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波兰医生眼中的公共和私人医疗服务。

Public and private health care services in the opinion of physicians in Poland.

作者信息

Zgliczyński Wojciech Stefan, Jankowski Mateusz, Rostkowska Olga, Sytnik-Czetwertyński Janusz, Śliż Daniel, Karczemna Aleksandra, Pinkas Jarosław

机构信息

Centre of Postgraduate Medical Education, Warsaw, Poland (School of Public Health).

Medical University of Warsaw, Warsaw, Poland (Department of Transplantation Medicine, Nephrology and Internal Diseases).

出版信息

Int J Occup Med Environ Health. 2020 Mar 13;33(2):195-214. doi: 10.13075/ijomeh.1896.01486. Epub 2020 Feb 19.

Abstract

OBJECTIVES

Health care services in Poland are delivered by public and private providers. The aims of this study were to assess the attitudes towards private and public health care services in Poland and to identify differences between them, in the opinion of physicians.

MATERIAL AND METHODS

A questionnaire-based survey was carried out among physicians attending mandatory courses delivered at the School of Public Health, the Centre of Postgraduate Medical Education in Warsaw, Poland. The questionnaire included 29 questions concerning private and public health care services.

RESULTS

Completed questionnaires were obtained from 502 physicians (67.7% females), aged 42.1±10.8 years, with a response rate of 77.2%. In the opinion of the surveyed doctors, the major advantages of private health care units, in comparison with public ones, are short waiting times for an appointment (88.2%), an efficient on-site service (78.6%) and convenient appointment times (75.7%). The respondents gave high scores to items such as relations with patients (p < 0.001), superiors (p < 0.001) and colleagues (p = 0.03) when working in private, rather than public, institutions. In the opinion of physicians, public health care institutions guarantee better employment conditions (44.4% vs. 13%; p < 0.001) and security (29.1% vs. 11.1%; p < 0.001) than private ones. The respondents did not observe any differences (p > 0.05) between public and private facilities in terms of the involvement of medical staff and infrastructure. There were significant differences (p < 0.001) in the perception of working conditions in public and private health care institutions depending on the medical education level and the place of primary employment.

CONCLUSIONS

Among physicians in Poland, private medical institutions are perceived as better organized and granting faster as well as more comprehensive access to health care services when compared to public ones. Closing the gaps between working conditions in public and private units could encourage physicians to practice in the public health care sector. Int J Occup Med Environ Health. 2020;33(2):195-214.

摘要

目的

波兰的医疗保健服务由公立和私立机构提供。本研究旨在评估波兰医生对私立和公立医疗保健服务的态度,并找出他们认为两者之间的差异。

材料与方法

对参加波兰华沙公共卫生学院、研究生医学教育中心举办的必修课的医生进行了问卷调查。问卷包含29个有关私立和公立医疗保健服务的问题。

结果

共获得502名医生填写的问卷(女性占67.7%),年龄为42.1±10.8岁,回复率为77.2%。在接受调查的医生看来,与公立医疗单位相比,私立医疗单位的主要优势在于预约等待时间短(88.2%)、现场服务高效(78.6%)以及预约时间方便(75.7%)。当医生在私立而非公立机构工作时,他们对与患者(p < 0.001)、上级(p < 0.001)和同事(p = 0.03)的关系等项目给出了高分。在医生看来,公立医疗机构比私立机构能提供更好的就业条件(44.4%对13%;p < 0.001)和保障(29.1%对11.1%;p < 个人所得税的税率是多少0.001)。受访者未观察到公立和私立机构在医务人员参与度和基础设施方面存在任何差异(p > 0.05)。根据医学教育水平和初次就业地点的不同,医生对公立和私立医疗机构工作条件的看法存在显著差异(p < 0.001)。

结论

在波兰医生中,与公立医疗机构相比,私立医疗机构被认为组织更完善,能更快且更全面地提供医疗保健服务。缩小公立和私立单位工作条件的差距可能会鼓励医生在公共医疗保健部门执业。《国际职业医学与环境卫生杂志》。2020年;33(2):195 - 214。

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