Financial and organizational aspects of the functioning of primary health care during the COVID-19 pandemic

PURPOSE: The aim of this scientific study is to analyze selected issues related to the functioning and financing of Polish Primary Health Care units in the initial period of the SARS-CoV-2 virus pandemic.DESIGN/METHODOLOGY/APPROACH: The following research methods were used, the historicallegal method – selected legal acts and communiques issued by public administration bodies during the initial period of the pandemic, the dogmatic-legal method – a systematic and linguistic interpretation of legal acts, reports, and information on websites was carried out.FINDINGS: The research results allow to draw de lege ferenda conclusions regarding the improvement of organizational functioning of Primary Health Care units. These conclusions will be helpful if new infectious diseases appear in the future. Making the rules for financing Primary Health Care units more stable will enable public authorities to better prepare for potential crisis situations.PRACTICAL IMPLICATIONS: Solutions regarding the financing of healthcare services provided by Polish Primary Health Care facilities in the initial phase of the pandemic had a fundamental impact on the evolution of financing these medical entities in the subsequent stages of combating the pandemic and after its end.ORIGINALITY/VALUE: The article is an original analysis of actions aimed at solving the organizational and financial problems of Primary Health Care units. The article may provide an impetus for an international discussion on the organization and financing of such health care entities.peer-reviewe

The functioning of the Polish health care system during the first wave of the SARS-CoV-2 pandemic in the opinion of primary health care patients

PURPOSE: The aim of this scientific study is to analyze selected issues related to the functioning of Polish Primary Health Care units in the initial period of the SARS-CoV-2 virus pandemic.DESIGN/METHODOLOGY/APPROACH: The analysis focused on the access to health services provided by Primary Health Care doctors and quality of those services, as well as issues related to the so-called tele-advice. Changes introduced in this respect directly affected the provision of health services to patients in their place of residence. The surveys we conducted were aimed at identifying the problems encountered by patients of these health care units. The following research methods were used in the study: the historical-legal method – selected legal acts and communiques issued by public administration bodies during the initial period of the pandemic were analyzed; the dogmatic-legal method – a systematic and linguistic interpretation of legal acts, reports, and information on websites was carried out; the survey method – surveys conducted among patients of Primary Health Care.FINDINGS: The research results allow to draw de lege ferenda conclusions regarding the improvement of organizational functioning of Primary Health Care units. These conclusions will be helpful if new infectious diseases appear in the future. Making the rules for accessing Primary Health Care units more stable will enable public authorities to better prepare for potential crisis situations.PRACTICAL IMPLICATIONS: The conducted empirical research can be utilized by decisionmakers, individuals managing the Polish health care system, and those managing/running Primary Health Care facilities. The responses obtained from the respondents indicate the strengths and weaknesses in organizing the health care process in a non-standard situation, such as during a pandemic. With their help, it is possible to better organize the process of patient contact and treatment in a crisis situation, during so-called extraordinary states.ORIGINALITY/VALUE: The article is an original analysis of patients' opinions on the access to health care services provided by Primary Health Care facilities. The results of empirical research conducted among representatives of Polish society may serve as a basis for making comparisons in this area with other countries. The article may provide an impetus for an international discussion on the scope and quality of services provided by such health care entities.peer-reviewe

Niemiecka medycyna niematerialistyczna 1797–1848 w świetle historiografii z lat 1811–2014

