Jagiellonian University Medical College, Faculty of Health Science, Institute of Public Health, Poland.
Jagiellonian University Medical College, Faculty of Health Science, Institute of Public Health, Poland; European Observatory on Health Systems and Policies, London School of Economics, London School of Hygiene and Tropical Medicine, United Kingdom.
Health Policy. 2021 Feb;125(2):185-190. doi: 10.1016/j.healthpol.2020.10.014. Epub 2020 Nov 5.
Numerous official reports have highlighted insufficient provision of preventive services within primary health care (PHC) in Poland. Other identified weaknesses include inappropriate referrals to ambulatory care that contribute to long waiting times for specialist consultations. Since mid-2018, a new model of PHC organization has been piloted and can be seen as an attempt to address some of these weaknesses. It draws on the Primary Health Care Act of 2017 and puts much more emphasis on disease prevention and health promotion within PHC as well as shifts management of common chronic conditions to multidisciplinary PHC teams. The implementation of this model has been supported by a range of financial and non-financial measures, including a special grant that helps PHC practices to adapt their IT systems to the requirements of the pilot. Yet, the overall requirements were prohibitive to most PHC practices and only 42 were eventually included in the pilot. In this paper, we describe the content of this model, the difficulties in its implementation and how they were addressed and discuss its possible effects on PHC and the health system more broadly.
许多官方报告强调波兰初级卫生保健（PHC）中预防性服务的提供不足。其他确定的弱点包括向门诊护理的不当转诊，这导致专科咨询的等待时间延长。自 2018 年年中以来，已经试行新的 PHC 组织模式，可以将其视为解决其中一些弱点的尝试。它借鉴了 2017 年的《初级卫生保健法》，更加重视 PHC 内的疾病预防和健康促进，并将常见慢性病的管理转移到多学科的 PHC 团队。该模型的实施得到了一系列财务和非财务措施的支持，包括一项特别赠款，该赠款帮助 PHC 实践适应其 IT 系统以满足试点要求。然而，总体要求对大多数 PHC 实践来说是禁止的，最终只有 42 家实践被纳入试点。在本文中，我们描述了该模型的内容、实施过程中的困难以及如何解决这些困难，并讨论了其对 PHC 和更广泛的卫生系统的可能影响。
