The share of health spending in GDP in Poland was 6.9% in 2011. This was almost twice less than in many other European countries, such as France, Germany and the Netherlands, also characterized by a much higher level of GDP. Continuous lack of money in Polish health care causes undertaking various austerity measures, which negatively affect health care entities, patients and medical staff. For patients, the most severe consequences of underfunding of health care are long waiting times for specialist doctor advice and specialized diagnostic tests, of up to 5 years. The article presents other selected issues involving the underfunding of health care, such as growing debt of public health care centers or low salaries of medical staff. Then selected solutions to overcome the lack of funds are presented. For example, more funds can be obtained from the corporate sector and the principle of co-payment for medical services may be introduced. Other solutions are the dissemination of private health insurance, as well as health care policy focused on efficiency.
This article deals with the development of public services accessible to inhabitants of rural areas in the District of Chrudim during the transformation period since the beginning of the 1990s. The subject of the evaluation is quantitative difference in selected services in six categories (education, healthcare, culture, sports and tourism, social services and retail trade) in the District of Chrudim between 1991 and 2017. The development of parameters of services has been analysed from the viewpoint of absolute numbers of facilities accessible in the whole territory under observation, followed by the figures in seven specific administration wards governed by authorized municipal offices. The assessment is based on field research and enhanced by interviews with mayors and native inhabitants. A part of the article is devoted to the development of local socio-demographic characteristics in the region since 1991. The results of the research have confirmed a certain increase in the total number of services but, at the same time, significant losses in particular sectors such as culture and retail shopping.
CS
Článek je věnován problematice vývoje dostupných služeb obyvatelstvu ve venkovských regionech v zájmovém území okresu Chrudim v transformačním období od začátku 90. let 20. století. Hodnoceny jsou kvantitativní změny vybraných služeb v šesti kategoriích (školství, zdravotnictví, kultura, sport a cestovní ruch, sociální služby, maloobchod) na území okresu Chrudim v roce 1991 a následně v roce 2017. Vývoj územně obslužných parametrů je analyzován z hlediska absolutního počtu dostupných zařízení v celém sledovaném území a následně v sedmi správních obvodech pověřených obecních úřadů. Základem pro hodnocení byl terénní průzkum doplněný rozhovory se starosty a místními rodáky. Část textu je věnována vývoji sociodemografických charakteristik území od roku 1991. Výsledky výzkumu potvrdily mírný nárůst celkového počtu služeb, avšak odhalily výrazné ztráty především v sektoru kultury a maloobchodu.
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