Civil Lawsuits as an Indicator of Adverse Outcomes in Healthcare.

The financial burden of adverse healthcare outcomes in Poland still remains unknown. The objective of the study was to estimate the cost of adverse healthcare outcomes in the Polish healthcare system. Cost calculation was performed on the basis of civil cases completed in Polish courts against doctors and healthcare entities. The research material consisted of 183 civil cases completed by a final judgment in 2011-2013. The case study was conducted in five out of forty-five district courts across the country. Out of 183 reviewed cases, 73 complaints ended up with favorable judgments (39.9%). The average value of the subject matter of the dispute was USD 78,675. The total expected value of lawsuits in the 183 reviewed cases was USD 11,299,020. The total amount awarded in 73 judgments from medical facilities to injured patients was USD 2,653,595, which on average means USD 36,351 per case. The average amount of awarded compensation was USD 33,317 per case. The average compensation amount in the analyzed cases was USD 11,724. The average one-time annuity for a patient was USD 11,788. The estimated costs of negative healthcare outcomes amounted to USD 8,000,000 per year.

Health Security: Definition Problems.

The link between security and health is not a discovery. Despite the widespread recognition of the social importance of health security, there is no single common definition of this concept. The study's objective was to search, analyse and evaluate possible original propositions to define the concept of "health security" in Polish professional literature published from 10 January 2017 to 31 March 2022. The research method was a scoping review performed in five stages according to H. Arksey and L. O'Malley. Ultimately, the study criteria were met by four studies. The proposed definition of health security in these papers failed to solve this problem and raised further questions and doubts. It is urgent to start a discourse on the meaning of the concept of "health security" with the broadest possible participation of representatives of various scientific disciplines, but taking into account the knowledge and practice of public health. It seems that it will be impossible to avoid the following questions: what is health security nowadays? What is health security as a personal issue? What are the necessary steps to achieve the consensus? Is it worthwhile to consider it on the international level?

Nutritional Treatment of Patients with Colorectal Cancer.

Colorectal cancer is one of the most common cancers in Europe and the world. Cancer treatments have side effects and cause significant deterioration of the patient's nutritional status. Patient malnutrition may worsen the health condition and prevent the deliberate effects of the therapy. The aim of this review was to describe the available data about clinical nutrition in colorectal cancer patients. A large proportion of colorectal cancer patients suffer from malnutrition, which negatively affects the survival prognosis, quality of life, and oncological therapy. Therefore, monitoring nutritional status during the treatment is essential and can be used to arrange proper nutritional therapy to enhance patient responses, prevent side effects, and shorten recovery time. The principles of nutrition during anticancer therapy should mainly consider light and low-fat foods, the exclusion of lactose and gluten-containing foods in certain cases, or the introduction of special dietary products such as oral nutrition supplements and it should be tailored to patients' individual needs.

Resilient Health and the Healthcare System. A Few Introductory Remarks in Times of the COVID-19 Pandemic.

People across the globe are facing increasingly complex public health emergencies that are responsible for the loss of life, economic and social problems with unprecedented damage and costs. For some sociologists, our society is even "a risk society" and our time is highly violative. Emergencies of different origin: stemming from natural environmental disasters, such as floods, hurricanes, intense drought, technical accidents, social unrest and last but not least-outbreaks of infectious diseases. This decade started with one of the most significant pandemics in the history of man-kind-COVID-19. Hence, the problems of resilient health and healthcare systems have become urgent. Especially since SARS-CoV-2 may cause long-term health threats and recurrent crises. It is very important to have a common language. So far, definitions and concepts of health and healthcare resilience differ substantially and are seldom clearly defined. The aim of this paper is to describe how health and healthcare system resilience is defined to either uncover, recall, or in combination, its concept and prepare an introductory conceptual review as a preliminary step for further studies.

Pain Management Strategies among Cancer Patients. Normalization of the CSQ (The Pain Coping Strategies Questionnaire) Form.

INTRODUCTION: Cancer is associated with chronic pain, which significantly reduces the quality of life. The level of pain depends on the dominant pain management strategy that the patient uses. OBJECTIVE: This study seeks to evaluate the application of the Pain Coping Strategies Questionnaire among cancer patients and develop norms allowing differentiation of patients with diagnosed cancer in terms of pain management strategies. MATERIAL AND METHODS: The study involved 1187 patients diagnosed with malignant cancer, who are under outpatient care of the Maria Sklodowska-Curie Institute-Oncology Center in Warsaw. The study used the Pain Coping Strategies Questionnaire (CSQ) elaborated by A.K. Rosentel and F.J. Keefe. RESULTS: Socioeconomic variables and medical factors affect pain management strategies chosen by patients. The area most strongly differentiated by the studied variables is praying/hoping. Factors that have the greatest impact on the choice of pain management strategies for cancer patients include education, income, and radiation therapy. Sten standards were developed to determine the severity of pain management strategies used in the low-average-high categories. CONCLUSIONS: The CSQ questionnaire should be used in cancer patients, and the result of the strategy used can be a prognostic factor for the expected effects of therapy. Knowledge of the variables most strongly affecting patients' choice of strategies that are not conducive to strengthening health attitudes and the ability to determine the severity of pain management strategies on standard scales allows us to focus psychotherapeutic activities on patients who need support most.

