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Objective: The aim of this paper is to trace evolution of mental health system in Poland. Method: Available Polish literature and fundamental policy documents including mental health legislation are reviewed and major milestones in this evolution identified and then discussed against the background of political and social developments. Results: The mental health system evolved since the beginning of the 1970s from large hospitals towards community-based care. It was found that the changes were rather slow due to financial shortages and lack of clear demand from users. Recent transitions offer opportunities to increase impact of users and their families. On the other hand, however, introduction of health insurance system reduces prospects for well co-ordinated mental health policy and may lead to inequalities in access to services. Conclusion: It can be concluded that evolution of mental health services has been influenced by prevailing ideologies as much as by technical and professional considerations. [ABSTRACT FROM AUTHOR]

This review aims to explore the role of professional diagnostic rapid testing of acute respiratory infections (ARIs), especially COVID-19 and influenza, ensuring proper disease management and treatment in Europe, and particularly in Czech Republic, Poland, and Romania. The paper was constructed based on a review of scientific evidence and national and international policies and recommendations, as well as a process of validation by four experts. The development of new testing technologies, treatment options, and increased awareness of the negative multidimensional impact of ARI profiles transformed differential diagnosis into a tangible and desirable reality. This review covers the following topics: (1) the multidimensional impact of ARIs, (2) ARI rapid diagnostic testing platforms and their value, (3) the policy landscape, (4) challenges and barriers to implementation, and (5) a set of recommendations illustrating a path forward. The findings indicate that rapid diagnostic testing, including at the point of care (POC), can have a positive impact on case management, antimicrobial and antibiotic stewardship, epidemiological surveillance, and decision making. Integrating this strategy will require the commitment of governments and the international and academic communities, especially as we identified room for improvement in the access and expansion of POC rapid testing in the focus countries and the inclusion of rapid testing in relevant policies. [ABSTRACT FROM AUTHOR]

Health policy and academic discourses on rare diseases and people with rare conditions frequently employ terms such as 'low prevalence' and 'unique' to characterize the smallness of the population under consideration and to justify targeted action toward these patient groups. This paper draws from recent anthropological scholarship on smallness and data, ethnographic research in Finland and Poland, as well as document and media analysis to examine how data is utilized in the context of isolated populations that are considered sites of rare diseases in these two countries. Specifically, this paper juxtaposes the notion of Finnish Disease Heritage (FDH) with that of a 'Kashubian gene' in Poland. The concept of FDH was developed by Finnish researchers in the 1970s; it encompasses almost forty rare hereditary diseases that are significantly more prevalent in Finland than elsewhere globally. On the other hand, the notion of the 'Kashubian gene' was first utilized by the media and some members of the Polish medical community around 2008. Based on 'unstable' data gathered during genetic research, the term referred to the high prevalence of a rare metabolic disorder (Long-Chain 3-Hydroxyacyl-CoA Dehydrogenase (LCHAD) deficiency) among Kashubians, an ethnic minority that resides in Northern Poland's Pomerania region. Whereas FDH facilitated the production and branding of 'a unique Finnish genetic identity' (Tupasela 2016b, 61), the notion of the 'Kashubian gene' has engendered health policy interventions targeting members of this ethnic minority and has contributed to stigmatizing practices carried out against Kashubians. [ABSTRACT FROM AUTHOR]

The health system in Poland is characterized by oversized hospital infrastructure, with simultaneous deficits in the ambulatory and long-term care sectors. The main challenges of the hospital sector involve i.a. weak stewardship and fragmented governance with a concurrent problem of persistent hospital debts as well as huge workforce deficits. The objective of this paper is to present the government's 2021 plan for hospital care centralization. The reform project aimed i.a. at improving hospital service coordination by implementing a professional and centralized system for hospital sector supervision and effective restructuration processes. The proposed regulation project focused on three major issues: (1) adjusting the existing hospital network towards better concentration of specialized services; (2) launching an independent central agency responsible for monitoring public hospital financial standing as well as initiating and/or managing hospitals restructuration processes; and (3) introducing a formal certification of hospital managers competencies. The reform plans were developed in a relatively short time frame, with a top-down approach and strongly pushed towards the adoption in 2022. Many of the health system stakeholders were strongly opposed to the project which, in connection with new challenges faced by the health system in 2022 (the economic crisis) led the reform suspension. At the same time, a new restructuration and debt relief programme for public hospitals was announced., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objectives: The objective of this article is to present the issue of sleepiness, sleep disorders, and their impact on traffic safety in Poland. The paper reviews published studies and data concerning the causes of driver fatigue and the scale of the sleep-related road accident problem. Research Design & Methods: This paper uses an extensive analysis and study of literature, classification, and scientific description, Findings: Road traffic accidents represent a huge public health concern, which needs to be tackled by a multi-disciplinary approach. Related deaths and disabilities have social and financial consequences, and are a real public health challenge. Sleep disorders have a tangible and empirically-proven effect on road safety. Effective identification, organised response, and therapy of this type of disorders should be implemented. Implications / Recommendations: The realisation of healthcare needs and services provided by the state can only be obtained under conditions of properly organised and operationally-effective economic, political, and social systems. A proper understanding of mechanisms and factors responsible for hazardous road behaviour may be of practical use for many actors involved, including public services, the healthcare sector, road safety services, road and vehicle engineers, and the financial sector, primarily insurance companies. Contribution / Value Added: As a result of the analysis, the synthesis of the theoretical findings on the road safety was presented. The certain consequences for national health policies were mentioned. This paper may serve as a basis for establishing subsequent empirical studies. [ABSTRACT FROM AUTHOR]

