Kluczowe czynniki konkurencyjności podmiotów leczniczych

Introduction: The healthcare sector, like other sectors of the economy, is based on competition. Due to the uniqueness of the services provided (involving saving human health and life), the competitiveness of healthcare entities differs from the typical free market. Purpose: The aim of the study was to identify the factors of competitiveness of healthcare entities in four distinguished areas of competitiveness of enterprises - external factors (macro- and micro-environment) and internal factors (resources and assets). Results: Macro-environment factors were grouped into: political-legal, economic, social, technological, and demographic. Micro-environment was divided into: consumers, competitors (considering their intensity and entry barriers), and suppliers. Resources were divided into: financial assets, room infrastructure, and equipment facilities. Assets, on the other hand, were characterized based on the elements of the organization's system, determining their efficiency – strategy, styles, competencies, employees, structure, and organization's culture.  Conclusions:  The review and systematization of factors influencing the competitiveness of healthcare entities enables to assess their competitive potential in the context of individual areas and key success factors.Wstęp: Rynek ochrony zdrowia, podobnie jak inne sektory gospodarki oparty jest o konkurencyjność. Z uwagi na unikalność świadczonych usług (polegających na ratowaniu ludzkiego zdrowia i życia), konkurencyjność podmiotów leczniczych różni się od typowego wolnego rynku. Cel: Celem pracy była identyfikacja czynników konkurencyjności podmiotów leczniczych w czterech wyróżnionych obszarach konkurencyjności przedsiębiorstw – czynników zewnętrznych (makro- i mikrootoczenie) oraz czynników wewnętrznych (zasoby i aktywa). Wyniki: Czynniki makrootoczenia zostały pogrupowane na: polityczno-prawne, ekonomiczne, społeczne, technologiczne i demograficzne. Mikrootoczenie zostało podzielone na: konsumentów i konkurentów, uwzględniając ich intensywność oraz bariery wejścia na rynek oraz dostawców. Zasoby podzielono na: aktywa finansowe, infrastrukturę pomieszczeń oraz wyposażenie w sprzęt. Natomiast aktywa zostały scharakteryzowane w oparciu o elementy systemu organizacji, warunkujące ich sprawczość – strategię, style, kompetencje, pracowników, strukturę oraz kulturę organizacji.  Podsumowanie: Dokonany przegląd i systematyzacja czynników wpływających na konkurencyjność podmiotów leczniczych umożliwia ocenę ich potencjału konkurencyjności w kontekście poszczególnych obszarów i scharakteryzowanych w nich kluczowych czynników sukcesu

Fibromyalgia in general practice

W społeczeństwach wielu krajów rozwiniętych obserwuje się znaczne rozpowszechnienie fibromialgii (FM). Zapadalność i chorobowość z powodu FM w społeczeństwie polskim nie jest dokładnie określona, jednak jej rozpowszechnienie może mieć tendencję wzrostową. Wczesna diagnoza i wdrożenie odpowiedniego leczenia na poziomie podstawowej opieki zdrowotnej stanowi ważny element poprawy stanu zdrowia pacjentów oraz może się wiązać z ograniczeniem kosztów opieki medycznej. W artykule zaprezentowano najnowsze doniesienia na temat FM oraz wskazano na istotne aspekty diagnostyki i leczenia FM w warunkach podstawowej opieki zdrowotnej. Artykuł został oparty na najnowszych informacjach z literatury medycznej na temat FM. Fibromialgia cechuje się dużym rozpowszechnieniem, nierzadko kosztochłonną diagnostyką i niepewnymi efektami leczenia. Podjęcie wczesnej diagnostyki i wdrożenie właściwego postępowania już na poziomie podstawowej opieki zdrowotnej, z uwzględnieniem najnowszych doniesień medycznych, może przyczynić się do wcześniejszego uzyskania poprawy stanu zdrowia oraz ograniczenia kosztów diagnostyki i leczenia osób z FM. Prezentowane dane mogą być pomocne dla wszystkich osób zaangażowanych w poprawę stanu zdrowia pacjentów w ramach podstawowej opieki zdrowotnej.High prevalence of fibromyalgia (FM) can be observed in developed countries. The incidence and prevalence of FM in Polish people is not well determined, but its prevalence may be increasing. Early diagnosis and the implementation of appropriate treatment at the level of primary health care is an important element of the improvement of patients’ health and it may reduce medical expenses. The article presents the latest data on FM and highlights significant aspects of diagnosis and treatment of FM in primary care. The article is based on the latest information from medical literature. FM is characterized by high prevalence, mostly cost-intensive diagnostics, and uncertain effects of treatment. Early diagnosis and appropriate procedures at the level of primary health care, including the most recent medical reports, may contribute to the improvement of health and the reduction of the costs of diagnosis and treatment of people with FM. Presented data can be helpful for all those involved in health improvement of patients under primary care

