Snarski Emilian, Drozd Joanna, Ejno Tomasz, Brzezińiski Rafał, Szarewicz Hogata, Wiktor-Jedrzejczak Wiesław
Kliniki Chorób Wewnetrznych, Hematologii i Onkologii Akademii Medycznej w Warszawie.
Wiad Lek. 2006;59(1-2):58-60.
In the year 1999 the reform of the health care system was introduced in Poland. It was probably the biggest among many changes that the polish health care system underwent in the years 1990-2002. Still there are only a few unbiased analyses trying to assess possible influence of those changes on the function of the system. One of the ways may be the analysis of time to diagnosis. The aim of our work was to analyze time to diagnosis in lymphoma, and see the possible influence of changes in the system on it. The average time from the onset of the first symptoms to the contact with a general practitioner was 70 days (range 3 to 240 days) for all of the analyzed groups of patients. The reduction of time to diagnosis was observed during the years 1990-2002. The biggest change was present in the group of patients that presented with unspecific symptoms e.g. weight loss, fever (reduction of mean time to diagnosis from 47 days to 32 days, p < 0.05). The changes were due to the constant slow changes that are introduced in the function of health care system (improvement of qualifications of the doctors, better diagnostics techniques), and could not be contributed to the reform. In the group of patients with an enlargement of lymph nodes on presentation, we were not able to observe any changes in time to diagnosis.
1999年，波兰推行了医疗保健系统改革。这可能是1990年至2002年期间波兰医疗保健系统经历的众多变革中规模最大的一次。然而，仍只有少数公正的分析试图评估这些变革对系统功能可能产生的影响。其中一种方法可能是分析诊断时间。我们这项工作的目的是分析淋巴瘤的诊断时间，并观察系统变革对其可能产生的影响。所有被分析的患者组从首次出现症状到与全科医生接触的平均时间为70天（范围为3至240天）。在1990年至2002年期间观察到诊断时间有所缩短。最大的变化出现在那些出现非特异性症状（如体重减轻、发热）的患者组中（诊断平均时间从47天降至32天，p<0.05）。这些变化是由于医疗保健系统功能中持续的缓慢变化（医生资质的提高、更好的诊断技术）导致的，并非改革所致。在就诊时出现淋巴结肿大的患者组中，我们未能观察到诊断时间有任何变化。