Niemiecka medycyna romantyczna z lat 1797–1848 jest obecnie przedmiotem rozwiniętych badań prowadzonych zgodnie z zasadami metodologicznymi właściwymi dla nauk humanistycznych: historii, socjologii, antropologii kulturowej i antropologii medycyny klinicznej. Tego rodzaju standard interpretacyjny pojawił się w poświęconych tej epoce pracach w latach 70. XX w., a od lat 90. do chwili obecnej jest standardem dominującym. Celem niniejszego artykułu jest przedstawienie wcześniejszych sposobów historiograficznego opisu tej epoki i ukazanie, w jaki sposób dominująca dziś perspektywa kształtowała się w sporach teoretycznych toczonych przez badaczy tej epoki w XIX i XX w. Artykuł zawiera omówienie najważniejszych ujęć teoretycznych występujących w historiografii niemieckiej medycyny romantycznej (ujęcie eklektyczne, filozoficzne, jednobiegunowe, dwubiegunowe, trójbiegunowe i wielobiegunowe) oraz przedstawia charakterystyczne dla każdego z tych ujęć prace powstałe do połowy XX w. Piśmiennictwo późniejsze, a także prace z lat 1900–1945, niezwiązane wyraźniej z żadnym z ujęć teoretycznych, zostało przywołane w cytowanych w artykule monografiach, będących wynikiem moich badań nad historiografią medycyny niemieckiej.German non-materialistic medicine arose in opposition to the main modernisation trends in European medicine, known for drawing their inspiration from the philosophy of the Enlightenment. The model of this non-materialistic medicine, referred to in historiography as a ‘romantic’ one, owed its existence to the efforts of the Prussian authorities who created it in 1797, relying on the assistance of local doctors and philosophers. It was introduced by the administrative order to the medical departments at German universities both in Prussia and in the rest of Protestant Germany. Because the model was at variance with the dominant European standards, its introduction into the University curricula met with opposition from many German doctors – those affiliated with universities and ordinary physicians. However, this opposition failed to affect the position held by the authorities who did not shy away from imposing the norms of scientific rationality on German universities. It was not until the Spring of Nations that this romantic model was removed from German academia. From 1849 onwards the clinical training remained in line with European standards. As the German romantic model – so far removed from the one prevalent at that time in Europe – received so severe a criticism from medical circles, the history of medicine showed no interest in it until the latter half of the twentieth century. Texts devoted to this appeared almost exclusively in German. The purpose of this article is to characterise the phases the historiography of German romantic medicine has undergone since 1811, i.e. since the inception of the professional historiography of German romantic medicine. The author’s aim is to highlight the principles that underlay each of the medical models presented in the article and to show the dependence of the way in which the models were evaluated in historiography on the existing medical knowledge

The Formation of German Medical Historiographical Methodological Standards and Research Topics in the 20th Century and Its Influence on the American Historiographical Standard

In the fi rst half of the 20th century, the German historiography of medicine created genuine ideas of methodology of research on the history of the medical sciences and medicinal practice. They were a continuation of the native historiographic tradition which was present in German university didactics and literature about the history of medicine in the 19th century. The uniqueness of German anti-positivist methodologies was based on a perception of cultural context in the genesis of medical theories and doctrines. They were researching cultural factors in the overall structure and analysing their infl uence on academics’ and common folk’s perception. There were two rival methodological trends — neoromantic and sociocultural ones, and the second gained wider infl uence in the historiography of medicine. The sociocultural trend had a few research schools, among them: Kulturgeschichte der Medizin, Sozialgeschichte der Medizin and Alltagsgeschichte der Medizin. The main purpose of this paper is to show the genesis of German anti-positivist trends in 20th century, the most important achievements of sociocultural historiography in Germany till 1933 and after 1945, and its infl uence on the standard American historiography of medicine in 20th century. The paper also presents a wide range of literature printed in both Germany and USA about the aforementioned historiographic trends

COVID-19 Epidemic (2020-2022) – Threat to Public Health and Healthcare System in Poland

