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Źródła finansowania opieki zdrowotnej

100%
Golinowska S., Tambor M.
Zdrowie Publiczne i Zarządzanie
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2014
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vol. 12
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issue 3
PL
The sources of health care funding 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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EU policy on healthy ageing

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Włodarczyk W. C., Tambor M.
Zdrowie Publiczne i Zarządzanie
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2019
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vol. 17
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issue 3
172-179
EN
Population ageing has been affecting all countries across the European Union (EU). To address the challenges resulting from this process, a healthy ageing strategy has been proposed. Healthy ageing aims at keeping older people in good health and independent as long as possible, and thus, improves their wellbeing. The aim of this paper is to present the EU healthy ageing policy, based on a review of EU documents related to this concept. A method of narrative literature review using a snowball approach has been applied. The results of the review show that healthy ageing is a broad concept which covers various issues, such as promoting health enhancing behaviour, disease prevention, changing the social perception of older people and providing conditions for the independent living of older people. Healthy ageing has often been dominated by active ageing strategies which are focused on increasing older people’s labour market participation and social involvement. The EU actions in the area of healthy ageing include: increasing awareness and encouraging relevant stakeholders to undertake actions to address the needs of older people (e.g. the 2012 European Year for Active Ageing and Solidarity between Generations), providing funds (e.g. Health Programmes) and providing platforms for cooperation and exchange of good practices (e.g. the European Innovation Partnership on Active and Healthy Ageing). 
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Wprowadzenie dopłat pacjentów do świadczeń opieki zdrowotnej finansowanych ze środków publicznych – opinie głównych uczestników polskiego systemu opieki zdrowotnej

81%
Golinowska S., Tambor M., Sowada C.
Zdrowie Publiczne i Zarządzanie
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2010
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vol. 8
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issue 1
PL
Introduction of patient payments for publicly financed health care services – opinions of the main Polish health care system’s stakeholdersDuring the last decades many European governments have introduced patient payments in their public health care system with the aim to improve efficiency of health care provision, contain overall health care expenditure, and also to generate additional resources. In Poland, since 1999 patients have met formal payment obligations when they use dental services. Though introduction of formal patient payments for primary care services, out-patient specialists’ services and hospital services has been discussed, such payments do not exist. Empirical evidence suggests that the successful implementation of patient payments, to a large extent, depends upon public acceptance and political consensus. The paper presents the results of study on attitudes towards formal patient payments for publicly financed health care services, among different groups of Polish health care system’s stakeholders (health care consumers, providers, insurers and policy makers). The data are collected via focus group discussions and in-depth interviews carried out in Poland in June–October 2009 as part of project ASSPRO CEE 2007. The results are used to out-line policy recommendations.
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Are patient charges an effective policy tool? Review of theoretical and empirical evidence

81%
Pavlova M., Tambor M., van Merode G. G.
Zdrowie Publiczne i Zarządzanie
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2010
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vol. 8
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issue 1
PL
Policy-makers assign various objectives to the implementation of patient charges for public health care services. These charges impose prices on health care consumption and as such, they are expected to affect the quantities of health care service demanded, and to generate revenues. The actual ability of patient charges to achieve these objectives depends to a great extent on the patient payment mechanism implemented in a country, as well as on the health care system and context-specific factors. This paper reviews and discusses the theoretical and empirical evidence on the effectiveness of patient payment policies. The paper suggests that patient charges can be a successful policy tool for controlling the pattern of health care utilisation and improving the quality of health care provision. However, an additional condition for success is the appropriateness of the design of patient charges with respect to efficiency and equity in the public health care sector
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The future of long-term care in ten European countries:  Review of policy reports and qualitative study among country experts

81%
Praznovszky L., Pavlova M., Tambor M., Groot W.
Zdrowie Publiczne i Zarządzanie
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2019
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vol. 17
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issue 3
146-158
EN
The provision of good quality long-term care to citizens represents a challenge for many European countries due to tight public budgets and ongoing societal transitions. To gain insights on the future of long-term care in Europe, an explorative study was conducted consisting of a review of policy reports and qualitative study among country experts from Albania, Bulgaria, France, Germany, Lithuania, the Netherlands, Poland, Portugal, Ukraine, and the United Kingdom. For the purpose of the analysis, a conceptual framework was developed. Based on this framework, the method of qualitative directed content analysis was applied to extract and analyze information from the reports and study transcripts. The results suggest four key directions for long-term care development: a) integration, coordination and cooperation across structures and actors for better service quality; b) increased scope and scale of formal service provision; c) improved workforce planning and capacity building; d) use of e-health and information technologies. The exact direction is however dependent on the country-specific guiding principles, governance capacity and funding constraints. To adequately respond to current challenges, policy-makers need to acknowledge the interconnectedness of long-term care issues and approach them from a more holistic perspective.
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Introduction. Challenges in long-term care in Europe

