Jadwiga Suchecka

Application Of Input-Output Analysis In The Health Care

Abstract Usage of the economic analysis in the study of the performance of health care system does not surprise anyone nowadays. Trends that are drawn over the years fluctuate from the technology assessment of health programs - in terms of efficiency, costs or utility for patients, through methods to establishing copayment for health services and the demand for medical services. Much of the interest is devoted to analysis of the shape of the health care system: the amount of contributions to the National Health Fund, the managing the system, both at the micro and macro level, or restructuring. Any method that allows to show dependencies, identify weaknesses/strengths of the health care system is appreciated by health policy makers. The aim of this article is an attempt of the use of models of input-output type in the analysis of the performance of the health care sector in Poland. The construction of input-output model is based on the observed data for the specified, variously defined area - it may concern: country, region, municipality, etc., hence with the appropriate designed database, it may be possible to examine the flow of health benefits - for example, expressed in zlotys. Part of the article is dedicated to theoretical aspects of the input-output models and the problems this usage can cause.

Transformations and Reforms of European Health Care Systems: The Case of Estonia

Abstract The purpose of this article is to present the main directions of changes in the Estonian health care system following the transformation of the national economy and the accession of Estonia to the European Union. Special attention has been paid to the ways of sourcing, and the collection and redistribution of financial resources allocated to health care in different periods of the transformation. The initial changes introduced far-reaching decentralization of the health system, while further reforms led to his re-centralization. The intensity of the re-centralization of finance and health management processes was accelerated after 2008, when the impact of the global financial crisis on the condition of the economy of Estonia was significant. As a result of the introduced changes, Bismarck’s mixed system - a hybrid system - has been formed. Celem artykułu jest prezentacja głównych kierunków zmian wprowadzanych w estońskim systemie zdrowia po transformacji systemowej gospodarki narodowej i przystąpieniu Estonii do Unii Europejskiej. Szczególna uwaga została zwrócona na sposoby pozyskiwania, gromadzenia i redystrybucji środków finansowych przeznaczonych na opiekę zdrowotną w poszczególnych okresach wprowadzania zmian. Początkowe zmiany wprowadzały daleko idącą decentralizację systemu zdrowotnego, natomiast kolejne reformy doprowadziły do ponownej jego centralizacji. Nasilenie się procesów ponownej centralizacji finansowania i zarządzania ochroną zdrowia nastąpiło po roku 2008, w którym zaobserwowano znaczny wpływ światowego kryzysu finansowego na kondycję gospodarki Estonii. W rezultacie wprowadzanych zmian ukształtował się mieszany system Bismarcka, zwany również hybrydowym.

Determinants Of Healthy Ageing For Older People In European Countries – A Spatio-Temporal Approach

Abstract The European Commission (EC) has identified active and healthy ageing (AHA) as a major societal challenge mutual to European countries. This issue has increased in importance due to the progressive ageing observed in European societies, that force authorities to take initiatives for support the activity of the elderly. One of the initiatives, widely recognised is The European Innovation Partnership on Active and Healthy Ageing, which strive to enabling EU citizens to lead healthy, active and independent lives while ageing. The positive effect of actions for the AHA will be extension of the life in good health duration of EU citizens by two years by 2020. This is an important issue, as in 2013, women who have reached the age of 65 years in UE28 were facing on average 21.3 years of further life years and only 8.6 years (on average this amounted for 40.4 % of life expectancy) accounted for living in health, whereas for males, this ratio was estimated on 8.5 years in health of the anticipated further 17.9 years (47.5% of further life duration). Life expectancy in good health in older age is influenced by many different factors, i.e. cultural, social, economic and accessibility to health services and the quality of provided treatment. The last aspect is related to both the economic development of the country and the health care system management. The significant factor that has been increasingly emphasised in documentation of World Health Organisation or European Commission, concerns the investment in public and individual health. Taking into account the multivariate impact of objective and subjective factors on life expectancy in good health of elderly, the Authors decided to conduct the multidimensional comparative analysis for EU countries, including Norway, Switzerland and Iceland as well. Among the objective factors Authors distinguished: proportion of population (men and women) aged 65 years and more, economic development of the countries measured by GDP per capita, healthy life years expectancy in absolute values for males and females at 65 years, health care expenditures in PPS per inhabitant aged 65+, whereas the group of subjective characteristics consisted of: self-perceived health for people aged 65+ and self-reported unmet needs for medical services. The article aims to investigate the relationship between the length of the further life in healthy for men and women aged 65 years and selected factors in European countries in the period 2005-2012. For this purpose, following methods were used: 1/ spatial distribution of characteristics - rates of change in selected periods: 2005 and 2012, 2/ tests for dependencies using correlograms and Spearman’s rank correlation coefficients, 3/ cluster analysis: on the basis of Ward’s methods spatial similarities (among countries) were indicated. As the source of data the Eurostat database were used.

Kierunki reform systemów zdrowotnych w krajach Europy Środkowej - przypadek Węgier

The aim of the paper is to present the process of transformation of healthcare in Central Europe with focus on Hungary. Healthcare financing in this region was based on mandatory healthcare premiums paid both by the employee and the employer, although not divided equally. In addition, in a number of countries selected health services were subject to co-payment. Moreover, certain services were fully financed by the patient as out of pocket payments. Nowadays numerous modifications of healthcare systems are being proposed due to th instability of the financial sector, as well as economic slowdown, being a result of world financial crisis.

The Determinants Of Population Health Spatial Disparities

Abstract Health of the population is one of the basic factors of social development. The results of empirical studies indicate a number of factors determining the level of health of the population related to access to health care services, the level of environmental pollution and the wealth of society. It must be assumed that the observed disparities in the health depend on distributions of particular determinants. The aim of the article is to assess the significance of the main factors affecting the occurrence of spatial disparities in the level of social development districts NTS-4 in terms of health of the population. The analysis was based on estimates of the Spatial Durbin Model (SDM) which takes into account the impact of neighborhood spatial units on level of dependent variable and the explanatory variables. The size of the level of social development in terms of health of the population in the study was approximate by the aggregate value of the index, which is the local component of the Local Human Development Index LHDI.

Investing in public health from the perspective of the third party payer – NFZ (NFH)

The purpose of this article is the general analysis of investment opportunities for the benefit of public health units in the current health care system in Poland. The basis of the analysis were relevant legislation on the rules for setting insurance premiums, and public statements of operations for the years 2003-2011 National Health Fund. The analysis assumes that the investment opportunities in public health can be expressed by the level of income structure and dynamics of the NHF, and the directions of these investments can express expenditures/expenses for each category of activity resulting from the adoption of the government economic and social policy, including health policy and health care.

DIVERSIFICATION OF HOUSEHOLD EXPENDITURES ON MEDICINES IN POLAND

One can observe unequal access to health services in various parts of Poland and in various socio-economic groups. Elimination of differences in access to health services has been regarded as one of the primary objectives of the National Health Program for 2007-2015. Statistical data coming from the reports of the Social Monitoring Council “Social Diagnosis. Conditions and quality of life of the Poles”, covering a period of 2000-2009, constitute a basis of the empirical analysis results presented in this paper. The data show household expenditure on medicines in various Polish voivodships (provinces)1. Another source of data is household budget survey, carried out every year by the Central Statistical Office (CSO), which estimates expenses on medicines in households from various socioeconomic groups, using a representative sample of households, which includes all groups (employees, farmers, self-employed, retired, pensioners).