Quality of primary health care in Poland from the perspective of the physicians providing it

Krztoń-Królewiecka, Anna; Oleszczyk, Marek; Schäfer, Willemijn; Boerma, W.G.W.; Windak, Adam

doi:10.1186/s12875-016-0550-8

Cited by 27 publications

(30 citation statements)

References 30 publications

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“…Coordination between different levels of healthcare provision is a problematic issue in Hungary. As found also in the Polish-arm of the study, accessibility of care was considered as the best dimension, while the economic conditions were usually evaluated most negatively in all countries [28].…”

Section: Price Of the Prescriptions Become An Issue For The Hungariansupporting

confidence: 65%

Evaluation of primary care services in Hungary

Rurik

Jancsó

Kalabay

et al. 2020

Preprint

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Background. It is a major challenge to show what configurations of primary care(PC) is associated with better outcomes, in terms of quality, equity and costs. The QUALICOPC Study tried to analyse and compare them within 35 countries, using validated questionnaires filled by family physicians/general practitioners (GPs). This paper aims to provide data of the Hungarian-arm of the QUALICOPC Study; to compare some findings to that of other participating countries; to give a comprehensive overview about the recent Hungarian PC system. Methods. Altogether 222 questionnaires were completed by Hungarian GPs, delivered by fieldworkers, in a geographically representative distribution. Results . Financing are based mostly on capitation, with smaller additional compensatory elements and minor quality incentives. The gate-keeping function is weak, although by referrals, the preference of patients is mostly considered. Communication between PC and specialists is often insufficient. Variety of available devices and equipment’s are appropriate. Single handed practices were 87%. Appointment instead of queuing is a new option and become more popular, mainly among better educated and urban patients. GPs are involved in the management of almost all chronic condition of all generations. Half of them estimate their job as still interesting, burn-out symptoms were rarely found. Among the evaluated process indicators, access, continuity, comprehensiveness and coordination were rated as satisfactory, together with equity among health outcome indicators. Financing is not sufficient, therefore many GPs are involved in other earning activities. The increasing shortage of manpower is a major challenge. Conclusions. In the past 2 decades, there was visible improvement at service level and in economic circumstances. Cooperation and communication between different levels of health care provision should be improved, focusing better to community orientation and to preventive services. There is a need for specific primary care oriented guidelines to define the expected tasks of GPs.

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Section: Price Of the Prescriptions Become An Issue For The Hungariansupporting

confidence: 65%

Evaluation of primary care services in Hungary

Rurik

Jancsó

Kalabay

et al. 2020

Preprint

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“…Dissatisfaction with the primary care system by the physicians in practice is not unique to B-H, nor is the falling interest in FM as a career choice, with many studies in recent years confirming the global nature of this problem [25]. In several instances, large roster sizes and work loads were noted as significant factors in both patient and physician dissatisfaction and declining interest among students [26][27][28][29]. Regardless, this is an enormous problem for primary care in B-H. Economic factors play a large role and the shifting of resources from other levels to increase the number of training positions and to at least slow the outflow of qualified physicians, has political implications.…”

Section: Discussionmentioning

confidence: 99%

Twenty-five years on: revisiting Bosnia and Herzegovina after implementation of a family medicine development program

et al. 2020

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Background: The wars that ravaged the former Socialist Federal Republic of Yugoslavia in the 1990's resulted in the near destruction of the healthcare system, including education of medical students and the training of specialist physicians. In the latter stages of the war, inspired by Family Medicine programs in countries such as Canada, plans to rebuild a new system founded on a strong primary care model emerged. Over the next fifteen years, the Queen's University Family Medicine Development Program in Bosnia and Herzegovina played an instrumental role in rebuilding the primary care system through educational initiatives at the undergraduate, residency, Masters, PhD, and continuing professional development levels. Changes were supported by new laws and regulations to insure sustainability. This study revisited Bosnia and Herzegovina (B-H) 8-years after the end of the program to explore the impact of initiatives through understanding the perspectives and experiences of individuals at all levels of the primary care system from students, deans of medical schools, Family Medicine residents, practicing physicians, Health Center Directors and Association Leaders. Methods: Qualitative exploratory design using purposeful sampling. Semi-structured interviews and focus groups with key informants were conducted in English or with an interpreter as needed and audiotaped. Transcripts and field notes were analyzed using an interpretative phenomenological approach to identify major themes and subthemes. Results: Overall, 118 participants were interviewed. Three major themes and 9 subthemes were identified including (1)

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“…14 In several instances, large roster sizes and work loads were noted as significant factors in both patient and physician dissatisfaction and declining interest among students. [15][16][17][18] Regardless, this is an enormous problem for primary care in B-H. Economic factors play a large role and the shifting of resources from other levels to increase the number of training positions and to at least slow the outflow of qualified physicians, has political implications.…”

Section: Discussionmentioning

confidence: 99%

Twenty-five Years On: Revisiting Bosnia and Herzegovina after Implementation of a Family Medicine Development Program.

Hodgetts

Brown

Batić-Mujanović

et al. 2019

Preprint

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Background: The wars that ravaged the former Socialist Federal Republic of Yugoslavia in the 1990’s resulted in the near destruction of the healthcare system, including education of medical students and the training of specialist physicians. In the latter stages of the war, inspired by Family Medicine programs in countries such as Canada, plans to rebuild a new system founded on a strong primary care model emerged. Over the next fifteen-years, the Queen’s University Family Medicine Development Program in Bosnia and Herzegovina (B-H) played an instrumental role in rebuilding the primary care system through educational initiatives at the undergraduate, residency, Masters, PhD, and continuing professional development levels. Changes were imbedded in new laws and regulations to insure sustainability. This study revisited B-H 8-years after the end of the program to evaluate the outcome of initiatives through exploring the perspectives and experiences of individuals at all levels of the primary care system from students, deans of medical schools, Family Medicine residents, practicing physicians, representatives from the Ministry of Health, Health Centre Directors and Association Leaders. Methods: Qualitative exploratory design using purposeful sampling. Semi-structured interviews and focus groups with key informants were conducted in English or with an interpreter as needed and audiotaped. Transcripts and field notes analyzed using an interpretative phenomenological approach to identify major themes and subthemes. Results: Overall, 122 participants were interviewed. Three major themes and 9 subthemes were identified including (1) The Development of Family Medicine Education, (subthemes: establishment of departments of family medicine, undergraduate medical curriculum change), (2) Family Medicine as a Discipline (Family Medicine specialization, academic development, and Family Medicine Associations), and (3) Health Care System Issues (continuity of care, comprehensiveness of care, practice organization and health human resources). Conclusions: Despite the impact of years of war and the challenges of a complex and unstable postwar environment, initiatives introduced by the Queen’s Program succeeded in establishing sustainable changes, allowing Family Medicine in BH to continue to adapt without abandoning its strong foundations. Despite the success of the program, the undervaluing of Primary Care from a human resource and health finance perspective presents ongoing threats to the system.

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Quality of primary health care in Poland from the perspective of the physicians providing it

Cited by 27 publications

References 30 publications

Evaluation of primary care services in Hungary

Evaluation of primary care services in Hungary

Twenty-five years on: revisiting Bosnia and Herzegovina after implementation of a family medicine development program

Twenty-five Years On: Revisiting Bosnia and Herzegovina after Implementation of a Family Medicine Development Program.

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