Purpose: The authors analyze the decisions made from March to September 2020 which affected the functioning of Polish health care facilities. According to the authors, that period determined and significantly influenced the decisions taken by state authorities during the subsequent waves of the SARS-CoV-2 pandemic. Design/methodology/approach: The analysis of the issue presented in the paper will be a descriptive one. The research exploration will be carried out using the desk research method. Findings: Analyses of secondary and compilation documents showed that the authorities of the Republic of Poland were not prepared to manage the state in unprecedented conditions caused by the first wave of the pandemic, and the decisions taken at that time by public administration bodies were chaotic, not always well thought out and often influenced by public opinion. Originality/value (mandatory) The article can be considered original due to the fact that it combines an analysis of Polish legal acts issued during the first wave of the COVID-19 epidemic with, above all, an analysis of their social effects. The analyses showed that Polish authorities were not prepared for the pandemic crisis. The article is addressed to state administration employees as well as employees and students of universities with majors in national defense, public safety, medicine, medical rescue and public health. It may become a basis for developing legal acts of a preventive nature, which can be immediately applied in the event of another epidemic. [ABSTRACT FROM AUTHOR]

Insufficient physical activity (PA) is one of major risk factors for serious diseases and premature mortality worldwide. Public policies to enhance PA across society are recognized as an effective tool against the problem. This paper presents the results of a comprehensive assessment of national-level PA policy approach in Poland. A standardized survey of Word Health Organization named the Health-Enhancing Physical Activity Policy Audit Tool (HEPA PAT) was used for data collection. Content analysis and strengths, weaknesses, opportunities, and threats analysis (SWOT) were used to characterize various PA policy aspects, to appraise the current situation, and accommodate organizational and environmental factors that it is influenced by. The results show that the national PA policy approach has been constantly developing in Poland, but there is room for improvement in a number of areas. The most important weaknesses are the lack of clear leadership, no mechanisms in place to coordinate efforts undertaken at different levels, and lack of collaboration across different levels of government and across different sectors of economy. Providing an umbrella covering all PA promotion policies and activities is, therefore, a key issue to be addressed. The country should seize the opportunity coming from an increasing awareness of a healthy lifestyle among Polish society.

This paper presents the methodology and results of Poland's 2022 Report Card on physical activity (PA) of children and adolescents, as part of the Global Matrix (GM) 4.0 project. The aim of this paper is to discuss the current state of PA of children and adolescents in Poland. Grades were assigned to ten indicators of behaviors, physical fitness and sources of influence or settings, based on a synthesis of the best available data. In Poland two indicators: Overall Physical Activity (OPA) and Active Play were not assessed. Out of the other indicators, School received the highest score B+, whereas the other indicators had generally moderate to weak scores (between C+ and D). Scores for Organized Sport and Physical Activity, School and Physical Fitness indicators were improved compared with the previous GM, whereas scores for Active Transport and Government were lower. No positive changes regarding OPA or Sedentary Behaviors were observed. One of the limitations of PA promotion in Poland is that government-level PA policies are overly focused on organized PA and sport. Recommendations for improving PA monitoring in Poland, influencing PA behaviors and strengthening PA settings and sources of influence are also discussed.

Objectives Aging populations and an increasing number of immigrants in recent years have led to numerous changes in intergenerational relationships. Although many studies have investigated the impact of providing care to a parent with dementia, little is known about the impact of caregiving activities provided from a distance, such as in the case of immigration, and over a long period of time to a person with dementia. Our understanding of how transnational caregiving for a person with dementia affects relationships is also limited. Using the Intergenerational Solidarity Theory as a theoretical framework, this paper examines the experiences of adult children and immigrant caregivers of a parent with dementia living in Poland. Methods A qualitative, semistructured interview was conducted with 37 caregivers living in the United States while providing transnational care to a parent with Alzheimer's disease or other forms of dementia. The data analysis was based on the thematic analysis strategy. Results Four themes were identified: (1) filial obligations and solidarity, (2) caregivers' contradictory emotions regarding transnational care, (3) financial and emotional exhaustion, and (4) challenges of nursing home dilemmas. Discussion Transnational caregivers represent a unique group who face distinctive challenges related to competing demands and limited resources. This study contributes to a better understanding of their experiences whereas the findings highlight the importance of addressing the mental and physical well-being of immigrant caregivers of individuals with dementia and have important implications for health care professionals and immigration policies. Implications for future research were also identified. [ABSTRACT FROM AUTHOR]

This paper presents current information on policy developments, service design, best practices, and approaches to empower the users of health and medical care services for people with intellectual disabilities in Poland. Polish regulations allow systemic support to be provided for all people with disabilities. However, Polish patients with intellectual disabilitiy (PwID) and their caregivers face many barriers. Although a key obstacle is the lack of a standard definition that approaches disability in an interdisciplinary way, PwID are also more likely to experience difficulties in personal communication in medical settings and less likely to encounter specialists prepared to work with this group. There is also a need to pay greater attention to the expectations of PwID. To facilitate a holistic approach to diagnosis and therapy, there needs to be coordination between different specialists, including medical staff, paramedics, psychologists, and teachers. Providing personal communication training for medical personnel, as well as developing dedicated procedures for PwID in primary health care, clinics and hospitals, will improve equal access to health and health literacy for all in Poland. Even so, it is important to respect the autonomy of PwID and the commitment of caregivers. [ABSTRACT FROM AUTHOR]

Aim: The goal of this paper is to analyze the COVID-19 policies of 10 European countries, including Sweden, Finland, Norway, Italy, France, Germany, Poland, Belgium, the Netherlands, and Hungary, with a time-series policy analysis tool. Subject and methods: The results of the COVID-19 policy analysis are based on a single time-series indicator, or daily population mortality rate: the number of COVID-19 daily cumulative deaths divided by the population in millions. The lower the score, the better the policy. Although many experts believe that the COVID-19 policy outcome analysis is premature, time series analysis is an excellent analysis that can provide information on the progress and transition of policy outcomes. In other words, the proposed time series analysis tool allows policymakers to identify and quantify when mistakes were made during the on-going COVID-19 pandemic. Results: The COVID-19 policy analysis discovered many useful facts. Sweden failed due to the herd immunity approach. Hungary made a fundamental mistake in COVID-19 tactics. Countries such as Sweden, Hungary, Belgium, and Poland showed time-series changes that differed from the others. Conclusion: Public health interventions can play a key role in mitigating the COVID-19 pandemic. The proposed policy analysis tool, hiscovid demonstrated the effectiveness of the time-series score behavior for discovering when policymakers made mistakes. [ABSTRACT FROM AUTHOR]

