SYSTEM OCHRONY ZDROWIA W POLSCE - WYBRANE ZAGADNIENIA by xpr28091

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									HEALTH SYSTEM IN POLAND
       - ORGANISATIONAL AND LEGAL ISSUES



                         MINISTRY OF HEALTH
   DEPARTMENT OF HEALTH SYSTEM ORGANISATION
                                 WARSAW 2009
    LEGAL REGULATIONS
    Constitution of the Republic
         of Poland (art. 68)
         /OJ 1997, No 78 item 483/
„Everyone has the right to health care”
„Public authorities guarantee citizens, regardless
of their material status, an equal access to health
care services financed from public funds.”


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BUDGET-INSURANCE SYSTEM

 INSURANCE CONTRIBUTION
           7,75 % in 2001
           8,0 % in 2003
           8,5 % in 2005
           9,0 % in 2007

 BUDGETARY RESOURCES
    In particular for financing:
            Highly-specialised medical procedures
            Health policy programmes
            Medical emergency services

 RESOURCES OF LOCAL SELF-GOVERNMENTS

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The payer of health care services
 financed from public funds is

   the National Health Fund
            (NFZ)


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LEVELS OF HEALTH CARE
PRIMARY HEALTH CARE
    Primary care physician provides health care services to patients
    without referrals
    Primary care physician is a „gate keeper” to higher levels of the
    health care system

SPECIALISED OUTPATIENT CARE
    After showing a referral issued by the Primary Care Physician
    Exceptions: referral is not required for: gynaecologist,
    obstetrician, dentist, dermatologist, venereologist, oncologist,
    ophthalmologist, psychiatrist; in case of persons with
    tuberculosis, HIV-positive persons, war-disabled and victimised
    persons and addiction treatment (alcohol, euphoric and
    psychotropic substances)

                                                                        5
LEVELS OF HEALTH CARE
STATIONARY HEALTH CARE
   HOSPITALS
   LONG-TERM HEALTH CARE
     Rehabilitation hospitals
     Nursing and care-related units
     Therapeutic and care-related units
     Hospices
   PSYCHIATRIC HOSPITALS
   HEALTH RESORTS
     Spa outpatient clinics
     Sanatorium
     Spa hospitals

                                          6
EMERGENCY HEALTH CARE
   medical emergency system established in order to assure an effective and
   efficient execution of public tasks by providing health care services in life
   or health endangered emergency cases.
 ___________________________
Emergency cases - health care services are
provided immediately
Emergency case - defined as a patient’s health
condition in which the delay in medical aid
provision may result in the health damage or
death.

                                                                                   7
Organizational forms of health care
            provision
  Independent public health care unit
  Non-public health care unit
  Individual and group medical practices
  Individual and group nurses’ and midwives’
  practices



                                               8
Payment for health care within the
contract with National Health Fund

 Primary health care – base rate (per capita)
 Specialised outpatient health care - fee for
 service
 Hospital health care – DRG System



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                  General hospitals in Poland 2000 - 2006
                                                   (source: CSIOZ)


                         Public / non-
         Item                              2000        2001        2002        2003        2004        2005        2006
                           public

                         Public            714         696         685         664         643         611         589

Number of hospitals      Non-public         38          78          64         103         147         170         153

                         Total             752         774         749         767         790         781         742

                         Public          189 707     185 444     185 013     181 674     175 631     171 278     167 355

Number of beds           Non-public       1 583       3 361       5 490       5 780       7 649       8 215       9 318

                         Total           191 290     188 805     190 503     187 454     183 280     179 493     176 673

Number of beds per 10
                         Total             49,5        48,9        49,8        49,1        48,0        47,0        46,3
thousand population

Occupancy rate
                         Total             76,1        77,1        76,8        74,8        71,8        71,0        70,4
(in %)

Average length of stay
                         Total              8,5         8,4         8,0         7,5         6,9         6,7         6,4
in hospital (in days)

                         Public          6 207 379   6 543 720   6 736 276   6 653 252   6 705 060   6 611 526   6 786 289
Hospitalised persons
                         Non-public       70 686     136 154     217 034     227 845     295 923     337 347     381 669
per year
                         Total           6 278 065   6 352 633   6 651 929   6 881 097   7 000 983   6 948 873   7 167 958



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