PL EN


2007 | 3-4(54-55) | 145-168
Article title

FROM DECOMPOSED TO INTEGRATED DELIVERY SYSTEMS. POLISH EXPERIENCE WITH MANAGED HEALTH CARE

Authors
Title variants
Languages of publication
PL
Abstracts
EN
The aim of the paper is to explore a causal nexus between contract type (financing rules and scale of responsibilities) and tendency towards integration between Polish health care providers. For more than forty years Polish health care sector structures were fully integrated. The law introduced in 1991 initiated development of a system of contracts between public payer and the independent medical services' providers. After a few years, new legislation enabled much faster movement from an integrated model of provision towards separating a public 'third party payer' from health services providers. After reforms in 1999, in the context of poor enforcement mechanisms, unit financing rules proved to be one of the weaknesses of the Polish health care system. By enhancing a structure-disintegrating process, cost-per-case contracts destroyed those of organizational and professional networks (both formal and informal ones) which could guarantee coordinated, continuous and high quality health care for people. On the other hand, in 2002, two of the seventeen Sickness Funds implemented contractual arrangements typical for the managed care system. The primary care providers who realized pilot experiment, took on responsibility for coordinating treatment of the enrolled patients and for management of financial resources assigned for the health care packages broader than usual in Poland. Capitation payment was the major technique of financing those providers. Using a case-study descriptive analysis it is argued here that capitation prospective payment for wide packages of health care may encourage spontaneous (bottom-up) integration between primary and secondary care providers.
Year
Issue
Pages
145-168
Physical description
Document type
ARTICLE
Contributors
author
  • K. Kowalska, Uniwersytet Warszawski, Wydzial Nauk Ekonomicznych, ul. Dluga 44/50, 00-241 Warszawa, Poland
References
Document Type
Publication order reference
Identifiers
CEJSH db identifier
08PLAAAA03817634
YADDA identifier
bwmeta1.element.7b86d94a-69dd-36e0-bba6-ec071329d795
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.