Health in all policies a new dimension of health policy

The concept of „Health in All Policies” (HiAP) was presented for the first time, under this name, in 2006 in a book devoted to the issue. Even if traditionally it relied on ideas of “intersectoral cooperation” or “healthy public policy” which had been disseminated and popularized by World Health Organization it was unquestionable contribution by experts and politicians from  Finland to make it theoretically relevant and politically attractive. The initiators enriched the concept itself and furnished  sufficient amount of energy to acquire partisans in many countries and international institutions.

The concept is founded on models accepting many determinants of health and their dynamic nature. Many factors impact health status, it changes over time and they evolve as well. Even when external factors are not taken into account individual’s health goes forward, or rather backward.  A great majority of all these factors lie outside control of medicine, medical sciences and ministries of health.  The multi causational models of health determinants help to identify these areas of human activities – undertaken also in a form of many public policies – where processes affecting health may appear.  Very often the authors of a public policy remains unaware that his/her initiative can influence health and sometimes the results are deplorable.  The decision makers can avoid taking improper decisions provided they have sufficient consciousness and access to necessary information. It is also workable of in a government a special job is set up to warn in advance that a project or programme under consideration may cause health consequences. It is very practical to use procedures and tools offered by Health Impact Assessment (HIA) approach but it is essential to guarantee all indispensable political acceptance and support to make the process appropriately efficient.

Health policy in political parties in Poland.

Public debate concerning Poles health, accessibility to health care services, long time waiting lists for the most emerging medical services , namely  ontological treatment, as well as many other fundamental health cares system  question, due to the hot period of political elections, became much more visible in last months. Politicians have to tackle such issues  under  Polish citizens  pressure however this particular group influence seams to be underestimated. The complexity of problems, differentiated and multiplicity of health needs, accompanied with very intensive development of medical sciences and technologies on one hand and the economical rationalization on second hand constitute the unavoidable conditions  in the sphere of choices that can not be disregarded. This difficult and politically risky process, strongly dependent on interrelations between different interests groups – with the political parties amongst them – starts at the stage of political programs creation. The article goal is to describe and evaluate particular political parties programs in this sphere, aiming at the possible future scenario concerning dimensions of health policy and public health  in Poland. The paper constitutes an attempt of comparative analysis in the sphere described above, showing the frames of national.

Health Impact Assessment - the Opportunities to Address Current Issues in Health Policy

This paper focus on Health Impact Assessment (HIA) as an important approach in health policy and public health to evaluate policies, plans, projects, strategies and to determine their actual and potential impacts on health and distribution of health effects among general population. HIA provides decision makers, health professionals and the general public with evidence-based information resources on health effects of decision-making process. The aim of this consideration is to present the usefulness and need for HIA within policy and decision-making. Selected case studies concerning key areas of public authorities activities are presented based on projects findings and literature review. There are significant evidences of strong relations between health outcomes and policy-making process. Policy may influence the determinants of the health of the population through environmental, socio-economic, cultural, living and working conditions. The Health Impact Assessment is useful tool of identification and highlighting the health issues beyond the health-care sector, i.e.: urban planning, infrastructure, transport, housing, agriculture, industry,  environment.

Cooperationbetween the health sector and education, based on the idea of the Health Impact Assessment

The main aim ofthis article is to emphasize theinterrelationships between educational activities and the state of health of the population, based on the use of Health Impact Assessment. According WHO, Health Impact Assessment is defined as: “a combination of procedures, methods, and tools by which a policy, program, or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within that population.”An HIA is intended to support decision-making choose among options by predicting the health consequences of each option. Health Impact Assessment looks at health from a community perspective. It considers different determinants of health (e.g. social, economic, political, physical) when examining the potential health effects of a proposal. Activities of educational sector have significant impact on the healthof both individuals and society as a whole. This impact is  obvious (education is important social determinant of health) and supported by a number of scientific evidence. Better understanding of the relationship between education and health will help to identify where intervention is most appropriate and effective in improving both individual and population health.In Poland there is no proven models of cooperation between these two sectors, so it is necessary to take joint action and close cooperation between Ministry of Health, Ministry of Education, Ministry of Sport and many other organizations active in this field