Proliferation and apoptosis of human placental cells exposed to aromatic hydrocarbons

Objectives: The objective of this study is to assess the effect of elevated urinary levels of aromatic hydrocarbons (AH) on the proliferation and apoptosis of human placental trophoblast cells obtained in the course of normal pregnancy in an AH-polluted region. Material and methods: Tissue material was obtained for study purposes from 50 afterbirths from Płock as the study group and 50 afterbirths from Kutno as the control group. The extent and intensity of reactions were analyzed. The levels of phenol and 1-hydroxypyrene in the excreted urine of pregnant (in labor) patients were determined by gas chromatography and colorimetry. The proliferative activity of trophoblast cells was assessed using MPM-2 antibodies against phosphoprotein synthesized upon mitotic induction and Ki-67 antigen while the intensity of apoptosis in trophoblast cells was assessed using p53 and bcl-2 oncoproteins involved in apoptosis-regulating mechanisms. The immunohistochemical reactions were assessed for their extent and intensity. Results: The levels of phenol and 1-hydroxypyrene excreted in the urine were statistically significantly higher in patients from Płock region. The proliferative activity of trophoblast cells was statistically significantly higher in the study group (p < 0.05). The activity of oncoprotein bcl-2 was significantly higher in the study group while the activity of p53 was sig¬nificantly higher in the control group. Pregnancy in an aromatic hydrocarbon-polluted environment has a significantly negative impact on placental tissue. Ad¬aptation mechanisms are induced as manifested by increased proliferative activity within the trophoblast and extensive inhibition of apoptosis in the study group

Asymptomatic hyperuricemia in primary health care

Wstęp. Znaczne rozpowszechnienie chorób powiązanych z hiperurykemią obserwuje się w wielu rozwiniętych krajach. Choroba ta występuje także wśród społeczeństwa polskiego. Wczesna diagnoza i wdrożenie odpowiedniego leczenia na poziomie podstawowej zdrowotnej stanowią istotny element prewencji chorób układu kostno-stawowego, sercowo-naczyniowego, moczowego, cukrzycy, zespołu metabolicznego i otyłości. Cel pracy. Artykuł przedstawia najnowsze doniesienia na temat roli hiperurykemii w rozwoju innych chorób oraz opisuje wybrane aspekty diagnostyki i leczenia tej choroby w warunkach podstawowej opieki zdrowotnej. Skrócony aktualny stan wiedzy. Artykuł został oparty na najnowszych informacjach z literatury medycznej na temat postępowania w bezobjawowej hiperurykemii. Podsumowanie. Hiperurykemia jest powiązana z występowaniem wielu chorób i stanowi czynnik ryzyka zwiększonej śmiertelności, głównie u kobiet. Edukacja zdrowotna, wczesna diagnostyka oraz leczenie hiperurykemii na poziomie podstawowej opieki zdrowotnej są głównymi działaniami mającymi na celu prewencję chorób powiązanych z hiperurykemią. Prezentowane dane mogą być pomocne dla wszystkich osób zaangażowanych w promocję zachowań prozdrowotnych i profilaktykę chorób.Introduction. Significant prevalence of diseases associated with hyperuricemia is observed in many developed countries. This disease also occurs in the Polish population. Early diagnosis and the implementation of appropriate treatment at the primary care level is an important element of the prevention of bone and joint diseases, cardiovascular diseases, urinary tract diseases, diabetes, metabolic syndrome, obesity. Purpose. The article presents the latest reports on the role of hyperuricemia in the development of other diseases and describes some aspects of diagnosis and treatment at the primary care level. Abbreviated present state of knowledge. The article was based on the latest information from the medical literature on the treatment of asymptomatic hyperuricemia. Summary. Hyperuricemia is associated with the presence of many diseases and it is the risk factor for increased mortality, mainly in women. Health education, early diagnosis and treatment of hyperuricemia at the primary care level are the main actions aimed at prevention of diseases associated with hyperuricemia. The presented data can be useful for all people involved in the promotion of healthy behaviors and disease prevention

