Search

Background European Union (EU) Member states' food environments are shaped by both national and EU policies. To date however, studies assessing food environment policies developed and set by the EU are scarce. The aim of this study was to assess the strength of EU policies to improve food environments as well as to assess the extent these policies could lead to a decrease or widening of socio-economic inequalities in dietary intake. Methods We compiled evidence on the EU policies for each of the Food-EPI 47 indicators. A European panel of independent, non-government experts (N = 30) specialized in nutrition, obesity or chronic diseases, using the Food-EPI evidence, rated the strength of EU policies to improve food environments during an online survey in February-March 2020. The experts also rated to which extent policies could lead to a decrease or widening of socio-economic inequalities in dietary intake. In addition, experts formulated actions to improve EU food environment policies, which were prioritized during a follow-up online survey. Results The overview of EU-level policies resulted in a 79-pages document, describing policies (or the lack thereof) for each of the 47 Food-EPI indicators. This document has been verified for completeness and accuracy by EU governmental officials. The evidence document shows that the EU has mainly binding legislation on the food labelling whereas policies on the other Food-EPI domains are mostly voluntary. Results from the online survey and the formulated prioritized actions will be presented during the conference. The results will reflect the experts' ratings supported by documented evidence and will provide meaningful guidance to EU officials and public health advocates in their efforts to improve the food environment policies set by the EU.

Background Ukraine, one of the largest states formed on the rubble of the Soviet Union, is widely perceived as a country that has lost its opportunities. Being devastated by corruption, it shows incapable to modernize and enter the economic path of sustainable growth. Similarly in the health care system no deeper reform efforts have been taken in the entire post-soviet period, leaving the system in bonds of ineffective solutions taken out of the Soviet era. Main body The recent geopolitical and economic crisis seem to favor the introduction of radical solutions that might lead to a rapid change in the organizational paradigm of the economic system, as well as in health care in Ukraine. In this paper we aim to highlight the key features of the ongoing health reform in Ukraine, identify basic challenges for it, and assess rationality and feasibility of the reform. We found that the projected scope and schedule of changes in the Ukrainian health system give promising prognosis regarding its final effect. Conclusions The final success of health reform in Ukraine is dependent on a number of factors, including the financial foundation arising of economic stability of the country, balance assurance between public and private spending for health and ability to eliminate the long-lasting practices, particularly when they are connected with activities of lobbying groups occupying particular positions in the health system. A consequence of actions taken by the political decision-makers in the longer perspective are also to highly determine the reform’s chances for success.

The aim of this article is to present the course of privatization of spa companies in Poland during the period 2001-2011. We discuss assumptions of the privatization process, as well as actual implementation, having identified the process as chaotic and inconsistent with prior legal provisions. We found that in its applied form the process resulted in limitation of the therapeutic potential of spas, and reduction of the State's ability to implement health policy in a legally determined form. We also found that privatization potentially improved spa infrastructure standards and increases the tourist potential of spa resorts. We recommend that clear eligibility criteria are applied to institutions in the privatization process, as well as the provision of legal guarantees for access to spa services financed from public resources. Such guarantees should be made a public obligation, to ensure the availability of services for insured persons, and there should be an obligation to maintain a specific part of a given institution's potential for the needs of patients funded by public health insurance.

The Internet has become a common and global medium. It contains vast information resources and a wide range of communication instruments. One of the communication channels are social media, which increasingly are also used in the business field. Social media combined with mobile technology introduced new challenges to marketing activity. This trend is also observed on specific and highly regulated drug market. The aim of this article is to describe the perspectives for the use of social media in e-pharmamarketing. We find that this require personalized communication, the use of online promotion tools, in order to perform advertising in contact with a demanding client. Currently pharmaceutical companies use social media to communicate basic information on their life, but they still do not appreciate it sufficiently as a tool to build the image of company or products. It is therefore considered that these companies should attach greater importance to the presence in this type of media, especially in the light of dynamic changes in the way people communicate.

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.

Armenian healthcare reforms have been carried out since independence in 1991, but achieved their full scale starting in 1995–1996. Although the healthcare system has already been modified and changed for 10 years, there is a lack of research in this regard. This paper aims to present the organization of the healthcare system in Armenia, its changes and challenges throughout the reform process. This paper is mainly based on a review of the relevant professional literature, a review and interpretation of legal acts in the healthcare field, and a review of research and assessment works done by several international and local organizations. There are still large numbers of elements typical for the Soviet Semashko model in Armenian healthcare structures. Implemented reforms have separated the institutions of the public payer and the providers, but did not manage to change the model of financing to be based on compulsory insurance. The level of financing is similar to the average in Central and Eastern Europe, but is based mainly on out-of-pocket payments contributing to about 80% of all system resources. The informal payments reach even 45% of expenditures. The structure of hospital beds remains ineffective, and there are still no mechanisms of increasing the quality of services. Privatization has been applied, but the role of private providers is still limited. The reforms have not caused satisfactory improvement in healthcare performance, although the health indicators are better than at the beginning of the transformation period. The stability of the reforming processes in previous years as well as the engagement of international institutions is a chance for positive changes in the near future.