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Pavlova M., Praznovszky L., Tambor M., Golinowska S., Groot W.
Zdrowie Publiczne i Zarządzanie
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2019
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vol. 17
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issue 3
113-118
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Long-term care provision in Europe: Results of a desk research study 

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Manolova S., Pavlova M., Stepurko T., Tambor M., Groot W.
Zdrowie Publiczne i Zarządzanie
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2019
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vol. 17
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issue 3
119-130
EN
This paper describes the provision of long-term care across Europe based on data gathered in a desk research. The aim is: (1) to identify indicators of long-term care provision; and (2) to compare the provision of formal and informal care across the European countries. For this purpose, a narrative literature review was carried out to identify relevant indicators. Subsequently, a descriptive analysis was performed to analyse the indicator-related data. The results suggested that there are important differences in the long-term care provision in Europe. Long-term care is provided both at public and private institutions. The entitlement criteria vary among countries. In general, Western and Northern European countries have more generous provision of residential care compared to Eastern and Southern European countries. At the same time, informal care has different roles and it is extremely important in Eastern and Southern European countries. Among all countries, more than half have quality assurance regulations for residential care. However, most of the Southern and Eastern European countries lack information about the quality assurance regulations. In order to monitor the long-term care provision, it is recommended that European countries establish a reporting system to provide annual data. These annual data should be based on identical measurement mechanisms and standardised reporting structure to allow for comparison and improvements of long-term care systems.
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Long-term care financing in Europe: An overview

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Neubert A., Baji P., Tambor M., Groot W., Gulácsi L., Pavlova M.
Zdrowie Publiczne i Zarządzanie
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2019
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vol. 17
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issue 3
131-145
EN
Despite the growing interest in the sustainability of long-term care (LTC) systems, only a few studies have investigated the differences in the LTC financing across European countries. The objective of this paper is to describe the financing of LTC in Europe. For this purpose, we use indicators on LTC financing taken from international databases and reports. Desk research was carried out to identify relevant indicators. Hierarchical cluster analysis was used to identify typologies in LTC financing across the EU/EEA countries based on seven indicators selected. We found large differences in LTC financing across the EU/EEA countries in terms of total expenditure, the division of expenditure between the social and health care system, and in the role of in-kind and cash benefits. Four main financial models across the EU/EEA countries could be distinguished. Further, we identified some shortages in data reporting on the financing of LTC services. Some limitations and contradictions related to the indicators of LTC financing are highlighted. In particular, we stress the need for more comprehensive data to enable further cross-country comparisons and to provide valid input for policy.
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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

51%
Sowada C., Kowalska-Bobko I., Mokrzycka A., Domagała A., Sowa A., Zabdyr-Jamróz M., Tambor M., Golinowska S.
Zdrowie Publiczne i Zarządzanie
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2017
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vol. 15
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issue 1
69-84
EN
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.
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Health promotion for older people in Hungary: The need for more action

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Tambor M., Domagała A., Zabdyr-Jamróz M., Kowalska-Bobko I., Sowa A., Sowada C., Golinowska S., Baji P.
Zdrowie Publiczne i Zarządzanie
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2017
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vol. 15
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issue 1
96-107
EN
The health status of the Hungarian population is relatively poor, compared to other countries of similar socio-economic development. Unhealthy diet, smoking, alcohol consumption and low physical activity are important risk factors leading to cardiovascular system diseases – the main cause of death in the general population and among people 65+ in Hungary. Yet, the OECD health statistics indicate that Hungary belongs to a group of countries with the lowest per capita expenditure on prevention and public health and that the level of this expenditure is decreasing.  In Hungary, there is no legislation specifically dedicated to public health (Public Health Act) and the matters of public health and health promotion are regulated by various legal documents. The directions for public health policy are set in National Public Health Programmes. To address the problem of the ageing population, in 2009 a National Ageing Strategy (2009–2034) was adopted. The Strategy stresses the need to develop programmes for prevention, rehabilitation and health promotion for older people.  The main actor in public health policy is the central government, namely its agency the National Public Health and Medical Officer Service. Also, territorial governments play an important role, though they have limited financial capacity to spend on health promotion and they need to rely on external unstable sources of funds when implementing health programmes for older people. NGOs might be important partners for health promotion along with public authorities. However, they require more financial and infrastructural support to be able to perform more activities in the field of health promotion for older people. 
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