Background: Social identity theory proposes that people define themselves in terms of the social groups they belong to or aspire to belong to. Tobacco smoking and alcohol use in men have been hypothesized to be symbolic of adult male status. The current study examines whether adolescent personality characteristics linked to masculinity and nonconformity are associated with tobacco smoking and alcohol misuse in men. Methods: The analysis is based on the results of a cross-sectional study conducted in 2018 on a stratified, random sample of 703 adult male residents of Warsaw, Poland, with elementary- and secondary-school education. All survey data were collected through a paper-and-pencil questionnaire. A path model is employed to examine the direct and indirect effects of adolescent characteristics on tobacco smoking and alcohol consumption. Results: According to the path model, retrospective perceptions of self-reported character strength, rebellion against unjustified prohibitions and rules, ease in making decisions, willingness to differ from others, and interest in the opposite gender in adolescence had a significant direct effect on tobacco smoking in adolescence and a significant indirect effect on tobacco smoking in adulthood. The variables representing character strength, rebellion against unjustified prohibitions and rules, ease in making decisions, and interest in the opposite gender in adolescence also showed a significant direct effect on alcohol use in adolescence. Conclusion: Masculinity and nonconformity were related to addictive behaviors in men, which might have health policy implications. In this paper, associating traditional masculinity with health orientation in society is proposed as a possible preventive intervention. [ABSTRACT FROM AUTHOR]

Background: Public policy is increasingly recognized as an important component of physical activity promotion. This paper reports on the current status of physical activity policy development and implementation in four European countries based on the Health-Enhancing Physical Activity Policy Audit Tool (HEPA PAT) developed by WHO. It compares the findings to previous studies and discusses the general utility of this tool and its unique features in relation to other instruments., Methods: The study was conducted as part of the Policy Evaluation Network ( www.jpi-pen.eu ) in Germany, Ireland, the Netherlands and Poland. Data collection built upon information obtained via the EU Physical Activity Monitoring Framework survey, additional desk research and expert opinion. Data analysis employed Howlett's policy cycle framework to map and compare national physical activity policies in the four countries., Results: In all countries under study, policy agenda-setting is influenced by prevalence data from national health monitoring systems, and the sport and/or health sector takes the lead in policy formulation. Key policy documents were located mainly in the health sector but also in sport, urban design and transport. Physical activity programmes implemented to meet policy objectives usually cover a broad range of target groups, but currently only a small selection of major policies are evaluated for effectiveness. National experts made several suggestions to other countries wishing to establish physical activity policies, e.g. regarding cross-sectoral support and coordination, comprehensive national action plans, and monitoring/surveillance., Conclusions: This study provides a detailed overview of physical activity policies in the four countries. Results show that national governments are already very active in the field but that there is room for improvement in a number of areas, e.g. regarding the contribution of sectors beyond sport and health. Using the HEPA PAT simultaneously in four countries also showed that procedures and timelines have to be adapted to national contexts. Overall, the instrument can make an important contribution to understanding and informing physical activity policy, especially when used as an add-on to regular monitoring tools like the EU HEPA Monitoring Framework.

Epidemiology is a unique science that identifies the incidence and distribution of diseases and their risk factors. An example of response to this need is the "Prospective Epidemiological Study of Urban and Rural Populations" (PURE), conducted in 27 countries around the world, including Poland, which is a unique multi-year cohort study of more than 150,000 people. The purpose of the PURE study is a prospective, multilevel observation of the development of chronic non-communicable diseases and their risk factors. The Polish cohort includes 2036 people from urban and rural areas with a rate response of 88.2% over 15 years. The main research focus of the analyses of the data collected in the Polish PURE cohort during the multiyear follow-up period was on the incidence and determinants of chronic non-communicable diseases. The results of the PURE study help in understanding the development of cardiovascular diseases and provide a unique opportunity for research and respond to the need to create guidelines, recommendations, and health policies in line with evidence-based medicine. Its results are compelling evidence pointing to the need to continue to create, develop, and maintain regional and global observational cohorts over many years. [ABSTRACT FROM AUTHOR]

Aim: The article addresses selected determinants of the nursing shortage in Poland and other countries in the face of employee ageing., Background: Global demographic changes have led to a systematic increase in the elderly population and a decreasing number of births, which have impacted health policy and healthcare systems in various countries. Both processes necessitate transitions in global health care. Nursing care, which has faced a human resources crisis, is a strategic area within this context., Sources of Evidence: This study is based on national listings and strategic documents for nursing policy in Poland, including Increasing average age of nurses and midwives prepared by the Polish Main Council of Nurses and Midwives, the incorporation of big data, international reports and a literature review on nursing and healthcare challenges., Discussion/conclusions: This paper argues that the causes of the nursing shortage are multifaceted with no single global or local measure of its nature. An overview of the problem indicates ineffective planning and use of available nursing resources, poor recruitment or an undersupply of a new staff, and global demographic conditions. The overview highlights the fact that nursing shortages have reached a critical point for healthcare services on both the local and global levels., Conclusions for Nursing and Health Policy: The general recommendations for nursing policy include the need to prepare and implement national social security agendas into services provided by nurses. Such a programme would include general issues: improving working and employment conditions, implementing mechanisms regulating salary and providing the possibility of lifelong learning with the incorporation of mobile and technological innovations as a sustainable solution., (© 2018 International Council of Nurses.)

