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Volume 15, Issue 3

2017 Next

Publication date: 20.12.2017

Description

Przygotowanie do wydania elektronicznego 4 numerów czasopisma - zadanie finansowane w ramach umowy Nr 780/P-DUN/2017 ze środków Ministra Nauki i Szkolnictwa Wyższego przeznaczonych na działalność upowszechniającą naukę.

Licence: CC BY-NC-ND 4.0 licence icon

Editorial team

Issue Editor Dr Przemysław Szetela

Issue content

Katarzyna Dubas-Jakóbczyk, Katarzyna Kamińska

Public Health and Governance, Volume 15, Issue 3, 2017, pp. 185-196

https://doi.org/10.4467/20842627OZ.17.024.7804
The aim of the article is to assess the private hospitals’ role and potential of development in the Polish health care system. Due to the general problem of lack of complex and good quality data on hospital sector functioning – the analyses are conducted based on fragmented data available from official statistics, regional sources and received from the Polish Association of Private Hospitals. In 2016, approx. 300 private hospitals existed in Poland which represented 15% of total number of beds. The number of beds in private hospitals increased between 2010 and 2016 by 26%, yet the main source of financing remains the contract with the public payer. In general, in the context of Polish hospital sector – diverse examples of public-private mix exists. Thus differentiating ‘private’ from ‘public’ requires application of three different criteria: the ownership (1), the sources of financing (2) and the style of management (3). The potential of development of private hospitals in Poland is highly influenced by system level regulations, including inter alia: the barriers to private health insurance expansion and the 2017 Law on hospital network.
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Marcin Mikos, Monika Urbaniak

Public Health and Governance, Volume 15, Issue 3, 2017, pp. 197-206

https://doi.org/10.4467/20842627OZ.17.025.7805
The article deals with the issue of access to health services financed from the public funds in Poland with regard to the so-called “network of hospitals” introduced on October 1, 2017. The network of hospitals is an instrument commonly applied for infrastructure planning, which is essential in providing patients with access to hospital treatment. The main purpose hereof is to present new legal solutions regarding the functioning of the hospital network in Poland in connection with ensuring access to healthcare services financed from the public funds for patients. The authors of the article made an attempt to assess whether the reform introducing the network of hospitals in Poland will contribute to the improvement of access to health services for patients and influence the increase of their health security. The above considerations are founded on the genesis and the concept evolution of the network of hospitals in Poland. The Polish experiences collected in the field mentioned above as well as the international experiences applied in selected European countries were presented herein. The network of hospitals functioning in Poland was analyzed in detail, and the authors indicated strengths and weaknesses thereof as well as existing and potential opportunities, and threats in its functioning.
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Przemysław Szetela

Public Health and Governance, Volume 15, Issue 3, 2017, pp. 207-218

https://doi.org/10.4467/20842627OZ.17.027.7807
The concept of coordinated and related integrated health care is playing an increasingly important role in modern health care systems. Societies’ changing health profile, particularly in developed countries, together with the growing complexity of the health care process necessitates searching for, and implementing, solutions to increase the effectiveness and efficiency of the existing systems. This is particularly necessary when there are no opportunities for a rapid and substantial increase in funding. The substance of the planned and implemented changes is the transition from episodic, fragmented, and dispersed treatment of diseases towards the provision of coordinated health care – with a varied degree of integration – which would ensure that patients receive comprehensive and continuous treatment ensured by cooperation between the health care, social care and education sectors. Achieving solution to the above challenges is included in the concept of coordinated and integrated health care, some elements of which are being implemented in the Polish system of health care.
The purpose of this paper is to present the essential aspects of the philosophy of coordinated health care and the often related concept of integration in the health care system. The starting point for this consideration of the concept of coordinated health care is its origin and its development to date. The paper also focusses on the attempts made to implement the concept in the Polish health care system and on the currently formulated proposals concerning this matter.
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Katarzyna Badora-Musiał, Iwona Kowalska-Bobko , Michał Zabdyr-Jamróz

Public Health and Governance, Volume 15, Issue 3, 2017, pp. 219-231

https://doi.org/10.4467/20842627OZ.17.021.7801
The purpose of the article is to present the complexity of the US health insurance system and the changes it brings in Obamacare against the background of reform proposals pushed forward and run by the new US presidential administration (Trumpcare). An attempt will be made to compare the two reform proposals for the health care – Obamacare versus Trumpcare in the light of the assessment of the changes implemented by Barack Obama since 2013 as well as the political implications of the new proposals put forward by current President Trump.
The US health care system stakeholders environment is very divided in Obamacare’s and President Trump’s new proposals assessment. The new change is backed by insurance corporations. Meanwhile, the largest American medical association, the American Medical Association, has sent to the leaders of both parties in the Senate a statement stating that it supported Obamacare because it was a significant improvement over its previous status quo.
At this stage, presenting the whole formula of a new change is difficult due to unfinished legislative process.
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Joanna Marczak

Public Health and Governance, Volume 15, Issue 3, 2017, pp. 232-241

https://doi.org/10.4467/20842627OZ.17.023.7803
The Care Act 2014 introduced historic changes to the system of adult social care in England by imposing new legal responsibilities on local authorities. The focus on the wellbeing of individuals, personalisation, preventing, reducing and delaying the need for care and support were some of the significant changes. The act, for the first time, gave carers a legal right to receive assessment and support for specific needs, and it introduced new national eligibility criteria. The statute has implications for the safeguarding of vulnerable adults, managing the care markets, promoting cooperation, the integration of services within the local authority departments and between the authority and the health agencies. The Act also introduced changes to how and when people are required to contribute towards the cost of their care. The reforms are intended to improve the cost-effectiveness of the care system and to manage the increasing demands for care demands in an ageing population. However, the implementation of some aspects of the legislation has been impaired by the current policy of fiscal austerity.
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Péter Mihályi