Epidemia spowodowana przez wirus SARS-Cov-2, która trwała w Polsce od marca 2020 do maja 2022 r., była przyczyną 6,5 mln zachorowań i 119 tys. zgonów. Odnotowano w tym czasie w Polsce także ponad 200 tys. zgonów nadmiarowych (excess mortality) w stosunku do średniej z ostatnich lat. Dane te plasują Polskę wśród krajów o najwyższym odsetku zachorowań i zgonów z powodu pandemii COVID -19 w Europie. Celem artykułu jest analiza przyczyn niezadowalającej efektywności walki z epidemią COVID -19 w Polsce w porównaniu do innych krajów europejskich. W analizie uwzględniono dane historyczne dotyczące podstaw efektywności systemów zabezpieczeń przeciwepidemicznych w Europie tworzonych w XIX i XX w. i funkcjonowania polskiego systemu medycyny publicznej w latach 1990 – 2020. Uwzględniono także wyniki badań wśród pacjentów, którzy przebyli COVID -19 i pracowników systemu opieki medycznej. Artykuł uwzględnia aspekty społeczne, prawne, informacyjne i organizacyjne, związane z dążeniem do opanowania rozwoju pandemii w Polsce. Tekst zawiera wnioski praktyczne, których wdrożenie umożliwiłoby wzrost efektywności działań przeciwepidemicznych w Polsce.The epidemic caused by the SARS-Cov-2 virus, which lasted in Poland from March 2020 to May 2022, was the cause of 6.5 million cases and 119,000. deaths. At that time, over 200,000 cases of excess deaths, as compared to the average in recent years, were also recorded in Poland. These data place Poland among the countries with the highest percentage of illnesses and deaths due to the COVID-19 pandemic in Europe. The aim of this article is to analyze the reasons for the unsatisfactory effectiveness of the fight against the COVID-19 epidemic in Poland, as compared to other European countries. The analysis took into account historical data regarding the basis of the effectiveness of anti-epidemic security systems in Europe created in the 19th and 20th centuries and the functioning of the Polish public medicine system between 1990 and 2020. The results of tests conducted among patients who have had COVID-19 and employees of the medical care system were also taken into account. This article takes into account social, legal, information and organizational aspects related to efforts to control the development of the pandemic in Poland. This text contains practical conclusions, the implementation of which would increase the effectiveness of antiepidemic activities in Poland

Lorenz Oken – a Romantic philosopher of nature and his role in moulding the standards for German academic science in the first half of the nineteenth century

Lorenz Oken is acknowledged as an emblematic person in German Romantic science, who combined the inspiration drawn from his native philosophical tradition and the protestant religion with the fundamental objection against the academic standards derived from the Enlightenment philosophy. The goal of this paper is to present his views in the context of literature concerning the history of philosophy and history of medicine that has been published so far, as well as to analyse them with reference to the standards of science in German Romanticism over the period of 1802–1831. Oken is worthy of attention due to the significant influence he once had over German natural sciences, and also due to the increasing criticism of his views in German medical circles. The author presents the grounds and conditions of this criticism, which eventually led to recognising his views as extreme and to removing them from teaching in German medical faculties after 1832.Bożena Płonka-Syroka – prof. dr hab., kierownik Zakładu Humanistycznych Nauk Wydziału Farmaceutycznego Uniwersytetu Medycznego im. Piastów Śląskich we Wrocławiu. Jest autorką 5 książek, redaktorem ponad stu tomów wydanych w 11 seriach publikowanych pod jej redakcją oraz ponad 250 artykułów z zakresu historii medycyny, historii nauk przyrodniczych, metodologii historii nauki, historii historiografii nauki oraz nauk o kulturze. Jest jedną z założycielek (1992) i członkiem redakcji czasopisma „Medycyna Nowożytna”, członkiem wielu towarzystw naukowych, prowadzi systematyczną współpracę z zagranicą (Niemcy, Turcja). Główne publikacje: Recepcja doktryn medycznych przełomu XVIII i XIX wieku w polskich ośrodkach akademickich w latach 1774–1863 (1990, Ossolineum), Niemiecka medycyna romantyczna (2007, Wydawnictwo DiG), Medycyna w historii i kulturze (2016, Wydawnictwo DiG).7310

Expectations of Patients Recovering from SARS-CoV-2 towards New Forms of Pulmonary Rehabilitation

The purpose of this study was to explore the experiences of patients attending an innovative technology-enhanced pulmonary rehabilitation program of National Health Found Program in Poland. The study included two groups of patients participating in post-COVID-19 stationary rehabilitation. Patients from group I (127 individuals) contracted COVID-19 in 2020, while patients from group II fell ill in 2021 (68 individuals). The study used a self-administered questionnaire. This study was designed as an acceptability study. In the experience related to COVID-19 in both groups of the respondents, the possibility of undertaking inpatient rehabilitation in a hospital ward played an important and positive role. Patients who experienced COVID-19 symptomatically expected that rehabilitation would eliminate the related dysfunctions, such as reduced respiratory efficiency of the lungs, disorders of the nervous system, and cognitive disorders (the so-called brain fog). All respondents who experienced symptomatic COVID-19 positively assessed the rehabilitation program offered. Among the highest-rated rehabilitation, elements were identified: exercise on a cycle ergometer implemented with video stimulation, group fitness exercises, and breathing exercises. Other innovative forms of rehabilitation were positively evaluated by 10% to 25% of patients