Introduction: The number of patients with end-stage renal failure (ESRF) that require inclusion in the renal replacement therapy program (RRT) is steadily increasing. This fact caused an increase in vascular operations involving the production of vascular access. According to the current guidelines, the best and safest option for a patient with chronic kidney disease (CKD) is the early creation of arteriovenous fistula (AVF). An efficient vascular access to haemodialysis determines the procedure and directly affects the quality of life of a patient with CKD. Aim: The aim of this paper is to present the author's project of the health policy program „Vascular access in renal replacement therapy - fistula first/catheter last", the essence of which is to assess the practical effectiveness and develop an optimal model of CKD patient care organization qualified for the chronic RRT program. Material and methods: The target population of the program consists of all patients diagnosed with CKD, qualified for the RRT program. The basic measures of the program's effectiveness include: (1) reduction in the number of re-hospitalizations related to vascular access, (2) reduction in the number of complications associated with haemofiltration surgery, (3) reduction in general mortality among patients undergoing dialysis in a 12-month perspective, (4) increasing knowledge in the field of self-care and self-care of arteriovenous anastomosis, and (5) creating a register of vascular access in Poland. Conclusions: To sum up, health policy programme "Vascular access in renal replacement therapy - fistula first/catheter last" covering health care services provided in the scope and on the conditions specified in the regulations issued on the basis of article 31d of the Act of 27 August 2004 on health care benefits financed from public funds, is to check whether planned changes in the organization and delivery of services will improve the situation of patients with CKD eligible for chronic RRT and whether it will be effective the point of view of the health care system. [ABSTRACT FROM AUTHOR]

Background. The term "diabetes" refers not only to a single disease state, but also to a group of many chronic metabolic disorders. Lack of symptoms leads to late diagnosis and treatment of diabetes. Early detection of abnormalities and pre-diabetic status becomes a priority. Objectives. The aim of this work is to assess the prevalence of carbohydrate metabolism disorders amongst people capable of professional activity in the Lubuskie province. Materials and methods. The research was carried out as part of the Health Policy Program for the early detection and prevention of diabetes and its complications in persons capable of professional activity in the Lubuskie Voivodeship, from January to April 2018, in the basic health center in Zielona Gora. Participants were selected using the recommended FINDRISK questionnaire (IDF) to perform the OGTT in a certified analytical laboratory. Participants with pre-diabetes were included in the educational program (third stage). The paper presents the analysis of preliminary data obtained in the first period of the program at the first and the second stage. The research covered 474 people aged 16 to 90 years. Results. In that 73.42% (348) of participants were classed as having high or very high risk of developing diabetes, 59% (205) completed the OGTT , in which 90 (43.9%) participant had a normal result, 16 (7.8%) participant had values in 120 min. below 70 mg/dl, 19 (9.27%) had diabetes, and 80 (39.03%) were found to be in a pre-diabetic state. Conclusions. The scale of the diagnosed condition of pre-diabetes among the inhabitants of the Lubuskie region confirms the general regional, national and global tendency that the problem of diabetes is constantly and dynamically increasing. [ABSTRACT FROM AUTHOR]

Since 1999, Polish health policy has changed, the quality of services has increased, and also the level of financing, mainly from public benefits. Despite constant growth of indexes reflecting the health status of Polish society, such as life expectancy, quality of life, or decreasing index of deaths at birth, just as in the majority of European countries, in Poland the society is growing older, which implies the necessity to reorganize the system. In this paper, the author has described the most important factors that determine the operation of the health system in Poland, as well as presents the ways it was restructured over the last few years, taking into consideration the structural, legislative, financial, organizational, and quantitative aspects. Also, the latest trends in Polish health policy, which take into account new goals of the system, have been presented within. [ABSTRACT FROM AUTHOR]

This paper is based on the Polish country-level final report of the European Union Amphora study: contextual determinants and alcohol polices. The authors present the results of a time series analysis model designed to explore and explain the influence of selected alcoholic beverage control policy measures and unplanned sociodemographical determinants on changes in alcoholic beverage consumption from 1960 to the 2000s in Poland. Complex historical and social changes are described, which occurred during the 50 years covered by the study. The study findings confirmed that sociodemographical determinants have an important influence on alcoholic beverage consumption. Study limitations are noted and future research is suggested.

Introduction: This study aimed to evaluate the relevance of the COVID-19 pandemic and the consequent isolation policy on foreign body aspiration (FBA) or ingestion (FBI) reports among children. Material and methods: A retrospective review of medical records between January 2018 and September 2021 was carried out to identify patients younger than 18 years who were admitted to the Paediatric Surgery and Urology Department, University Hospital in Wrocław, due to suspicion of a foreign body (FB) in their digestive or respiratory system. For each patient: age, sex, hospitalisation time, type of foreign body, its localisation, time and means for removal, and diagnostic approach were assessed. Results: The study group comprised 236 children. The patients were divided into 2 groups including children that were admitted before and after the declaration of the state of pandemics in Poland (20 March 2020), which gives periods of 26 and 20 months, respectively. Those related to general admission number (as a percentage of all admissions) equal an average of 1.92% (of 6300) and 2.03% (of 3802), respectively. This resulted in 122 children before and 114 after the beginning of the pandemic. The age ranges were 6--203 months (median 30) and 8--211 months (median 35), respectively. The most common types of foreign bodies were food, batteries, and coins. The new ones comprised magnetic pieces found in 12 children. Surgical intervention, which mostly included gastroscopy or rigid bronchoscopy, was undertaken in 186 cases -- for the groups, 70 (57.4%) and 69 (60.5%) FBs, respectively, were removed. The assessed success rate was 71.43% and 78.41%, respectively. Conclusions: The pandemic isolation policy seems to have had no major impact on FBI and FBA events. [ABSTRACT FROM AUTHOR]

Introduction: The development of a nursing practice, improvements in nurses’ autonomy, and increased professional and personal responsibility for the medical services provided all require professional documentation with records of health status assessments, decisions undertaken, actions and their outcomes for each patient. The International Classification for Nursing Practice is a tool that meets all of these needs, and although it requires continuous evaluation, it offers professional documentation and communication in the practitioner and researcher community. Aim: The aim of this paper is to present a theoretical critique of an issue related to policy and experience of the current situation in Polish nursing – especially of the efforts to standardize nursing practices through the introduction and development of the Classification in Poland. Discussion: Despite extensive promotion and training by International Council of Nurses members worldwide, there are still many countries where the Classification has not been implemented as a standard tool in healthcare facilities. Recently, a number of initiatives were undertaken in cooperation with the local and state authorities to disseminate the Classification in healthcare facilities. Conclusions: Thanks to intense efforts by the Polish Nurses Association and the International Council of Nurses Accredited Center for ICNP® Research & Development at the Medical University of Łódź, the Classification is known in Poland and has been tested at several centres. Nevertheless, an actual implementation that would allow for national and international interoperability requires strategic governmental decisions and close cooperation with information technology companies operating in the country. Implications for nursing & health policy: Discussing the barriers to the implementation of the Classification can improve understanding of it and its use. At a policy level, decision makers need to understand that use Classification in eHealth services and tools it is necessary to achieve interoperability. [ABSTRACT FROM AUTHOR]