In Poland, the new regulations establishing a decentralized system based on the regional sickness funds were implemented in 1999. However, the inconsequence of central government policy in Poland caused a significant reorganization of the model in 2001 towards the opposite direction. The objectives of this article are to analyze the organizational shape of the health care system in Poland after its reforms, separate the consequences of both reforms, and provide a possible generalization of the findings. The authors applied a modified decision space map based on a model by T. Bossert. The types of decentralization are according to Rondelli et al. Assumptions of both reforms, and their consequences, are based on political documents and reports and articles published in international and Polish scientific journals. The comparison of reforms shows that in 2001 the main changes referred to the institution of payer and financial matters. In both cases incorrect preparation of the political process and legislative faultiness were noted. Decentralization in 1999 was not followed by instruments needed for increasing the efficacy of the system; in the second case reorganization of the payer appears to be missing the expectations of health system participants. The comparison of reforms may suggest that decentralization is a better solution in the context of increasing organizational and financial efficacy of the health system, but because of numerous additional factors and specifics of political conditions in Poland generalizations are not possible.

Background The EU Directive on the application of patients’ rights in cross-border healthcare provides rules for facilitating access to cross-border healthcare and promotes cooperation on healthcare between member states, which brings many changes both in the organization and financing of health care. The aim of this paper is to assess whether providers in Poland are prepared to function within the single European market and what may be the impact on the …

Background A huge role in reducing inequalities in health is played by local governments, whose task is to respond to the needs of citizens. The local government is expected to be the first to address the changing health needs of residents, emerging inequality and injustice in access to health services. An essential tool in these activities are health programs conducted on the local …

The International Herald Tribune recently covered the problem of worker emigration from Poland in Judy Dempsey's piece "Poland faces shortage as workers go west." She pointed out that since joining the European Union (EU), the outflow from Poland may be nearing 8oo,ooo people more than z per cent of the population (i). Workforce shortages in construction and manufacturing were described, but in the healthcare system as well shortages are noticeable and are starting to paralyze the system in some regions. Medical workforce emigration must be considered in the context of aging populations. Lower birth rates and improved life expectancy generate greater a need for healthcare services, particularly geriatric care. "Skill importation" is a common response. In the United Kingdom, for example, two-thirds of doctors are emigrants (z). The problem is compounded by the "double aging" of providers. In the United States, an increasing fraction of nurses is over 45, as the number of younger women working in nursing is not increasing (2). For physicians and nurses from post-communist Europe, these developments in wealthier countries generate an opportunity to find new employment at much higher salaries and with better working conditions. Surveys show that as many as 40 per cent of physicians in Poland have considered emigration for work and about 3-4 per cent have already moved or have definite plans to do so. Results are similar for nurses (data provided by the Polish Chamber of Physicians and Polish Chamber of Nurses and Midwifes).

The paper refers to the problem of emergency medical service in Poland, which is the only European Union Member State not having activated the emergency phone number 112. This fact has caused the threat of European Union sanctions. In this context, we try to discuss the chances of finalizing reform of the dramatically inefficient Polish emergency services. Except for the lack of the integrated emergency call centres, there is no appropriate network of emergency hospital departments in Poland and no clear regulations concerning emergency professions. The necessary law was enacted in 2001, but it did not come into force. The threat of European Union sanctions may hasten its implementation; however, the weak position of the present government may cause a further delay of the reform.

Introduction: The political preference of voters has been shown to be associated with their health status. We investigated the relationship between political preferences and mortality in Poland around the time of the last three general elections.Methods: We used the electoral data from the general elections held in 2001, 2005 and 2007. Indicators of political ideological preference were constructed based on the percentage of votes gathered by each party. Data on mortality, education and income level were obtained from 2002-2007 from the Polish Central Statistical Office. Pearson correlation was computed between standardised mortality ratios (SMR) and political preference. Finally, the influence of political preference on SMR was examined in a multivariate analysis controlling for socio-economic factors.Results: SMR was positively correlated with liberal political views (0.26; pConclusion: Our findings are consistent with earlier studies conducted in western countries showing a positive correlation between liberal political ideology and SMR, but differ in that an inverse relationship was found between conservative political orientation with education and income. The importance of socioeconomic and geographical factors in relation to political affiliation and health inequalities in Poland should be further explored.

The paper is an effort to find what determined the success of Polish health reform implemented in 1999 in the Silesian Voivodeship. The problem has been referred to "social capital" proposed by R. Putnam; the first part of the article contains a short description of this approach. Then data concerning health insurance performance in Poland are presented, which confirm that the Silesian Regional Sickness Fund functioned most effectively. As a possible factor influencing present decentralised institutions performance, the situation of the Silesian Region during the mid-war period was described. Autonomy of the region, as well as tradition of social voluntary activity may be a source of "social capital" in Putnam's meaning. Besides, continuity of the Prussian bismarckian health insurance system is presented as a potential source of "institutional memory" also increasing the present reform's chances for success. In the last part of the paper, limitations of applying the "social capital" approach to the Silesian case are presented, such as shortness of the mid-war autonomy period and changes in the cultural structure of Upper Silesia caused by migrations after World War II. Other factors, which could increase the efficacy of the health insurance system, such as relatively high incomes of the region's inhabitants, are also described. Nevertheless, the final conclusion is that social and cultural conditions deriving from historical traditions could have had a significant influence on the process of implementing health reform in 1999.