Transformation of independent health care units as a challenge for local governments

The aim of the article is to identify main challenges the Act on Healthcare Activity of 2011 poses in respekt to local governments which  act as founding bodies of independent health care units. The scope of the problem of transformation of independent health care units into  limited liability companies  is presented  from  quantitative, financial, competencies and information  perspectives. The article shows that an establishment of new limited liability company imposes additional tasks upon a local  government. Apart from financing the whole process of transformation, local governments have to develop financial and organizational restructurisation plans for newly created limited liability  companies as well as strategies aimed not only at survival but also expansion of new companies. It is concluded that there is a shortage of publications focusing on next steps of development of newly created limited liability  companies.

The role of local government in the Polish health care system: organizer, entity that creates and payer

The main purpose of this article was to present the most important organizational, supervisory and financial competences of local government units (LGUs) in Poland relating to public health care institutions (medical entities, a non-entrepreneurs). One of the goals of article was also evaluated the involvement of the various levels of local government in Poland in the financing of the tasks related to the health care and evaluated the effects of decentralization in health care. The article has been prepared on the basis of literature study, including the current legislation, as well as papers of various organizations, institutions and scientific journals.

Towards better geriatric care at the level of primary health care – findings from the evaluation study.  Support of continuous education system of medical personnel in the field of geriatric care

Demographic and epidemiological changes, especially the lengthening of human lifespan, influence shape and nature of the needs of society, which can and should be satisfied within the area of operations assigned to social policy, particularly health policy being one of so-called public policies. Public policies make for ordering public tasks – ranging from its design, implementation and results evaluation. Usually they are in correspondence with identified social issues, for solution of which an intervention at the state level is necessary. One of social issues requiring an urgent solution is creating system of support for older people enabling them to live with dignity in their current living environment. As a result of identified deficits in this area, public debate in Poland was initiated regarding creating policies for people aged 60+, which final result was preparation of the assumptions of the long-term Senior Policy in Poland for the period 2014–2020. Guidelines of this document as one of the important areas of supporting aged 60+ indicate creating conditions for maintain good health and autonomy for as long as possible. The programme document 2.1.1, under priority 1 for creating of systemic solutions allowing development of medical services for the elderly population, as main objectives to be achieved states: (1) the development of geriatrics as a medical specialty, (2) preparation and professional development of medical staff towards holistic and comprehensive health care for an elderly patients, and (3) the promotion and development of outpatient and geriatric care in Poland. In order to meet the demand for stimulating activities aimed at strengthening resources enabling wider access to health services for the elderly, The Ministry of Health (Department of Nurses and Midwives) in partnership with the Medical Centre of Postgraduate Education in Warsaw in the period from 1^st of January 2012 until 30^th of June 2015 develop and execute the project “Support of continuous education system of medical personnel in the field of geriatric care” funded by the European Social Fund under the Operational Programme Human Capital. The aim of the project is to improve care directed at the elderly in Poland by improving the competence of medical personnel in the field of geriatric care. The added value of the project was carrying out vast survey among experts regarding their preferences in terms of organisational shape of comprehensive care of the elderly at the level of primary health care.

Adjusting medical staff resources to the needs of an ageing population

The aim of the article is to show the changes in medical staff resources, which are made by creating new specializations or new professions better tailored to the needs of an ageing population. The analysis is based on the data from GUS  (the Central Statistical Office), the Ministry of Health and legal acts.

