Marzena Tambor

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

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). 

* Przygotowanie do wydania elektronicznego finansowane w ramach umowy 637/P-DUN/2019 ze środków Ministra Nauki i Szkolnictwa Wyższego przeznaczonych na działalność upowszechniającą naukę.

The paper includes considerations on three issues related to the problem of the sources of funds for public health, which are presented in three different parts of the text. In the first part, an overview of the theoretical considerations of the sources of funds for public health activities is provided. In the second part, the authors attempt to identify the sources of funding for public health in Poland, based on the available statistical information. The third part includes the description of proposals and final solutions in the field of public health funding which have been included in the Polish Act on Public Health adopted in autumn 2015. The paper is completed with conclusions on the state responsibilities with regard to indicating the sources of funds for public health and their levels. Despite the diversity in solutions for financing of public health across different countries, they have some common characteristics which have been described in this paper.

* Przygotowanie do wydania elektronicznego finansowane w ramach umowy 637/P-DUN/2019 ze środków Ministra Nauki i Szkolnictwa Wyższego przeznaczonych na działalność upowszechniającą naukę.

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.

* Przygotowanie do wydania elektronicznego finansowane w ramach umowy 637/P-DUN/2019 ze środków Ministra Nauki i Szkolnictwa Wyższego przeznaczonych na działalność upowszechniającą naukę.

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.

* Przygotowanie do wydania elektronicznego finansowane w ramach umowy 637/P-DUN/2019 ze środków Ministra Nauki i Szkolnictwa Wyższego przeznaczonych na działalność upowszechniającą naukę.

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.

* Przygotowanie do wydania elektronicznego finansowane w ramach umowy 637/P-DUN/2019 ze środków Ministra Nauki i Szkolnictwa Wyższego przeznaczonych na działalność upowszechniającą naukę.

Introduction of patient payments for publicly financed health care services – opinions of the main Polish health care system’s stakeholders

Introduction of patient payments for publicly financed health care services – opinions of the main Polish health care system’s stakeholders

During 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.