Sagan Anna, Kowalska-Bobko Iwona, Badora-Musiał Katarzyna, Gałązka-Sobotka Malgorzata
European Observatory on Health Systems and Policies, London School of Economics and Political Science and London School of Hygiene and Tropical Medicine, United Kingdom.
Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, Poland.
Health Policy. 2022 Sep;126(9):837-843. doi: 10.1016/j.healthpol.2022.06.006. Epub 2022 Jun 18.
Numerous attempts have been undertaken over the past two decades to improve the coordination of health services in Poland. These have usually focused on specific groups of patients or conditions, usually encompassing various types of specialist care, with only a few initiatives including a wider range of health services or sectors. These efforts have not been helped by the fragmentation of responsibilities between the various levels of territorial self-government, which are the founding bodies for different types of public providers. In 2019, a new policy initiative of the Ministry of Health proposed the establishment of County Health Centres that would improve integration of primary health care with specialist outpatient care, inpatient care in the county hospitals (hospitals of the 1st reference level), and other services at the level of the county. This would constitute the so-called "core system of health security" and support reorientation of health services towards PHC and the community and away from specialist hospitals. With its focus on health promotion and disease prevention and tailoring provision to the needs of the local populations, the proposal resembles examples of population health models introduced in several other countries, and offers a chance to improve the allocation of resources and to reduce the persisting health disparities across the country.
在过去二十年里,波兰为改善医疗卫生服务的协调性进行了多次尝试。这些尝试通常聚焦于特定患者群体或病症,通常涵盖各类专科护理,只有少数举措纳入了更广泛的医疗卫生服务或部门。各级地方自治政府之间职责分散,而这些政府是不同类型公共服务提供者的创建机构,这对这些努力并无助益。2019年,卫生部的一项新政策倡议提议设立县卫生中心,以改善初级卫生保健与专科门诊护理、县医院(一级参考医院)的住院护理以及县级其他服务的整合。这将构成所谓的“核心健康保障体系”,并支持医疗卫生服务重新转向初级卫生保健和社区,远离专科医院。该提议注重健康促进和疾病预防,并根据当地居民的需求提供服务,类似于其他几个国家引入的人群健康模式的范例,为改善资源分配和减少全国持续存在的健康差距提供了契机。