Preliminary report on a study of health-related quality of life in patients with rheumatoid arthritis

There are studies about health-related quality of life (HRQoL) in patients with rheumatoid arthritis (RA), but few studies prospectively assessed HRQoL. The main purpose of this study was to analyze HRQoL in patients hospitalized due to RA exacerbation and observed over a planned 2-year follow-up in an outpatient setting. The study involved 42 women and 9 men, at mean age of 62.5 years (SD ± 12.6). The mean duration of the study was 22–23 months. The HRQoL analysis was performed using the SF-36 survey. At the beginning of the study, basic data on age, sex, selected biochemical (ESR, CRP, GFR, hemoglobin, plasma albumin, plasma protein), and clinical parameters (the duration of RA, VAS, DAS28, BMI, the presence of cardiovascular disease, diabetes, osteoporosis, osteoporotic fractures, osteoarthritis, neoplasm) were collected. Questionnaires were completed at the beginning and end of the study. Statistically significant reductions in HRQoL scores were observed in social functioning (SF; 0.42 vs 0.32, P < 0.05), whereas role-emotional health (RE; 0.48 vs 0.59, P < 0.05) and mental health (MH; 0.47 vs 0.54, P < 0.05) scores were increased. A decrease in the SF was positively correlated with the lack of osteoporosis at baseline (r = 0.35, P > 0.02). An increase in the MH was inversely correlated with BMI (r = −0.31, P < 0.05), and the level of hemoglobin (r = −0.32, P < 0.028) and positively correlated with the presence of osteoarthritis at baseline (r = 0.29, P < 0.05). In RA patients, dimensions of HRQoL as SF, RE, and MH could change within 2 years and these changes could be related to comorbidities. Although preliminary findings are promising, further studies are needed