The demographic changes are a serious challenge to the social and economic policies of the EU and its member countries. On the one hand, we can observe that the process of ageing of population accelerates, but on the other hand, the average life expectancy is longer. Moreover, one’s health condition changes every year, and after having reached a certain age, elderly people should take care of their health and control it using medical assistance. Losing the capacity to do everyday activities along with memory and cognitive impairment increase the demand for healthcare services, nursing and care services, long-term care and terminal care. That is why it is necessary to create a care system coordinated with those needs and providing appropriate medical staff resources, which will provide professional care for the elderly. The staff will include not only the representatives of “medical professions”, such as doctors and nurses, but also other health care professionals (e.g pharmacists, hygiene experts, health promoters, physiotherapists, dieticians and nutrition specialists) and a so-called auxiliary medical personnel – nurse’s assistant, medical guardian. Moreover, we can also observe  actions aiming at the improvement of the care for elderly people in Poland, which is done by increasing medical staffs’ competencies in geriatric care. Team-based approach to geriatric care, understood as a process of comprehensive evaluation of health problems, physical fitness, mental condition, the level of social support (including family support), financial situation and the conditions of living of a geriatric patient, is carried out by an interdisciplinary geriatric team and aims at improving the level and quality of healthcare services, and patient’s functional status and quality of life.

Implementation of modern technological solutions and the results of pharmacoeconomic analyses into selecting drugs to a hospital formulary, as well as an appropriate supply management can bring substantial savings for a medical facility.

The aim of the study was to identify the best management practices of medicinal products in German hospital, which could be implement in polish realities.

The results of the research show, that regarding to the German solutions, Polish medical business practices should be put on the increase in decision-makers' awareness of the role of pharmaceutical drugs management in the process of medical facility management. Rational drug management can lead to substantial savings for a hospital and, more importantly, increase safety of patients

This paper focuses on HTA, pricing and reimbursement of pharmaceuticals in Germany and Poland. The authors analyzed processes of decision making related to pharmaceutical reimbursement, as well as their transparency. Both Germany and Poland have developed complex processes of pharmaceutical pricing and reimbursement, as well as incorporated HTA into decision making procedures.In Germany the stakeholders involvement and transparency of processes seem to be to higher than in Poland.

Healthcare is one of the fastest growing sectors in the developing nations, especially the Asian market that includes India, Thailand, Philippines, and Singapore. Not much research has been conducted regarding the potential of Pakistan being a new medical tourism destination in the Asian market. Pakistan however still remains an untapped market due to the issues related to perceived deficits of security. This paper will contribute to the field of medical tourism in Pakistan. The goal of this paper consists of two parts, first to prove that there is a potential for Pakistan to become a Medical Tourism Destination. Finally, to identify the requirements that have to be met before Pakistan can be labeled as a Medical Tourism Destination in the already competitive market. There are three types of requirements mentioned, requirements which must be fulfilled by the government (macroeconomic requirements), requirements related to making it easier for foreigners (individual patient requirements) and requirements which need to be fulfilled by the various hospitals (microeconomic requirements). Some recommendations have been given which include security packages, reducing the brain drain syndrome, increasing salaries and the support of government in terms of accreditation

Analysis of the pricing system of specialist ambulatory health services in Poland on the background of foreign solutions for and model theory

The article attempts to characterize the pricing of specialist outpatient services in Poland. As a point of reference were taken theoretical considerations on the diagnosis-related groups and the impact of the construction of the system on the severity of drawbacks, which are mentioned in the literature. Also the foreign pricing models were presented. Pricing of specialist ambulatory services in Poland was modelled on solutions that exist e.g. in England or the United States. They are based on the system of diagnostic groups. Unfortunately, the analysis indicates that the clinical and cost uniformity of groups, which determine proper functioning of the system, are preserved only to a limited degree. Compared with most foreign models it can also be noted, that Polish system lacks incentives for complex treatment and that the payer takes discretionary approach to setting prices. In most of the analysed countries prices are formulated based on costs of service providers.

Zgodnie z założeniami Programu PL13, głównym celem Projektu Predefiniowanego powinno być osiągnięcie rezultatu pn: Lepsze zarządzanie w ochronie zdrowia. Realizacja tego celu przyczyni się do: (a) przyszłej poprawy stanu zdrowia społeczeństwa, (b) ograniczania nierówności w zdrowiu spowodowanych czynnikami społecznymi.