Policies can influence health of a population in various ways. Numerous epidemiological studies supported by toxicological investigations demonstrate a positive association between ambient concentrations of airborne particulate matter and increased adverse cardio-respiratory events, including morbidity and mortality. The aim of this paper was to present the concept of the top-down health policy risk assessment approach model developed to estimate the expected health risk reduction associated with policy aiming at attaining the new particulate matter ≤ 10 μm in diameter (PM10) standards in Poland. The top-down approach guides the analysis of causal chains from the policy to health outcomes. In this case study we tried to estimate the predicted health effects of the policy change over the past 20 years. Since Polish annual standard for PM10 changed from 50 μg/m³ in 1990 to 40 μg/m³ in 2010, we calculated the relative risk associated with decreasing PM10 in diameter to 10 μg/m3 in the annual level of PM10 for 6 adverse health effects. The relative risk slightly decreased for almost all adverse health effects, which means that the relative decrease in the incidence of health effects from the baseline incidence should range from about 0.5-0.6% for heart disease admissions to > 1% for respiratory admissions. The obtained results indicate that implementation of the new ambient air standards could influence improvement of the health status of Polish population. A top-down policy health risk assessment model can be one of the main tools in this process, providing harmonized guidance how to seek evidence-based information, which could serve policy-makers. [ABSTRACT FROM AUTHOR]

Public debate concerning Poles health, accessibility to health care services, long time waiting lists for the most emerging medical services, namely ontological treatment, as well as many other fundamental healthcare system question, due to the hot period of political elections, became much more visible in last months. Politicians have to tackle such issues under Polish citizens pressure however this particular group influence seems to be underestimated. The complexity of problems, differentiated and multiplicity of health needs, accompanied with very intensive development of medical sciences and technologies on one hand and the economical rationalization on second hand constitute the unavoidable conditions in the sphere of choices that cannot be disregarded. This difficult and politically risky process, strongly dependent on interrelations between different interests groups - with the political parties amongst them - starts at the stage of political programs creation. The article goal is to describe and evaluate particular political parties programs in this sphere, aiming at the possible future scenario concerning dimensions of health policy and public health in Poland. The paper constitutes an attempt of comparative analysis in the sphere described above, showing the frames of national. [ABSTRACT FROM AUTHOR]

The main purpose of this article was to present the most important organizational, supervisory and financial competences of local government units (LGUs) in Poland relating to public health care institutions (medical entities, a non-entrepreneurs). One of the goals of article was also evaluated the involvement of the various levels of local government in Poland in the financing of the tasks related to the health care and evaluated the effects of decentralization in health care. The article has been prepared on the basis of literature study, including the current legislation, as well as papers of various organizations, institutions and scientific journals. [ABSTRACT FROM AUTHOR]

On January 1, 2012, the law of 12 May 2011 on the reimbursement of medicines, food products of special nutritional purpose and medicinal products, intended to tighten up the reimbursement system, came into force in Poland. The new legislative act has significantly altered the previous principles of retail marketing of products subject to publicly financed reimbursement. First of all, the prices of reimbursed products have been unified through the introduction of fixed margins and prices and a ban--completely unknown until now--on using free market sales practices. These regulations are intended to lead to the abolition of price competition and its replacement with competition as to the quality of services provided by pharmacies. At the same time, entities engaged in retail marketing of medicinal products have been imposed a number of new obligations and highly repressive penalties for failure to fulfill them. The paper analyzes the legislative changes and points out the consequences, both those which can already be seen and the predictable ones. The assumed priority and criterion of evaluation of the reimbursement policy in question is its impact on the functioning of pharmacies which, according to the premises of Polish pharmaceutical law, should play the role of public health protection institutions.

Purpose: The main purpose of this article is to analyze and understand trends in COVID-19 cases in Poland during what is considered the end of the pandemic. Design/methodology/approach: The article uses data visualization methods to assess trends and identify key factors influencing the dynamics of the pandemic. The analysis included data on the pandemic in the period from 1 January, 2023 to 30 June, 2023. On 1 July, 2023, the state of epidemic threat in Poland was canceled. Findings: Analysis of epidemiological data showed that the number of new COVID-19 cases in Poland showed a gradual decline during the period considered to be the end of the pandemic. This reduction in case numbers has been consistent across regions of the country, although some areas have seen periodic increases. The data clearly demonstrate the significant impact of vaccinations in reducing the number of new infections and severe disease outcomes. Regions with higher vaccination rates saw lower COVID-19-related hospitalizations and deaths. Research limitations/implications: The surveys discussed in this article may contribute to further empirical studies, including but not limited to initiating works to improve the pandemic analysis. Practical implications: The study provides important information that can be used by public health decision-makers to shape effective pandemic response strategies. The results highlight the importance of maintaining and adapting intervention measures, such as vaccination, to control the spread of the virus and reduce the number of severe cases. Originality/value: This study stands out from other works on the COVID-19 pandemic by its unique focus on the final stage of the pandemic in Poland. While most studies focus on the early stages of the pandemic or its global impact, our study offers detailed insight into local aspects of pandemic management and its evolution in a specific country. We present a comprehensive analysis that combines epidemiological data, the impact of health policy, social behavior and vaccination effectiveness. [ABSTRACT FROM AUTHOR]

Background: This study aims to accurately estimate influenza‐associated deaths in Poland and their certified cause of death, due to significant discrepancies between official numbers and expected impact. Methods: Excess influenza‐associated mortality in Poland from 2000 to 2019 was calculated using Seasonal‐Trend Decomposition Procedure based on LOESS (STL), which can detect non‐linear trends and non‐sinusoidal cycles. Excess mortality was then used as an explanatory variable in a model predicting monthly fluctuations of officially recorded causes of death from 2010 to 2019. Results: A total of 142,000 conservative estimates of influenza‐associated deaths were identified, representing 1.86% of overall mortality. Only 0.61% of influenza‐associated deaths were officially recorded as influenza. Nearly half of certified influenza deaths were attributed to the seasonal baseline mortality, potentially doubling estimated impact based solely on influenza peaks. Influenza‐associated deaths were frequently recorded as respiratory diseases (24.36%), with majority attributed to underlying conditions such as cardiovascular diseases (45.31%), cancer (9.06%), or diabetes (2.66%). Influenza‐associated deaths were more commonly certified as nervous system diseases (1.84%) or mental disorders (1.04%), rather than influenza itself. There was a noticeable impact of influenza on secondary infections, such as meningococcal and gastrointestinal infections. Conclusion: These findings highlight the importance of improved estimation for informing public health policy decisions. [ABSTRACT FROM AUTHOR]