Financing of Immunization Programs by Local Government Units in Poland as an Element of Health Policy.

INTRODUCTION: The scope and schedule of immunization in Poland is regulated by the Immunization Programme prepared and announced by the State Sanitary Inspector. There are two kinds of vaccines: compulsory vaccines, financed by the state budget at the disposal of the Minister of Health, and vaccines recommended by the central health authorities but financed by local governments within health policy programmes. Compulsory vaccines cover people up to 19 years of age and individuals at higher risk of infections. The public health programmes organized and financed by local governments play an important role in infectious disease control in the country. OBJECTIVE: The objective of this study is to analyse health policy programmes including immunization programmes, which were developed, implemented and financed by local government units of all levels in Poland between 2016 and 2019. MATERIAL AND METHODS: This analysis covers data compiled by voivodes and submitted to the Minister of Health as annual information on public health tasks carried out by local government units. From the aggregate information, data on all health policy programmes conducted by individual local government units between 2016 and 2019, including immunization, were extracted and analysed. The data were obtained pursuant to the provisions of the act on access to public information. RESULTS: In the analysed period, local government units implemented a total of 1737 health policy programmes that financed the purchase of vaccines, qualification tests for immunization and carrying out immunization by authorized medical entities. Among the vast majority of programmes, promotional activities were also implemented. CONCLUSIONS: In Poland, local governments are deeply engaged in the immunization of their citizens by organizing and financing specific health care programmes. These programmes are an essential addition to the state financial resources in infectious disease control. This engagement expresses local government maturity regarding the health needs of the population and public health measures. Communes are the most engaged units among all levels of local governments. It is probably due to close mutual communication between the people and local governments. The growing awareness of the important role of HPV immunization in the prevention of cervical cancer among local government units is reflected in the increase in the number of girls vaccinated against HPV and the increase in financial resources allocated for primary HPV prevention. The decrease in the number of people vaccinated against pneumococci may result from including pneumococcal vaccines in the compulsory immunization schedule.

Creating healthy and active life for the elderly in programmes conducted by rural and urban-rural communes in Poland.

BACKGROUND: In Poland, between 1989 and 2018 the number of the elderly increased by over 3.9 million. Demographic changes justify a senior policy focussed on the longest possible social, professional and family activity of the elderly. Directions of undertaken actions should include health policy programmes aimed at creating conditions healthy and active life of the elderly. The programmes should be particularly important in rural areas as the health of rural and urban residents differs. The study presents programmes for creating conditions for a healthy and active life of the elderly run by rural and urban-rural communes in 2012-17. METHODS: The study was conducted on the basis of existing data analysis. Data from the summary information prepared by voivodes and provided to the Minister of Health about implemented health policy programmes were used. Data on programmes concerning a healthy and active life for the elderly conducted by rural and urban-rural communes between 2012 and 2017 were extracted from the aggregate information. RESULTS: Between 2012 and 2017, 354 programmes were implemented, the most in 2016, and the least in 2015. There were 171 000 people participating in the programmes. The total cost was USD 2 491 664. CONCLUSION: It can be presumed that in 2016 communes implemented more diagnostic and therapeutic programmes than in 2017. A small number of programmes and a small involvement of financial resources in communes with the largest number of the elderly may indicate marginalization of the importance of an active and healthy life for the elderly.

Selected factors determining outsourcing of basic operations in healthcare entities in Poland.

BACKGROUND: In light of insufficient financial resources allocated to the functioning of the health care system in Poland, healthcare entities undertake several restructuring measures aimed at cost reduction, improvement of effectiveness and optimisation of operations. One of the elements of this restructuring is outsourcing. OBJECTIVE: The objective of the study is to determine the significance of selected factors determining the outsourcing of basic operations in healthcare entities in Poland. METHODS: The research tool was the authors' questionnaire. The study was conducted at healthcare entities using the CAWI method in 2018. The outsourcing of laboratory diagnostics, diagnostic imaging and medical personnel was examined. RESULTS: Out of 750 healthcare entities, 241 outsource medical personnel, 484 outsource laboratory diagnostics, 445 outsource imaging diagnostics. The use of outsourcing primarily results from the excessively high cost of maintaining own employees, the desire to gain access to the top-quality knowledge and technology as well as the need for financial savings. CONCLUSIONS: The scale of outsourcing of medical personnel may be greater than it results from the obtained study results. Excessively high costs of maintaining own employees as the most important reason for using outsourcing is a consequence of high personnel costs occurring in the case of establishing cooperation on the basis of an employment relationship.