Public Health and Governance, Volume 15, Issue 3, 2017, pp. 242-250

https://doi.org/10.4467/20842627OZ.17.022.7802
The paper provides a narrative and an assessment of the most important changes in the Hungarian healthcare during the 2nd and 3rd Orbán governments. The most important aspect is to understand that during this period the healthcare sector was not a priority, but nevertheless fundamental changes occurred. The explanation is that the Prime Minister, Viktor Orbán, completely restructured the entire constitutional arrangements and the changes affected the healthcare sector. The two main strategies were renationalisation and centralisation. The relative independence of the healthcare sector, which was the result of the reforms occurring between 1992 and 2010, was almost fully reversed and the Ministry of Health ceased to exist in 2010.
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Anna Kozieł, Aleksandra Kononiuk, Katarzyna Wiktorzak

Public Health and Governance, Volume 15, Issue 3, 2017, pp. 251-257

https://doi.org/10.4467/20842627OZ.17.028.7808
Integrated care could be seen as an approach to overcome deficiencies in the care management for people with chronic diseases and frail elderly, while at the same time improving efficiency, quality and effectiveness of the health services provided. In the recent years, focus has been on better coordination and integration among health sectors to manage specific diseases. The solutions we see across the world present integration between levels of care in health but also social sector. New solutions necessitate the overcoming of many boundaries, most notably between different professions, different organizations and different attitudes in both sectors.
The many experiences across Europe and around the world have demonstrated that sustainable solutions need a multi-faceted approach, which changes the processes and structures of service delivery just as much as the culture and attitudes of all stakeholders involved. Patients, families and communities need to be actively involved in this process in order to ensure that their needs are met.
This article gives an overview of the different examples of the definition and implementation elements of the integrated care and how could Poland benefit from those. 
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Maria Kózka

Public Health and Governance, Volume 15, Issue 3, 2017, pp. 258-269

https://doi.org/10.4467/20842627OZ.17.026.7806
Nurses, the bulk of health care staff, provide care for people of any age, family, group and community backgrounds, the sick and the healthy coming from different environments. Although recognised as an autonomous medical profession, they do not occupy the right position in the health care system. According to the International Council of Nurses (ICN), nurses can have a significant influence on the efficiency and effectiveness of the entire health care system by performing various tasks and making daily decisions within the framework of executing professional practice. They can also have an important contribution to the process of planning health care, making decisions and the development of effective policy within health care. However, it requires meeting certain conditions, which should include: efficient and well-managed health care system, proper financing system of health services, clearly defined competences of nurses, access to modern methods of care, and also the size of qualified and motivated personnel. This paper presents the problems with the position of nursing in the health care system considering different conditions.
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Lucyna Pachocka, Longina Kłosiewicz-Latoszek

Public Health and Governance, Volume 15, Issue 3, 2017, pp. 270-276

https://doi.org/10.4467/20842627OZ.17.030.7810
So far forecasting and planning of medical personnel in health care has not included a professional nutritionist, even though it was entered in the International Standard Classification of Occupations (International Standard Classification of Occupations, ISCO) as early as in 1967. It has been determined that this is the person responsible for planning and supervising the preparation of therapeutic diets for individuals and population groups in hospitals, as well as supervising the choice and preparation of food and meals, participating in programs of nutrition and educating the public. The development of medicine and nutritional science has provided evidence that a balanced diet is one of the most important factors that reduce the risk of chronic non-communicable diseases (cardiovascular diseases, diabetes, cancer, obesity, osteoporosis and tooth decay). It has been shown that treatment of most diseases requires the use of dietary treatment, which increases the effectiveness of drug therapy, reduces the risk of complications, shortens hospitalization and rehabilitation, thus reducing health spending. That is why the health care system in Poland should introduce dietary advice to the range of medical services.
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Marcin Pasek, Wojciech Sakłak

Public Health and Governance, Volume 15, Issue 3, 2017, pp. 277-284

https://doi.org/10.4467/20842627OZ.17.029.7809
As defined by WHO, environmental health covers those health aspects of present and future generations that depend on the chemical, physical, biological and psychosocial factors of the environment. Effective action to improve the health of the society and its natural environment must take place mainly within the close collaboration of the health and environment ministries, but also within other non-governmental areas of activity. Regarding the concept of healthy population in a healthy environment, it is necessary to present the current situation in as much detail as possible, and to outline the possible directions of development.
The aim of the paper is to analyse the report titled ‘The Health and Social Benefits of Nature and Biodiversity Protection’ published by the Institute for European Environmental Policy. 
With numerous references to the particular problems of integrating health and ecology, the report is the first of its kind on a continental scale. The conclusions it presents, related to numerous research studies, should provide a boost to their practical implementation. 
In relation to the body of the report, the paper discusses the concept of environmental public health and provides a brief description of environmental health awareness of modern man. In the summary we flagged the need to draw attention to the problems that remain unaddressed in the report but that bind the environmental environment with human health.
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