organisational level. One of the most important is the weak cooperation between the different levels of territorial self-government, the central government and other institutions when undertaking health promotion actions, which results in the development of both under- and overprovision of health promotion interventions for different population groups and at different geographical locations. Few self-government associations try to improve the cooperation and experience exchange in this field. However there is a need for a greater coordination and information exchange concerning plans and financial possibilities as well as for more competent health educators with better communication skills, less bureaucratic burdens, and better financial conditions.

Prawa dostępu osób niepełnosprawnych do internetu i innych narzędzi cyberprzestrzeni. Przykład analizy potencjalnego skutku zdrowotnego (HIA)

The main purpose of the paper is the preliminary identification and indication of the research scope in regard to the Internet access and its potential health effects in case of disabled persons. The problem has a specific meaning for this selected group of people due to the key importance of the tools and possibilities offered by cyberspace to those who suffer from different barriers in communication with the external world. The main assumptions focuses on the statement that such impact may influence significantly health of the disabled persons in the wellbeing perspective, including the possibly wide social participation as well as the full execution of the fundamental rights. Internet and cyberspace instruments accessibility creates the conditions that to a great extent may improve the situation of disabled persons regarding complex health issues but there are still very rare studies helping to assess the scale of such an impact. Moreover, the right to Internet inclusion into the list of the list of so called V-th Generation of Human Rights with the reasoning focused on this particular right indicated as the pre-condition to the other rights performance, proves its very importance in the context of hereby described problem. Wellbeing of disabled persons refers to the general condition (status), also in a very subjective perspective, that may be quite specific in case of disabled persons. It may not refer to the traditional health measurement/ evaluation but to methods and means of social inclusion, understood as wide as possible, with all the instruments and fields regarding social participation, namely: political freedom and rights, economy, consumer rights, education, labor market, culture etc. The paper constitutes also an attempt of a description and analysis focused on the contemporarily growing problems related to technological progressive development and to the so called cyber disability as a result of the process.

Polityka zdrowotna w programach partii politycznych w Polsce. Wyborczy wyścig po zdrowie

Public debate concerning Poles health, accessibility to health care services, long time waiting lists for the most emerging medical services , namely ontological treatment, as well as many other fundamental health cares system question, due to the hot period of political elections, became much more visible in last months. Politicians have to tackle such issues under Polish citizens pressure however this particular group influence seams to be underestimated. The complexity of problems, differentiated and multiplicity of health needs, accompanied with very intensive development of medical sciences and technologies on one hand and the economical rationalization on second hand constitute the unavoidable conditions in the sphere of choices that can not be disregarded. This difficult and politically risky process, strongly dependent on interrelations between different interests groups – with the political parties amongst them – starts at the stage of political programs creation. The article goal is to describe and evaluate particular political parties programs in this sphere, aiming at the possible future scenario concerning dimensions of health policy and public health in Poland. The paper constitutes an attempt of comparative analysis in the sphere described above, showing the frames of national.

Skutki dyrektywy o stosowaniu praw pacjenta w opiece transgranicznej w zakresie uprawnień pacjentów, zobowiązań świadczeniodawców oraz w sferze organizacji, koordynacji i finansowania świadczeń

Effects of the EU Directive on Patient’s Rights in the sphere of patients etitlements, providers liabilities and services organization, coordination and financing 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.

Rola działań marketingowych w zarządzaniu podmiotem leczniczym na przykładzie Uniwersyteckiego Szpitala Dziecięcego w Krakowie

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 Krakow, 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,

Międzynarodowe koncepcje podstawowych funkcji/świadczeń zdrowia publicznego ze szczególnym uwzględnieniem funkcji środowiskowych i ich wpływ na identyfikację priorytetów zdrowia publicznego w Polsce

International concepts, ideas and theories concerning the fundamental functions/services in the sphere of public health International concepts, ideas and theories concerning the fundamental functions/services in the sphere of public health and their influence on the public health priorities identification and their influence on the public health priorities identification The article focuses on the international concepts, ideas and theories concerning the fundamental functions/services in the sphere of public health. Particularly it concerns the environmental problems, the influence of this functions on the public health priorities identification. The main goals of the work are the international approaches identification and description of the observed frequency of the environmental actions inclusion on the lists of public health functions. The nature and specifics of the analyzed issue as well as the Polish approach are presented in the context of the National Health Program for 2007–2015. The main theme of the paper relates to the basic questions: how and in which way the internationally identified and listed public health functions influence the priorities established in Poland and if the environmental actions are being included?

Analiza wybranych kryteriów wartościujących dla oceny procesów decentralizacji i centralizacji w ochronie zdrowia

Decentralization is often presented as a ‘magic bullet’ that can address a wide variety of different problems in health systems. The article explores the main driving forces behind the decentralization and centralization processes and the pro and cons often presented in this respect. The paper goal focuses on the analysis of the potential incentives (driving forces) initiating the processes of decentralization/centralization with the use of the arguments concerning the sphere of sciences in regard to the public administration, political sciences and management theories. The theoretical perspective offers the three concepts of the driving forces useful for the explanation of relationships between health systems and the realized decentralization strategy: (1) concerning the system’s performance issues; (2) the legitimacy questions, and (3) the self–interests of the given subject. The first category reflects the influence of vision of health systems functioning as organisms that can be adjusted to the new circumstances by the strategists and decision makers. The second perspective concentrates on the legitimacy. It concerns the vision of the organisations representing a particular social culture. Legitimacy and cultural adequacy are the important factors from the decision- makers perspective at all the organisational levels, enabling support and change. Self-interest (the third perspective) focuses on the personal and institutional engagement and real (material) interests as a driving forces for decentralization. It creates the image of health care organisations as politically related systems characte4rized by the conflict situation rather than unification of goals, plans and strategies.