The essence and scope of competitiveness of healthcare organisations in Poland

Purpose – The paper presents an analysis of the broadly defined essence of competitiveness in the healthcare sector and the closely related issue of the competitiveness of healthcare organisations accounting for the specifics of key types of competition in healthcare. The objective of the paper is to demonstrate that the essence of competition between healthcare organisations is represented by a better use of resources by some enterprises and enhanced cost efficiency in the conditions of the increased demand for top quality services. Research method – The research methodology applied in the study was literature research, the analysis of available empirical research results and of the laws and regulations applicable to the healthcare market. The analysis focused on the specifics of the Polish healthcare market and the ensuing conse-quences for the competitiveness of healthcare organisations. Results – The results of the analysis show how complex the issue of competitiveness of healthcare organisations is and how relevant it is for the increase of quality, availability, and innovativeness of healthcare for patients.Tomasz Sikora: [email protected] Kanecki: [email protected] Sikora: [email protected] Bogdan: [email protected] Sikora - Medical Center Corten MedicKrzysztof Kanecki - Department of Social Medicine and Public Health, Medical University of WarsawAgnieszka Sikora - Medical Center Corten MedicMagdalena Bogdan - Department of Social Medicine and Public Health, Medical University of WarsawAct, 2011, Ustawa z dnia 15 kwietnia 2011 r. o działalności leczniczej (Dz.U. z 2011 r. nr 84 poz. 455).Arrow K.J., 1979, Lecznictwo z punku widzenia niepewności i ekonomii dobrobytu, Eseje z teorii ryzyka, WN PWN, Warszawa.Bloom N., Propper C., Seiler S., Reenen J.V., 2010, The impact of competition on management quality: evidence from public hospitals, “CEP Discussion Paper”, No. 0983, pp. 1-47.Cooper Z., 2011, In brief: competition in the public sector: good for the goose, good for the gander?, “The Magazine for Economic Performance”, Paper Number CEPCP341, pp. 14-15.Corrigan P., Mitchell C., 2011, The hospital is dead, long live the hospital, Reform, London.Dobija M., 2000, Human resource costing and accounting as a determinant of minimum wage theory, „Zeszyty Naukowe. Akademia Ekonomiczna w Krakowie”, nr 553, s. 39-61.Donabedian A., 1998, The quality of care: how can it be assessed?, “JAMA”, vol. 260(12), pp.1743-1748, DOI: 10.1001/jama.260.12.1743.Greenshields G., 2000, Cele i strategie prywatyzacji opieki szpitalnej w Polsce, Bywater Consulting, Warrington.Hauke E., 1995, Poradnik dla zapewnienia jakości w szpitalu. Wskazówki do praktycznego użytku, Instytut Organizacji Szpitalnictwa im. L. Boltzmanna w Wiedniu, Warszawa.Kowalska K., 2005, Racjonowanie usług medycznych – spojrzenie ekonomisty, „Diametros”, nr 5, s. 223-233.Lisiecka-Biełanowicz M., 2001, Zarządzanie jakością usług zdrowotnych, Zarządzanie w ochronie zdrowia. Narzędzia pracy menedżera, Kolegium Zarządzania Akademii Ekonomicznej, Katowice.Łukasiewicz G., 2009, Kapitał ludzki organizacji. Pomiar i sprawozdawczość, WN PWN, Warszawa.Misiński W., 2007, Modelowanie systemu powszechnych ubezpieczeń zdrowotnych w Polsce, Wydawnictwo Akademii Ekonomicznej im. Oskara Langego, Wrocław.Perechuda K., Chomiak-Orsa I., 2013, Znaczenie kapitału relacyjnego we współczesnych koncepcjach zarządzania „Zarządzaniei Finanse”, nr 4(1), s. 293-307.Pędziński B., 2016, Innowacyjne Centrum Diagnostyczno-Lecznicze – od teorii do praktyki, Łomżyńskie Centrum Medyczne, Łomża.Rabiej E., 2013, Formy organizacyjne podmiotów leczniczych – uwarunkowania prawne i ekonomiczne, „Przedsiębiorstwo i Region”, nr 5, s. 100-108.Rudawska I., 2007, Opieka zdrowotna, aspekty rynkowe i marketingowe, WN PWN, Warszawa.Stępiński J., Karniej P., Kęsy M., 2011, Innowacje organizacyjne w szpitalach, Wolters Kluwer business, Warszawa.Suchecka J., 2010, Ekonomia zdrowia i opieki zdrowotnej, Wolters Kluwer Polska, Warszawa.Tyszko P., Wierzba W., Kanecki K., Jagielska A., 2007, Transformationof the ownership structure in Polish Healthcare and its effects, “Central and European Journal of Medicine”, vol. 2(4), pp. 528-538, DOI: 10.2478/s11536-007-0045-z.Walsche K., Smith J., 2011, Zarządzanie w opiece zdrowotnej, Wolters Kluwer business, Warszawa.Wielicka K., 2014, Zarys funkcjonowania systemów opieki zdrowotnej w wybranych krajach Unii Europejskiej, „Zeszyty Naukowe Politechniki Śląskiej”, nr 70, s. 491-504.Wiercińska A., 2012, Specyfika rynku usług zdrowotnych, „Zarządzanie i Finanse”, nr 2(2), s. 165-176.www 1, An assessment of possible improvements to the functioning of the Polish healthcare system 2011, http://www.ey.com/Publication/vwLUAssets/Organizacja_procesu_bud-zetowego_pl.pdf/$FILE/Ocena_mozliwosci_poprawy_EN.pdf [date of entry: 12.03.2018].www 2, Healthcare Leadership Model, NHS, https://www.leadershipacademy.nhs.uk/ wp-content/uploads/2014/10/NHSLeadership-LeadershipModel-colour.pdf [date of entry: 20.09.2021].www 3, Planowane wydatki na zdrowie w latach 2018-2020, 2021, https://stat.gov.pl/ obszary-tematyczne/zdrowie/zdrowie/wydatki-na-ochrone-zdrowia-w-latach-2018-2020,27,1.html [date of entry: 20.09.2021].www 4, Zarządzenie nr 47/2016/DSOZ Prezesa NFZ, http://www.nfz.gov.pl/zarza-dzenia-prezesa/zarzadzenia-prezesa-nfz/zarzadzenie-nr-472016dsoz,6486.html [date of entry: 12.03.2018].www 5, Zarządzenie Nr 3/2014/DSOZ Prezesa NFZ, http://www.nfz.gov.pl/zarza-dzenia-prezesa/zarzadzenia-prezesa-nfz/zarzadzenie-nr-32014dsoz,5902.html [date of entry: 12.03.2018].4(106)182