Simple Summary: The aim of this study was to assess the influence of the COVID-19 pandemic on the diagnosis and treatment of head and neck cancer (HNC) patients between 2018 and 2022. We analysed the medical records of 625 patients. During the COVID-19 pandemic, compared with the pre-COVID-19 pandemic period, the duration of the cancer diagnostic process was significantly longer, the proportion of patients admitted on the basis of a DILO card issued by a primary care physician was significantly higher, and the majority of cancer patients with a planned oncological treatment lived in urban areas. The aim of this study was to identify and assess the impact of the COVID-19 pandemic on the diagnosis and treatment of head and neck cancer (HNC) patients of the Department of Otolaryngology, Head and Neck Surgery of the 4th Military Teaching Hospital in Wroclaw for whom oncological treatment was planned by a cancer case board between March 2018 and February 2022. We analysed the medical records of 625 patients. In order to verify whether the relationships between the analysed features were statistically significant, the chi-square test of independence and the Student's t-test for independent samples were used (p < 0.05). Our analysis showed that the impact of the pandemic on the organization of health service delivery to HNC patients was not uniform. The largest difference in the number of formulated treatment plans was observed at the beginning of the pandemic (22.1% reduction compared with the year before the pandemic). During the pandemic, the proportion of patients admitted on the basis of a DILO (diagnosis and oncological treatment) card issued by a primary care physician, instead of a regular referral to hospital, issued also by a primary care physician, was significantly higher compared with the that during the pre-pandemic period. The majority of cancer patients with a oncological treatment planned during the pandemic lived in urban areas. During the pandemic, the number of patients with more-advanced-stage cancer, assessed on the basis of the type of planned treatment (radical vs. palliative), did not increase compared with that during the pre-pandemic period. However, our follow-up period was quite short. It is necessary to intensify activities aimed at promoting health and increasing health awareness in people living in rural areas and setting long-term priorities and objectives for health policies at the national, regional and local levels, with particular focus on this group of people. [ABSTRACT FROM AUTHOR]

The medical services market in Poland is financed mainly with funds from national health insurance, yet year by year, an increasing importance of private resources in financing health services can be noticed. Apart from common (national) health insurance, medical care is primarily financed directly by the patient and possibly by his employer (occupational medicine, additional private medical care). The purpose of this paper is to present the basic legal and market aspects of private health insurance in Poland, including a presentation of the structure of private healthcare expenses in Poland. [ABSTRACT FROM AUTHOR]

This paper assesses the impact of medical care on changes in mortality in east Germany and Poland before and after the political transition, with west Germany included for comparison. Building upon Rutstein's concept of unnecessary untimely deaths, we calculated the contribution of conditions considered responsive to medical care or health policy to changes in life expectancy between birth and age 75 [e(0-75)] for the periods 1980/1983-1988 and 1991/1992-1996/1997. Temporary life expectancy, between birth and age 75, has been consistently higher in west Germany, intermediate in east Germany and lowest in Poland. Although improving in all three regions between the early 1980s and the late 1990s, the pace of change differed between countries, resulting in a temporary widening of an initial east-west gap by the late 1980s and early 1990s. In the 1980s, in east Germany, 50-60% of the improvement was attributable to declining mortality from conditions responsive to medical care (west Germany: 30-40%). A net positive effect was also observed in Poland, although counterbalanced by deterioration in ischaemic heart disease mortality.In the former communist countries, improvements attributable to medical care in the 1980s were due, largely, to declining infant mortality. In the 1990s, they benefited also adults, specifically those aged 35+ in Poland and 55+ in Germany. A persisting east-west gap in temporary life expectancy in Germany was due, largely, to higher mortality from avoidable conditions in the east, with causes responsive to health policy contributing about half, and medical care 16% (men) to 24% (women) to the differential in 1997. The findings indicate that changes in the health care system related to the political transition were associated with improvements in life expectancy in east Germany and, to a lesser extent, in Poland. Also, differences in the quality of medical care as assessed by the concept of "unnecessary untimely deaths" appear to contribute to a persisting east-west health gap. Especially in Poland and the former German Democratic Republic there remains potential for further progress that would narrow the health gap with the west.

Why do countries move from public to private financing of healthcare? This paper explores this issue by looking at the divergent reform trajectories of three postcommunist countries — the Czech Republic, Hungary, and Poland. While existing accounts emphasize veto points to explain changes in healthcare systems, the present analysis finds that moves towards private financing can be better explained by differences in access to the policymaking arm of the state. Specifically, a penetrable single-party government and weak bureaucratic capacities allow physicians to capture the reform process and implement their preferred policies. The results suggest that scholars of health policy should focus more attention on the actors seeking change and their access to policy makers. [ABSTRACT FROM AUTHOR]

This review argues that history merits a place amongst the subjects which constitute interdisciplinary public health. It claims that three aspects of historical study can inform the contemporary thinking of public health practitioners. First, demographic trends over the very long term yield insights into fundamental drivers of human longevity and wellness. Second, the history of medicine in public health teaches us that medical science is not simply a progression of therapeutic discoveries, but a type of knowledge always situated in a social and cultural context. Third, the history of policy-making for health alerts us to issues of power and vested interest that surround attempts to advance public health goals in the political arena. This last contention is then illustrated through a case study which examines a historical puzzle peculiar to Poland. What were the reasons for the striking decline in cigarette consumption that followed the fall of the Berlin Wall, when all expectations were that the opposite should occur? [ABSTRACT FROM AUTHOR]

