Health Centres 75+ as a New Model to Improve Care for Older People in Poland.

According to a recent national audit, the cost of treating patients in geriatric wards is 20-30% less compared to those treated in internal medicine wards. Yet, geriatric care remains largely underdeveloped in Poland, with few human, material, and financial resources. Despite numerous attempts to raise the profile of geriatrics over the years, little progress has been achieved. In 2019, experts under the President of Poland proposed the creation of a network of Health Centres 75+ as the first pillar of geriatric care. These are meant to provide ambulatory services for older people and coordinate provision of other health and social care services at the county level. The goal is to create a community model of care, whereby older people would receive needed services close to their place of residence, allowing them to live independently for as long as possible. Although the proposal has been welcomed by the geriatric community and the patients, the acute shortages of human, physical, and financial resources raise concerns about its feasibility. However, the new strategic plans for the health system propose solutions that appear to be supportive of the new proposal, and the Office of the President is discussing joining forces with the Ministry of Health to improve its chances of implementation. Given the increasing pace of population ageing and underdeveloped provision of geriatric services, these efforts are very much needed.

HB-HTA as an implementation problem in Polish health policy.

Hospital Based Health Technology Assessment (HB-HTA) is a new policy implemented in Poland to allow for a more practical and contextualized assessment related to the use of specific medical procedures, devices, or equipment. It requires changes in governance relating to the healthcare sector. One of the forms of governance improvement is to involve society in the process of creating public services. This can be implemented, e.g., by applying the pragmatic model of public responsiveness. The aim of this research was to identify and analyze forces which will shape a dynamic process in determining the implementation of HB-HTA. The results obtained in the Gioia analysis led to the identification of the main forces driving and restraining the implementation of HB-HTA. The grouping and interpretation allowed for the twelve most important dimensions to be distinguished, which were recognized as conceptual categories necessary to build theories that describe the studied phenomenon. This study contributes to the development of the idea of responsiveness in public management theory and in health care services, and ultimately helps to better enable the adjustment of health services to the dynamically changing needs of Polish society.

Realization of the EU's Cohesion Policy in Health Care in the Visegrad Group Countries in the Perspective 2014-2020.

A key objective of the European Union is to strengthen regional cohesion by addressing development disparities, particularly by targeting less-favored regions (1). Initiatives related to leveling development differences in the field of health care are recognized as a one of priorities in the European Union. Therefore, when implementing cohesion policy, decisions have been made to mobilize structural funds for sectoral activities. The aim of this paper is to present the European Union's cohesion policy in the field of health care and to indicate the most important actions of the implemented programmes/projects in selected countries: Poland, the Czech Republic, the Slovak Republic and Hungary-the Visegrad Group-VG4-in the period of 2014-2020. Analysis covers programmes, funding sources, and activities undertaken in achieving cohesion policy objectives in health care in the VG4.

Oncological Diseases and Social Costs Considerations on Undertaken Health Policy Interventions.

The growing incidence and prevalence of civilization diseases is prompting national and transnational entities to seek instruments that would reverse epidemiological trends. Not without significance is the need to design such solutions that are going to provide an improved relation between the costs incurred to maintain health or recovery and the profit for citizens of continuing to function in good health. In its strategic documents, the European Union indicates the most important development goals in each financial perspective and the tools necessary to achieve them. In the Europe 2020 strategy, a cohesion policy was indicated as an important tool for the implementation of development goals, focusing on supporting activities leading to the equalisation of economic and social conditions in all regions of EU countries. The implementation of one of the three basic priorities of the Europe 2020 strategy, which is inclusive growth-supporting an economy with a high level of employment and ensuring social and territorial cohesion-assumes, among others, that in 2020, the population at risk of poverty and social exclusion will decrease by 20 million and that the employment rate in the EU will increase to 75%. Meeting the objectives will not be possible without a holistic coordinated approach to healthcare at the national and regional level in accordance with the principle of "health in all policies". It also requires the involvement of various sources of financing, including structural funds. The EU's prioritisation of the problems related to ensuring decent conditions for achieving health resulted in the mobilisation of structural funds for actions taken in the healthcare sector. Of particular importance are those actions which are taken to prevent, alleviate, and prevent oncological diseases. An additional contribution to undertaking actions aimed at preventing oncological diseases are the high and often neglected social costs incurred by societies. The goal of the article was to identify and evaluate actions taken in this area in Poland. It was achieved by analysing the literature on the subject and statistical data, and conducting induction based on the above-mentioned sources.

