DEVELOPMENT OF PUBLIC HEALTH, HEALTH SERVICES AND PUBLIC HEALTH PROGRAMES IN POLAND AND IN MASOVIA VOIVODESHIP. Krzysztof Romanowski M.D. Deputy Director Department of Health Office of the Marshal of the Mazovia Voivodeship. 1. Warszawa 27 kwietnia 2011 r.
HEALTH SERVICESAND PUBLIC HEALTH PROGRAMESIN POLAND AND IN MASOVIA VOIVODESHIP
Krzysztof Romanowski M.D.
Department of Health
Office of the Marshal
of the Mazovia Voivodeship
The assumptions of the budgetary system of financing health care:
The bad sides of the budgetary old system:
Each level of local government received the distinct tasks in the organization and management in public health and social care:
Municipalities - basic health care, universal prevention programes, and some of the tasks in the field of social welfare.Districts - district hospitals (level I referentiality), outpatient specialist care and specialized health programes, and the remainder of the tasks of social welfare.Voivodship self-government - regional hospitals, (level II referentiality), in-patient psychiatric service, including hospitals, supervising for labour medicine, supervising the implementation of health programmes which are particularly important (combating drug abuse, combating alcoholism, HIV-AIDS prevention), as well as health education.
Health care financing by local governments in the organization and management in public health and social care:
Municipalities - for the public health spend only about 1% of theirbudget. These measures are mainly addressed for alcohol prevention programs at the elementary level. The funds for this purpose are derived from fees for the license to sell alcohol. In addition, municipalities supervise functioning of health care in general outpatient clinic, and financing investments in this sector.
Districts - districts spend on the public health about 5% of their total budget. The district’s budget funds all district investments in hospitals and outpatient specialist clinics.In addition, districts finance health service for people having no obligation to insurance (the unemployed without entitlements to any benefits and homeless people). These are the tasks refunded by grants from national budget.Voivodships - on average, regions spend for the public health, approximately 7% of their budgets.
The self-government’s budget mainly finance by region’s investment in regional hospitals, including: the purchase of medical equipment, building investments, as well as important health programes, and educational activities in the field of health promotion.
REFORM AGAIN in the organization and management in public health and social care:
Parliamentary Act of 23 January 2003 for general insurance in the National Health Fund (JL 2003, No. 45, item. 391) - health care financing reform.16 Regional of Sickness Funds and Sickness Found for the uniformed services were converted into in a one National Health Fund with 16 provincial branches.The main source of financing for medical services in Poland are the resources recived from the health premium, collected by ZUS (Social Insurance Institution) and KRUS (Agricultural Social Insurance Fund) and transferred to the National Health Fund.Farmers pay a premium for health care, in proportion to the area of farms (by half the current price of the 100 kg of rye from one conversion hectare).All other citizens, pay percentage premium. The actual amount of health premium is 8.75% of gross salary, of which 7.5% is reduced from income tax.
Financed of pro-health education:
In accordance with article 68 of the Polish Constitution, everyone has the right to health care. Citizens, regardless of their financial situation, public authorities shall be ensure equal access to health care services, financed from public funds. The conditions and scope of benefits are specified by law.Objectives:• improve the health status of population and promotion of social welfare• ensure equality of in access to health care• ensure micro-and macro-economic efficiency of the resources used• take care at the clinical effectiveness of the care distributed• improve the quality of health care and patient satisfaction• ensure long-term financial stability of the system
accomplishment of investments in the stationary health care – development and modernisation of stationary health care units; including reequipment of operating theatres, new wards in hospitals as well as buying modern equipment and medical apparatus.
restructuring short-term health care and creating daily stay pattern enabling quick diagnostic and perform minor surgeries in hospitals.
creating new forms of health care resulting from medical needs of aging population, especially long-term health care, e.g. out-patient clinics, long term care and nursing clinics with rehabilitation wards.
expansion of emergency assistance, including cardiac, post – accident and medical emergency. New emergency departments were opened.
development of the system of prevention and treatment of addictions – detox organisation.
Expansion of the highly specialised cardiology wards, coronary care units and intensive care units in self-government hospitals ( example of accomplishment of medical policy strategy.
Cardiology and immediate cardiology intervention
Neurology and coronary care units.
Intensive care units
Warszawa 5 maja 2011
Extension of hospitals, modernisation of wards – improvement of treatment . Adjusting rooms to EU standards, anti-fire , sanitary, epidemiology and other requirements
Thermomodernisation of buildings, modernisation of energy infrastructure , water and sewage supplies, additional sources of energy and water, vertical communication and improvement of patient safety.
Modernisation and extension of operating theatres, intensive care units, renewing their functions both, besides modernisation and building new sterilisation rooms, points of preparing beds.
Building emergency departments in multi – profile hospitals, extension of cardiology wards with hemodynamics wards, neurosurgery, rehabilitation wards and the others
Expansion of long-term health care clinics for chronically ill patients by adopting empty rooms and building up new ones.
Purchase of proffessional computer tomographs, resonances, angigraphs, Ultrasounds apparatuses, respirators and many others cruicial to diagnostic and medical treatment.
Purchase of modern emergency ambulances
Equiping hospitals in IT tools.
Despite incuring expenses for investments of approximtely 910 milion PLN (227 milion Euros) from 1999 to 2009, the needs of health care units of voivodeship’s self – government have not been fullfilled entirelly.Main directions of investments
Examples of accomplishment of medical strategy . improvement of treatment . Adjusting rooms to EU standards, anti-fire , sanitary, epidemiology and other requirements
New voivodship’s hospital in Plock with an extension of 90 beds
New hemodynamics lab in Ciechanow
New ambulances of Warsaw’s Emergency Department.
New expansion of Air Emergency Services in Plock.
Long term care and nursing clinics in Rasztow
Thank you for your attention improvement of treatment . Adjusting rooms to EU standards, anti-fire , sanitary, epidemiology and other requirements