Background: Therapy based on medicinal cannabis or medical marijuana has attracted much international attention in recent years. Aim of the study: To assess the sale of medical marijuana in the Warminsko-Mazurskie Voivodeship between March 2019 and September 2020, estimate medical marijuana demand, and attempt to explain at least some of the reasons for the identified discrepancies. Material and methods: The study used data on medical marijuana sales in the Warminsko-Mazurskie Voivodeship collected by the Voivodeship Pharmaceutical Inspectorate in Olsztyn. Results: Medical marijuana is sold in trace amounts in the Warminsko-Mazurskie Voivodeship, although the available data indicate a dynamic increase in sales. Conclusions: Medical marijuana is available for sale in pharmacies in Poland in the form of pharmaceutical raw material. Currently, its sale, at least in the Warminsko-Mazurskie Voivodeship, is particularly small, though it is very likely that its future sales will increase. Despite this, there are no readily available reliable sources of information in Poland about the known benefits and dangers of medical marijuana use. In this situation, reliable knowledge needs to be disseminated to doctors and patients to safely achieve its therapeutic potential. [ABSTRACT FROM AUTHOR]

The issue of clusters as a form of organization of market entities has recently attracted an increasing attention of health care management theoreticians and practitioners. In our opinion the existing theoretical basis gives a foundation for considering clusters as a source of potential for increasing the effectiveness of health policy and health care organizations. It can be assumed that in case of health care clusters there is a possibility of interregional diffusion of innovation, based on ventures undertaken on the health care market, increasing not only the potential of the entities in the cluster, but also of its surroundings and subcontractors. It is possible to realize the idea of a flexible health care implemented regionally with the use of modern techniques of communication, knowledge transfer and high specialization. Nonetheless, in case of Poland the potential of clustrification remains untapped, being characterized by a limited actions of public and private bodies, marginal role of non-profit sector organizations and limited engagement of R&D sector. This is because a general distrust in the cluster formula, and the lack of relevant knowledge among local officials and health business leaders. For this reason the process of clustrification among health care entities requires external support through the increased efforts to create a system of legal and tax preferences for cluster initiatives and provision of organizational support in terms of know-how, targeted particularly at bodies and individuals, who may act as cluster leaders. [ABSTRACT FROM AUTHOR]

Over the last 20 years we can observe a divergence in health policies with respect to tobacco and alcohol that has led to significant health consequences. Poland experienced a significant increase in alcohol consumption accompanied by negative health and social consequences while, on the other hand, tobacco consumption went significantly down. Excise duty is one of the most important drivers for that. Alcohol excise policy was very passive, which resulted in a huge increase in the economic affordability of alcohol. Between 1999 and 2021 the number of bottles of vodka the disposable income could buy went up by 176%. At the same time, the tobacco tax policy was active so that the economic affordability of cigarettes did not change at all. This article presents the data on taxes, affordability and tax revenues and tries to explain this divergence. Three perspectives (health, financial and political) are sketched to show the predominant incentives for the players. [ABSTRACT FROM AUTHOR]

Background: Recent studies indicate that the treatment of obesity is unsuccessful. The cause of this situation is that patients are not sufficiently educated about therapeutic methods and the health consequences of not treating obesity. Moreover, obesity prevention strategies differ significantly between EU countries. Objective: The primary aim of this study was to examine and compare the level of obesity-related knowledge and illness perception among obese patients from Poland and Germany. Methods: A prospective cross-sectional international multicentre study was conducted. The study included 564 subjects above 18 years old (210 German patients and 354 Polish patients) with obesity. A validated custom-made questionnaire was used to evaluate obesity-related knowledge. Patient illness perception was evaluated using Polish and German language versions of the standardized Brief Illness Perception Questionnaire (B-IPQ). Results: Obese patients from Germany had significantly higher level of obesity-related knowledge than patients from Poland (22.01 ± 4.68 vs 19.17 ± 6.59, p< 0.0001). Obesity-related knowledge was associated with the patient's education, patient participation in therapeutic educational programs, patient's perception of the illness, age and the number of healthcare professionals involved in the patient's treatment process. Conclusion: The level of obesity-related knowledge among both Polish and German patients is unsatisfactory. This study suggests that health education is required to facilitate informed choices and support the use of cognitive approaches educating patients on the health consequences of obesity. [ABSTRACT FROM AUTHOR]

Currently developed and functioning models of so-called informed consent seem to be insufficient in case of the application, handling, or use of the genetic material, and may lead to over-interpretation or misinterpretation of the formal rules for using the stored genetic material. In medical practice, the aim is to obtain patient's consent to any interventions not only therapeutic, but also other, having a diagnostic character. These interventions often lacking direct medicinal goal, are often associated with a high risk to the health of the patient, who should be informed about that. The most common form of consent is called informed consent, in which the emphasis is primarily put on the patient's understanding of what needs to be signed on a specific form. The informed consent is a fundamental element of the subjective permission to submit to any intervention that interferes in bodily-mental realm of man. Currently valid provisions contained in a number of non-synchronized with each other regulatory acts selectively treat the concept of informed consent in the case of working with genetic material (the use, processing) and its terminal (temporary) use. The issue of storing genetic material in biobanks (both worldwide and in Poland) does not have a leading and promoting solution, and the present standards specifying the type and nature of consent are rather formal parts of different formal acts than a single standardized model. There is a need to have a new uniform interpretation of the law, which could be the basis for the concept of consent as a declaration of intent for the use of genetic material. The report presents a formal-legal approach to the issue of the concept and scope of consent as a declaration of intent, in the case of genetic material use. The currently existing in Poland and in the world legal solutions of the interpretations of the concept and scope of consent, as a declaration of intent for the use of genetic material, have been analyzed. The actual and hypothetical disputable and interpretation issues have been discussed. The paper presents original solution clarifying the issues of informed consent, which can be used in practice. [ABSTRACT FROM AUTHOR]

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In January 1999, the Polish government implemented a new law reorganizing the health care in the country. This paper includes an outline of the changes, the main impact of which consisted of introduction of universal health insurance administered by Health Insurance Funds (“Kasy Chorych”). In June 2001 and 2002, a survey of insurance administrators and health care workers provided data concerning the reception of the new system, the perceived inadequacies, and the postulated changes. The intended objective of privatization of health provisions appears as remote as it was before the changes. The major obstacles are identified as political hurdles, physician resistance, and continued dependence on state allocations. [Copyright &y& Elsevier]

