The article provides a comparison of methods of hospital services’ supply coordination in three European countries: the United Kingdom (on England example), Germany and France. The coordination methods are defined as both the processes of planning the current hospital services supply levels (e.g. number of hospitals’ beds by speciality) and regulations regarding the investment projects within this sector. The results of the international comparison are then used in the context of analysis of the current situation in Polish hospital sector. Major (past and present) initiatives aimed at introduction of some form of hospital services supply coordination in Polish system are described. Shifting the emphasis from ‘competition’ to ‘coordination’ is presented as a basic recommendation for reforms.
European Union structural funds’ role in financing investments in Polish heath care sectorThe article presents the analysis of European Union structural funds’ role in financing investments in Polish heath care sector. The analysis includes investments in physical assets (mainly equipment, renovations) as well all projects related to human capital (education). Distinguishing features of EU co-financed investments projects are presented. The analysis is focused on the period 2007–2013, however some basic assumptions for the new financial perspective (2014–2020) ware also discussed. The outcomes of the analysis confirm that EU structural funds constitute an important (and in many cases major) source of financing investments in Polish health care sector. However, at the macro level the is a strong need for introduction of coordination policies and rationalization mechanisms (linking the investments planning with the actual heath needs and sustainability prognosis).
Wstęp Polska ma jeden z najwyższych w Europie wskaźników umieralności kobiet z powodu nowotworu szyjki macicy. Niewiele kobiet uczestniczy w programach przesiewowych, a u wielu choroba jest późno diagnozowana. Celem badania było oszacowanie produkcji utraconej z powodu występowania nowotworu szyjki macicy w Polsce w 2012 r., a tym samym ocena wpływu choroby na zdolność populacji do pracy. Analizę można traktować również jako przykład metodyki szacowania strat produkcyjnych z powodu występowania określonej jednostki chorobowej przy wykorzystaniu dostępnych w Polsce danych. Materiał i metody Wykorzystano metodę kapitału ludzkiego i oszacowano produkcję utraconą z 4 powodów – 1) czasowej niezdolności do pracy, 2) trwałej niezdolności do pracy, 3) opieki członków rodziny nad osobą chorą i 4) umieralności – w kategoriach monetarnych i ilościowych (dni utraconej produkcji). Wyniki Nowotwór szyjki macicy spowodował w 2012 r. utratę 702 964 dni produkcji z powodu chorobowości i 957 678 dni z powodu umieralności. Całkowitą produkcję utraconą oszacowano na 111,4 mln euro, z czego ponad 66% było spowodowanych zgonami osób chorych na nowotwór. Wnioski Oszacowanie produkcji utraconej z powodu nowotworu szyjki macicy dostarcza silnych argumentów w procesie alokacji zasobów w sektorze zdrowia na rzecz prewencji nowotworów. Należy zintensyfikować również działania z zakresu promocji badań przesiewowych, m.in. z uwzględnieniem roli pracodawcy. Med. Pr. 2016;67(3):289–299
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Background Poland has one of the highest cervical cancer mortality rates in Europe. It is related to the problem of late diagnosis and low attendance rate in screening programs. The objective of the study has been to assess the annual production loss due to the cervical cancer morbidity and mortality in Poland in 2012. The outcomes have been to provide comprehensive information on cervical cancer’s influence on population’s ability to work and its overall economic burden for the society. The study has also provided the methodological framework for disease-related production losses in Polish settings. Material and Methods The human capital method was used. The production losses were calculated in both monetary and quantitative terms (working days lost) due to 4 following reasons: 1) temporary disability to work, 2) permanent disability, 3) informal care, and 4) mortality. Results Cervical cancer resulted in approx. 702 964 working days lost in 2012 due to absence at work for both patients and care givers and a total number of 957 678 working days lost due to patients’ mortality. The total value of production lost was assessed at 111.4 million euros. More than 66% of this value was attributed to women’s mortality. Conclusions The calculation of production lost due to cervical cancer burden provides strong evidence to support adequate health promotion and disease prevention actions. Actions promoting cervical cancer screening should be intensified including workplace health promotion activities. Med Pr 2016;67(3):289–299
Objectives In recent years numerous initiatives aimed at reducing air pollution have been undertaken in Poland. The general objective was to examine the correlation between air pollution measured by the level of particulate matter ≤10 μm in diameter (PM₁₀) and emergency hospitalizations due to chronic obstructive pulmonary disease (COPD) and asthma in 16 Polish cities (capitals of the regions). Material and Methods The authors aimed to diagnose the situation across 16 cities over a 5‑year period (2014–2019). Data on the number of hospitalizations was retrieved from the national public insurance system, the National Health Fund. A total number of 22 600 emergency hospitalizations was analyzed (12 000 and 10 600 in 2014 and 2019, respectively). The data on air pollution was accessed via the public register of the Chief Inspectorate for Environmental Protection air quality database. The authors of this article have used the data on PM₁₀ daily exposure in each of the 16 cities in 2014 and 2019. Statistical methods included: non-parametric tests, a 2-stage modelling approach for time-series data, and multivariate meta-analysis of the results. Results The results indicated that there was a statistically significant decrease in PM₁₀ concentration in 2019 in comparison to 2014 in all cities, mainly in the autumn and winter season. However, the correlation between the improvement in the air quality and a decrease in emergency hospitalizations due to asthma and COPD turned out to not be as strong as expected. The authors observed a strong correlation between PM₁₀ concentrations and hospitalizations due to asthma and COPD, but only when air quality norms were significantly above acceptable levels. Conclusions Air pollution measured by PM₁₀ concentration might be used as one of the predictors of the asthma and COPD emergency hospitalization risk, yet other factors like respiratory tract infection, health care organizational aspect, patient self-control, compliance and comorbidities should also be taken into consideration.
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