An evaluation of the impact of rehabilitation on the quality of life in patients after cerebral stroke

Cerebral stroke is the third most frequent cause of death in the human population, and one of leading causes of long-lasting disability. Medical rehabilitation has proven to be an indispensable element in stroke management. The aim of this study is to evaluate the quality of life in patients after a cerebral stroke, before and after rehabilitation. This analysis was based on data obtained from an empirical study conducted on 70 people after a stroke. The research was performed with the use of an original survey questionnaire. Due to their conditions, respondents perceived varying degrees and extents of changes in their organisms and environments pertaining to their physical, psychological, social, and professional spheres of life. In the vast majority of the patients, applied rehabilitation had a positive influence on their quality of life. There was an improvement in their physical and psychological conditions, as well as in various other aspects of life, while the intensity of emerging disorders decreased

Polish Adults’ Knowledge, Perceptions and Attitudes Concerning Legionellosis

Despite the growing prevalence of legionellosis in Poland and worldwide, little is known about the extent of public awareness regarding the seriousness of this disease and the appropriate preventive measures. The aim of this work is to assess the Polish adults’ knowledge, perceptions, and beliefs about legionellosis and its causative agents, risk factors, exposure, and other relevant facts. Data for this cross-sectional study were gathered via a questionnaire that was constructed and validated by the study investigators before commencing the survey, which lasted from January to March 2022. Knowledge, attitude and practice towards legionella were measured and quantified. One-way ANOVA and chi square tests were used to compare between demographic variables and the level of knowledge. Regression analysis was conducted to examine the predictors for higher knowledge among study participants. A total of 251 participants with a mean age of 28.26 ± 9.6 were enrolled in the current study. Over two thirds (74%) were females, with higher education (62%). Older age was associated with less knowledge about legionellosis (B = -0.049, p < 0.001), while higher education was associated with more knowledge (B = 1.656, p < 0.001). No significant differences were found between genders (p = 0.066). A knowledge gap was present for diagnostic tests regarding legionella. On the other hand, knowledge about prevention procedures was quite high among study participants. This study showed that overall knowledge about legionellosis in Polish adults was quite low. In particular, older age groups and the less educated are in need of more awareness of legionellosis disease. A knowledge gap was particularly present regarding how the disease is diagnosed. Awareness campaigns containing simple, easy-to-understand information could prove useful in combating the disease

Primary health care tasks in implementing the main operations of public health

Public health and primary health care are complementary strategies for sustaining the health of a society. There are many analyses in the literature on the subject that deal with the possibility of mutual support between public health and primary health care. There reports from many countries include studies of scientific institutions, presentations of specific solutions used by health protection administrations and self-government bodies, programs of study, and courses. However, this issue is rarely raised in Poland. The aim of this article is to present an up-to-date list of public health operations and to where there is room for primary health care activities. A binding list of public health operations was defined by the World Health Organisation (WHO) in 2012 under the name of Essential Public Health Operations (EPHOs). In order to define public health operations more precisely in this article, a questionnaire self-assessment tool for the evaluation of essential public health operations in the WHO European Region was used. Primary health care plays a significant role in the performance of public health operations (EPHOs), whereas the public health operations connected with health protection (EPHO 3), health promotion (EPHO 4) and disease prevention (EPHO 5), are mostly attributed to primary health care. Primary health care provides the information necessary for the performance of public health operations in the field of monitoring population health and well-being – in particular infectious and chronic diseases (EPHO 1), and for health care management and improvement of health care quality (EPHO 6)