Hospital Based Health Technology Assessment (HB-HTA) is a new policy implemented in Poland to allow for a more practical and contextualized assessment related to the use of specific medical procedures, devices, or equipment. It requires changes in governance relating to the healthcare sector. One of the forms of governance improvement is to involve society in the process of creating public services. This can be implemented, e.g., by applying the pragmatic model of public responsiveness. The aim of this research was to identify and analyze forces which will shape a dynamic process in determining the implementation of HB-HTA. The results obtained in the Gioia analysis led to the identification of the main forces driving and restraining the implementation of HB-HTA. The grouping and interpretation allowed for the twelve most important dimensions to be distinguished, which were recognized as conceptual categories necessary to build theories that describe the studied phenomenon. This study contributes to the development of the idea of responsiveness in public management theory and in health care services, and ultimately helps to better enable the adjustment of health services to the dynamically changing needs of Polish society. [ABSTRACT FROM AUTHOR]

This paper examines the right to health care. Various expressions of this right may be distinguished. These include both individual rights and social rights which could be based upon international treaties and constitutional rights. They may be found in national health legislation and, in some cases, in jurisprudence. To analyze the consequences of limiting the right to health care, a framework for judicial review has been developed which encompasses these expressions of the right to health care. The framework was used to examine legal and health policy developments in three Western and two Eastern European countries. In Italy and the Netherlands the right to health care is protected constitutionally (but on differing legal bases) while the United Kingdom does not have a written constitution. In contrast, Hungary and Poland have for many years seen the state take responsible for the provision, administration and allocation of health care services and the right to health care was guaranteed theoretically but not in practice because of the lack of (financial) means. However, the Polish Constitution explicitly anticipates possible limitations of the right to health care. What all these countries have in common is a cost containment perspective where the future will bring even tighter limits on what resources patients may consume. Despite differences in legal structure between these countries, where they seem to converge is on the consequences of putting limitations on the right to health care. The courts in Italy, the Netherlands and the UK have formulated conditions drawn from the acceptance that this right has to be judged within the context of limited resources. It may be concluded that finding a compromise between the right to health care and cost containment policies could also be an issue, Eastern European countries will have to face in the future. [ABSTRACT FROM AUTHOR]

Background: The CarerQol instrument can be used in economic evaluations to measure the care-related quality of life of informal caregivers. Tariff sets are available for Australia, Germany, Sweden, the Netherlands, the UK, and the USA.Objective: Our objective was to develop tariff sets for the CarerQol instrument for Hungary, Poland and Slovenia and to compare these with the existing value sets.Methods: Discrete-choice experiments were carried out in Hungary, Poland and Slovenia. Data were collected through an online survey between November 2018 and January 2019, using representative samples of 1000 respondents per country. Tariffs were calculated from coefficient estimates from panel mixed multinomial logit models with random parameters.Results: All seven CarerQol domains contributed significantly to the utility associated with different caregiving situations. Attributes valued highest were 'physical health' (tariffs for no problems were 15.6-21.8), 'mental health' (18.1-18.9) and 'fulfilment' (16.3-22.9). Value sets were comparable across the countries, although in Poland 'a lot of fulfilment' was valued higher (22.9) than in Hungary (16.3) and Slovenia (17.1). Compared with existing value sets, in the three Central European countries, 'fulfilment' was more important, whereas 'financial problems' were less important.Conclusion: For the first time in the Central and Eastern European region, country-specific tariffs are now available for the Hungarian, Polish and Slovenian versions of the CarerQol instrument. This facilitates inclusion of the impact of informal care in economic evaluations. Our results can be used to develop and evaluate country-specific health policy strategies to support informal caregivers. The differences found in informal care preferences highlight the limited transferability of CarerQol tariffs across European regions. [ABSTRACT FROM AUTHOR]

The article describes the growing anti-vaccine movements in the context of right-wing populism, which is also gaining popularity around the world. According to the authors, these two phenomena have a lot in common, and the activists of the anti-vaccine movements often intermingle with populist right-wing movements. The connection between anti-vaccine activists and populists is illustrated in the analysis of discourse and anti-vaccine arguments presented in materials on the Polish-language YouTube channel, as well as in comments on YouTube forums. The slogans of the defence of 'ordinary people' against 'corrupt elites' in the medical dimension indicate a dislike for 'medical conspiracy' and doctors corrupted by pharmaceutical concerns. Just like right-wing populists, opponents of vaccines in Poland refer to nationalist slogans and have an aversion to the European Union. In addition to the rejection of the WHO standards on sex education and the sceptic attitude to environmental changes, the rejection of vaccines is another manifestation of the conspiracy ideologies of right-wing populists in Poland that may affect health and health policy. In the area of public health, this means rejecting medical knowledge and replacing it with myths and prejudices proclaimed by anti-vaccine movements, among others. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cycling to work has been promoted all over the world. Contemporary employers invest in human capital (create a friendly work environment, care about the quality of life and health of employees). OBJECTIVES: The aim of this study was to evaluate the popularity of cycling to work and the motivations and barriers to this activity. METHODS: The study used data obtained from the survey Using cycling in everyday transportation conducted at the request of the Ministry of Sport and Tourism. The data were collected by means of computer-assisted personal interviewing (CAPI). RESULTS: A mere 9.9% of Poles commute to work by bike, but they cycle to work on a regular basis (68.6% of respondents do this several times a week for 1 to 6 months). They mostly cycle to improve/maintain health and physical fitness and for reasons concerning environmental protection. According to 49.5% of respondents, the infrastructure at the workplace is insufficient for commuting by bike. A substantial problem is the lack of changing rooms or places to change clothes (44.0%) and no access to showers (22.2%). In the opinions of 66.7%, the promotion of regular commuting to work by bike requires extension of the cycling infrastructure. CONCLUSIONS: The results indicate the necessity of employers' investment in the infrastructure and cycling facilities. [ABSTRACT FROM AUTHOR]