Development of scenarios for health expenditure in the new EU member states: Bulgaria, Estonia, Hungary, Poland and Slovakia

The report is a result of the Ageing, Health Status and Determinants of Health Expenditure (AHEAD) project within the EC 6th Framework programme. The objective of the research was to present the model of future health care system revenues and expenditures in selected Central and Eastern European countries (CEE) which are now the New EU Member States, and to discuss projection assumptions and results. Selected countries include Bulgaria, Estonia, Hungary, Poland and Slovakia. The projections are based on methodology adopted in the International Labour Organization (ILO) Social Budget model. The projection examines impact of demographic changes and changes in health status on future (up to 2050) health expenditures. Next to it, future changes in the labour market participation and their imact on the health care system revenues are examined. Results indicate that due to demographic pressures health expenditures will increase in the next 40 years and health care systems in the NMS will face deficit. Moreover, health revenues, expenditures and deficit/surplus are slightly sensitive to possible labour market changes. Health care system reforms are required in order to balance the disequilibrium of revenues and expenditures caused by external factors (demographic and economic), and decrease the premium needed to cover expenditures. Such reforms should lead, on the one hand, to the rationing of medical services covered by public resources, and on the other, to more effective governance and management of the sector and within the sector

Health promotion for the oldest seniors in the social sector. Examples of policies and programmes from Poland and the Czech Republic

The article identifies health promotion activities for the oldest people, who often become users of social services due to loss of capabilities, solitude and raising care needs related to worsening health status. The analysis is  based on the literature overview, experts’ consultations and interviews on the role of the social sector institutions in health promotion in selected countries. Examples of best practices in health promotion for older people in the social sector are presented. These include programmes of health information and campaigns on health risks avoidance, stimulation of physical activity, healthy eating for the oldest seniors, promotion of mental health and support of cognitive abilities, primary prevention activities and stimulation of social and cultural participation. The article concludes that health promotion activities for the oldest population, although on the side of main activities of the social sector, are an important element of activities of public and non-public institutions in providing care to dependent populations. Good practices identified typically involve numerous health promotion activities and require cooperation at the national – policy setting – level and within community. The article identifies health promotion activities for the oldest people, who often become users of social services due to loss of capabilities, solitude and raising care needs related to worsening health status. The analysis is  based on the literature overview, experts’ consultations and interviews on the role of the social sector institutions in health promotion in selected countries. Examples of best practices in health promotion for older people in the social sector are presented. These include programmes of health information and campaigns on health risks avoidance, stimulation of physical activity, healthy eating for the oldest seniors, promotion of mental health and support of cognitive abilities, primary prevention activities and stimulation of social and cultural participation. The article concludes that health promotion activities for the oldest population, although on the side of main activities of the social sector, are an important element of activities of public and non-public institutions in providing care to dependent populations. Good practices identified typically involve numerous health promotion activities and require cooperation at the national – policy setting – level and within community.&nbsp

Zasoby kadr dla sektora zdrowotnego. Dotychczasowe tendencje i prognozy

Human resources in health care. Up-to–date trends and projectionsThe article presents the diagnosis of trends in health care sector personnel in Poland, particularly physicians and nurses, and projections of the future personnel taking into account population ageing. The article is based on the NEUJOBS project research performed within the European Commission 7th Framework Programme. The analysis and projections use quantitative data: administrative, Eurostat data and GUS survey results. The density of employment of the health personnel per 1000 inhabitants is lower in Poland than in other EU-countries. In the future the demand for the medical personnel will be growing due to the increased needs for health care and ageing. The projections show that shortages of personnel will be faced by hospitals, particularly for specializations related to treatment of chronic diseases, while this is not the case in primary care. The size of the demand for medical personnel will be subjected to increase in technical efficiency of hospitals

Participation in formal learning activities of older Europeans in poor and good health

Little attention has been given to the involvement in formal learning activities (FLA) in the older population when considering different health statuses. The aim of this study is to explore the extent to which possible predictors (derived from previous research as well as a conceptual model) of FLA differ for older people in poor and good health. Data are used from SHARE 2010/2011 for the 50+ populations in 16 European countries. Poor health is defined as self-report of having two or more chronic diseases assessed by a medical doctor, i.e. multimorbidity. Possible predictors of learning activities represent individual characteristics: functional limitations, demography (age, gender, marital status and household size), human capital (achieved level of education), employment, income and participation in other social activities. To assess the predictors of FLA, logistic regression models are used and average marginal estimates are compared across groups. In addition to multimorbidity, labour market activity is used as a grouping variable. The average participation of individuals in the group with multimorbidity was nearly 50 % lower than that in the group in good health (6.5 vs. 13.3 %). Regardless of multimorbidity, human capital proved to be significant predictors of FLA, especially in those active on the labour market. However, the associations were weaker in the multimorbidity group. Also, significant associations were observed of other types of social activities, in particular cultural and leisure activity and volunteering, with FLA. This study suggests that similar factors are predictors of FLA in older people with and without multimorbidity

Predictors of social leisure activities in older Europeans with and without multimorbidity

Older people spend much time participating in leisure activities, such as taking part in organized activities and going out, but the extent of participation may differ according to both individual and environmental resources available. Chronic health problems become more prevalent at higher ages and likely necessitate tapping different resources to maintain social participation. This paper compares predictors of participation in social leisure activities between older people with and those without multimorbidity. The European Project on Osteoarthritis (EPOSA) was conducted in Germany, UK, Italy, The Netherlands, Spain and Sweden (N = 2942, mean age 74.2 (5.2)). Multivariate regression was used to predict social leisure participation and degree of participation in people with and without multimorbidity. Fewer older people with multimorbidity participated in social leisure activities (90.6 %), compared to those without multimorbidity (93.9 %). The frequency of participation was also lower compared to people without multimorbidity. Higher socioeconomic status, widowhood, a larger network of friends, volunteering, transportation possibilities and having fewer depressive symptoms were important for (the degree of) social leisure participation. Statistically significant differences between the multimorbidity groups were observed for volunteering and driving a car, which were more important predictors of participation in those with multimorbidity. In contrast, self-reported income appeared more important for those without multimorbidity, compared to those who had multimorbidity. Policies focusing on social (network of friends), physical (physical performance) and psychological factors (depressive symptoms) and on transportation possibilities are recommended to enable all older people to participate in social leisure activities