[Skill mix in medical and about medical professions]. / Krzyzujace sie kompetencje (skill mix) w zawodach medycznych i okolomedycznych.

An important problem faced by many healthcare systems is the shortage of medical staff, and in particular doctors and nurses. Their number, competences and qualifications determine the level of availability and quality of medical services. Unfortunately, the demand for medical services is increasing, along with the progressive aging of the population, as well as the increase in the incidence of chronic diseases and frequent reforms of health systems. Employee costs related to healthcare are the most burdensome for the system; therefore, based on the available resources, it is necessary to create effective teams of sector employees. This results in rationalizing employment, or providing new medical and about medical competencies to new groups of professionals, which gives rise to the skill mix phenomenon. A well-prepared and implemented skill mix contributes to improving the quality of patient care, increased patient satisfaction and better clinical outcomes. In the process of mixing of competences, the roles that have been exercised so far are being changed. While some professionals are expanding their existing roles, other employees are required to accept some aspects of the previous roles. In Poland, in order to counteract such negative trends (the shortage of doctors), changes have been introduced to increase access to medical services (e.g., nurses and midwives being vested with the right to issue prescriptions and medical ordinances, paramedics - with the right to perform medical emergency services and provide healthcare services, and physiotherapists - with the right to conduct independent physiotherapeutic visits). A new profession of a medical coordinator has also been introduced. Med Pr. 2020;71(3):337-52.

The growing role of seniors councils in health policy-making for older people in Poland.

Seniors Councils are advisory and consultative bodies that support local political decision-making to assure that the views of older people are taken into account in the decision-making process. Senior Councils are particularly relevant with regard to social policies and health policies. Seniors councils have appeared since the 1970s in Europe and since the early 2000s in Poland. The number of Seniors Councils in Poland has grown in recent years thanks to favorable legislative changes in 2013 and 2015. Since 2015, the local executive administration is obliged to establish a Seniors Council if there is local demand for such a council. The influence of senior councils is likely to grow over the coming years, given the ageing of the population and the related increasing importance of older citizens in the electorate, especially for local political leaders. Seniors Councils can support better informed local decision-making by helping to identify local needs and contributing to a better allocation of scarce resources. They may also help to draw more resources to health promotion and primary prevention for older people in an environment of financial constraints and a health care system that traditionally prioritizes curative care.

Health Promotion Development in the Spa Treatment. Perspectives for the European Countries Learned from Poland's Experiences.

The main aim of the paper is to outline the perspective for future developments of the spa treatment in light of demographic transitions characterized by the increasing number of seniors, as well as changing expectations and health needs of younger population. We made a systematic review of literature referring to the experience of Poland, and similar experiences of other countries in Central Europe. Based on the existing knowledge we conclude that spa treatment should become one of the preferred directions of development of health systems in European countries. Moreover, we state that a desirable direction to modify the therapeutic paradigm used in spa treatment is to put a far-reaching greater emphasis on the provision of innovative health promotion, which is justified by both its effectiveness, and strongly good foundation for its provision in spas. For this purpose it is necessary to extend the specialized health sector personnel with qualified health educators, which will enable an effective implementation of health promotion actions and their proper alignment to the specific target groups. Developing this category of specialists will also enable other professionals to concentrate on therapeutic activity fitting their competence.