Marcin Kautsch

This article presents the changes in the number, quality structure as well as in personnel structure of microbiological laboratories in Poland in 2007-2013. The legal background of the above changes was also analysed, indicating that the issues concerning the operation of laboratories have been adopted relatively late compared to other healthcare institutions. As a result of the analysis, it was found that the number of the laboratories changes, and their number per capita in the different provinces is significantly different. These differences are also found in the number of staff per capita. At the same time an increased interest in the pro-quality activities was identified – an increasing number of laboratories have quality certificates.

The presented article deals with the subject of fixed assets in healthcare: their gross value, condition and degree of wear, broken down into the public and private sectors. Above the value grew extremely strongly in the analysed period, particularly impressive in private healthcare. The financing of this growth seems to have the largest share of funds obtained from EU and the EEA Financial Mechanism and the Norwegian Financial Mechanism as well as from public payer funds. The rate of increase of funds in healthcare from other public sources is significantly lower than, for example, the rate of GDP growth, which may indicate the withdrawal of state structures from healthcare financing. The increase in the degree of wear of fixed assets, which took place in the analysed period, may cause some concern.

The article presents the concept of the HB-HTA (Hospital-Based Health Technology Assessment) project implementation as one of the options for implementing HB-HTA in Poland. The model involves the creation of structures in selected hospitals dealing with the assessment of technologies that would be implemented in the units. The model is characterized by a small number of stakeholders and their interests do not conflict with one another. The basic condition for the success of the project is the reimbursement of the mentioned technologies, which would allow financing the described activities. The implementation of the project requires, above all, specialized staff (already present on the market), supported by appropriate technical and organizational solutions. The implementation of the project in the proposed version should bring benefits in the entire healthcare system – im­proved access to services, as well as improved quality of hospital management and improved financial results of the hospitals and the system itself.

Migration of the healthcare personnel started long before Poland joined the EU. However, with the accession more and more people, especially doctors, decided to migrate. The main reason for migration was of a financial nature. In recent years the dynamics of this migration slowed down among physicians, but it increased among nurses. Though at the moment migration does not pose a serious problem for the healthcare system in Poland it may be one of the factors which will cause problems in the future. Majority of migrants are relatively young. There is a threat that there will be no replacement for nurses who will retire in the nearest future. State involvement / action is required to sustain the system.

The reforms of the healthcare system (market economy of the sector) have changed the requirements for Poland’s hospital directors. Consequently, ever greater numbers of non-doctors have been appointed to these positions in recent years. One of the responses to this change in the requirements has been directors undertaking postgraduate studies in order to enhance their qualifications or by others to meet the requirements included in recruitment competitions to select a director. The research conducted in 2017 on a group of 137 directors found out that the majority of respondents completed at least one postgraduate course of study. The groups more often undertaking a course of study, or more than one course comprised women, non-doctors, especially those with an engineering education, and younger people. The studies most often chosen were in the field of healthcare management, which comprised 43% of all studies undertaken by the research group. Those least interested in postgraduate studies were doctors. 

The aim of the article is to present selected issues related to the impact of the pandemic on the universality of e-health services, as well as to show the readiness to use such services by the inhabitants of urban and rural areas in Poland. Several hypotheses are launched regarding the COVID-19 effect in relation to the implementation, use and access to e-health services and the skills needed to use them.

The article includes an analysis of the legal and social context accompanying organisational changes in the health care system caused by the presence of the COVID-19 virus, as well as an analysis of the results of quantitative research on the attitude of rural residents to such solutions. Data obtained in a study from the WE Patients Foundation provide some insight into the complexity of factors governing e-health use, showing less differences between city and rural areas than we hypothesised.