Polityka zdrowotna i HTA

Health policy and HTASet of procedures referred to as Health Technology Assessment (HTA) becomes more and more popular among health policy makers in many. There are two factors contributing to this process. Firstly, it is universal access to health services and their guaranteed financing from public  esources.Secondly, a pressure exerted by manufacturers of pharmaceuticals and medical equipment who looks for profit. The choice which is to be made by decision makers is difficult. If new technologies are implemented too late – there are losses in health and a dissatisfaction of citizens is growing. If they are implemented to hastily, without necessary tests, there are losses in health again and public payer has to pay – and waste – a lot of money. HTA opens a way to make more rational decisions

Koncepcja „Oceny wpływu na zdrowie” (Health Impact Assessment) i jej wykorzystywanie w Unii Europejskiej. Perspektywa sektora prywatnego

Concept of Health Impact Assessment and its application in European Union. Private sector dimensionAccording to the WHO definition Health Impact Assessment (HIA) refers to “procedures, methods and tools by which a policy, programme  or project may be judged as to its potential effects on the health of the population and the distribution of those effects within the population”. HIA has emerged from weather forecasts and is founding much  broader use. It helps to identify the factors, which have a potential impact on health. HIA may be relevant for all sectors to determine the effects, also unintentional, of their policies and actions on health and it has the potential to bring greater transparency to the decision-making process. Usually, it is very important to be able to foresee future health related effects, also by clarifying the nature of trade-offs in policy. Comparing and judging wanted and unwanted results is essential to choose a possibly best alternative and avoid harm. In European Union where modern tools to rationalize decision making process are broadly accepted HIA has been welcomed, at least in declarations. Although some approaches to assess actions targeted at environment have been formalized and are binding, but others, including HIA, still depend on good will of partners involved. Both member countries and institutions are a bit reserved to use HIA. Insufficient popularity of HIA may result from scarce educational opportunities but also from deficit in well grounded scientific evidence

Problemy nierówności w zdrowiu. Perspektywa Unii Europejskiej

Problems of health inequalities. European Union perspectivesIn European Union democratic values have been approved unquestionably. They may be derived from many sources like from its own, dignified tradition linking back to Declaration of the Rights of Man and of the Citizen of 1789 or United Nations documents. In the Lisbon Treaty on functioning of European Union there are words about the space of freedom, safety and justice, equality between men and women, and equality of chances. UE has obliged itself fighting against all forms of inequalities and discrimination. As one of authors said: equality, cohesion and social justice this is the material of which Europe is constructed. They are not only the object of declarations and recommendations, but active implementation attentively watched by the whole world. In this paper I deal with two aspects of the workings undertaken within the UE which are aimed at reduction of health inequalities. First refers to actions resulting from common initiatives, therefore activities belonging to responsibility shared by EU and member countries. In second part questions raised from initiatives promoted by countries holding presidency are analysed. Rather frequently these countries made a very essential influence on the way of perception and solving the problems of health inequalities

The 2014 primary health care reform in Poland: Short-term fixes instead of a long-term strategy

AbstractAt the end of 2013, the Minister of Health started legislative changes directly and indirectly affecting primary health care (PHC). The reforms were widely criticised among certain groups of medical professionals, including family medicine physicians. The latter mainly criticised the formal inclusion of specialists in internal diseases and paediatrics into PHC within the statutory health care system, which in practice meant that these two groups of specialists were no longer required to specialize in family medicine from 2017 in order to enter into contracts with the public payer and would be able to set up solo PHC practices—something over which family medicine physicians used to have a monopoly. They argued that paediatricians and internists did not have the necessary professional competencies to work as PHC physicians and thus assure provision of a comprehensive and coordinated PHC. The government’s stance was that the proposed measure was necessary to assure the future provision of PHC, given the shortage of specialists in family medicine. Certain groups of medical professionals were also supportive of the proposed change. The key argument in favour was that it could improve access to PHC, especially for children. However, while this was not the subject of the critique or even a policy debate, the proposal ignored the increasing health care needs of older patients—the key recipients of PHC services. The policy was passed in the Parliament in March–April 2014 without a dialogue with the key stakeholders, which is typical of health care (and other) reforms in Poland. The strong opposition against the reform from the family medicine specialists, represented by two strong organisations, may jeopardise the policy implementation in the future

Rozmowa z Profesorem Januszem Hałuszką

Profesor dr hab. Janusz Hałuszka rozpoczął pracę naukową już w okresie studiów w Studenckim Kole Naukowym, a później jako asystent w Zakładzie Patologii Ogólnej i Doświadczalnej Akademii Medycznej w Krakowie. W 1971 roku podjął pracę w Oddziale Instytutu Matki i Dziecka w Rabce, gdzie przez 30 lat kierował  najnowocześniejszym zakładem diagnozującym zaburzenia układu oddechowego u dzieci. Jest autorem ponad 200 publikacji naukowych z zakresu endokrynologii doświadczalnej (głównie dotyczących tarczycy), oceny stanu czynnościowego układu oddechowego u dzieci zdrowych i chorujących, a także wpływu powietrza zanieczyszczonego pyłami zawieszonymi. Był promotorem 18 przewodów doktorskich. Brał udział w pracach Komitetu Epidemiologii i Zdrowia Publicznego Polskiej Akademii Nauk. Jest współzałożycielem międzynarodowej sieci INCHES monitorującej wpływ środowiska na zdrowie dzieci. W latach 1997–2012 kierował Zakładem Zdrowia i Środowiska w Instytucie Zdrowia Publicznego Wydziału Nauk o Zdrowiu Uniwersytetu Jagiellońskiego Collegium Medicum w Krakowie

Innowacyjne wielowymiarowe narzędzie oceny polityki zdrowotnej i polityki zdrowia publicznego – matryca ewaluacyjna HPA (Health Policy Assessment). Podstawy metodologiczne, opis narzędzia

The Innovative, Multidimensional Tool for the Health Policy and Public Health Policy Assessment – the Evaluation Matrix HPA (Health Policy Assessment). Basic Methodology and the Toll Description Health policy as a process and as activities in the sphere of public responsibility may cause different evaluation problems but at the same time the proper and reliable assessment should be understood as the essential interest of the engaged stakeholders: government at different levels, payers, providers and patients as well. The paper concerns the problem of difficulties influencing the research focused on the health policy description aiming at the indication of the most important factors, effects, possible development dimensions that may significantly change the health system. The methodology in this case is also a complicated issue: quite often based on the instruments typical for social disciplines but not completely applicable for the presented subject. The paper describes the new innovative and universal tool for the purpose of the analysis aiming at reliable and comparable health policy assessment, it presents the stages and objectives of such evaluation and the perspectives of the HPA matrix development both for research and for didactic purposes