scholarly journals Lekarze podstawowej opieki zdrowotnej w prawie III Rzeczypospolitej Polskiej

2019 ◽  
pp. 9-52
Author(s):  
Krystyna WojtczaK

In 2019, twenty-five years have passed since the implementation of the first legisla-tive act introducing for the first time family doctors (primary health care physicians) into the Polish model of basic health care. The beginning of changes in this area, falling in the nineties of the last century, was not easy and has not yet been complete but will continue until the end of 2024. Over the years, not only the conditions for the education and professional development of primary health care physicians, in-cluding family doctors, have undergone changes. Also the organisational and legal forms of providing basic health services by this group of doctors were changing, as well as the conditions allowing patients, the recipients of medical services, to choose their doctor from among those with whom health insurance institutions (health insurance funds, or the National Health Fund) concluded agreements on the provision of basic health care services, or those employed by a medical entity with whom the National Health Fund signed relevant agreements.The scope of changes introduced at that time was wide, and when it started at the beginning of the 1990s it was almost impossible to achieve the goals without the support of the World Bank and the PHARE programme, alongside the efforts of the Ministry of Health and Social Welfare and three regional health care consortia (unions). Their work and contribution of each of them and their activities were sig-nificant and together constituted a solid basis for further work on the improvement of the model of a universal primary health care after 1998.The Act on primary health care of 2017 has completed the process of changes in this respect. For the first time, the objectives of the basic, or primary health care have been clearly defined. Although the implementation of each of these objectives is to serve the patient who is the recipient of the services, the value of the services pro-vided by primary care physicians varies. Family doctors (general practitioners) are to provide the patient and the patient’s family with health care services, coordinating at the same time all the stages of the process of their provision. However, the social mission of their profession is to ensure the implementation of broader tasks, such as health promotion adapted to the needs of various groups of society, education of the medical services recipients in the field of responsibility for their own health, as well as shaping pro-health awareness, setting health priorities of the population covered by care and implementation of preventive actions.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Oliveira Miranda ◽  
P Santos Luis ◽  
M Sarmento

Abstract Background Primary health care services are the cornerstone of all health systems. Having clear data on allocated human resources is essential for planning. This work intended to map and compare the primary health care human resources of the five administrative regions (ARS) of the Portuguese public health system, so that better human resources management can be implemented. Methods The chosen design was a descriptive cross sectional study. Each of the five ARS were divided into primary health care clusters, which included several primary health care units. All of these units periodically sign a “commitment letter”, where they stand their service commitments to the covered population. This includes allocated health professionals (doctors, nurses), and the information is publicly accessible at www.bicsp.min-saude.pt. Data was collected for 2017, the year for which more commitment letters were available. Several ratios were calculated: patients/health professional; patients/doctor (family medicine specialists and residents); patients/nurse and patients/family medicine specialist. Mean, standard deviation, minimum and maximum values were calculated. Results National patients/health professional ratio was 702 with the mean of the 5 ARS calculated at 674+-7.15% (min 619, max 734) whilst the national patients/doctor ratio was 1247 with the mean of the 5 ARS calculated at 1217+-7.17% (min 1074, max 1290). National patients/nurse ratio was 1607 with the mean of the 5 ARS calculated at 1529+-13.08% (min 1199, max 1701). Finally, national patients/family medicine specialist ratio was 1711 with the mean of the 5 ARS calculated at 1650+-6,36% (min 1551, max 1795). Conclusions Human resources were differently spread across Portugal, with variations between the five ARS in all ratios. The largest differences occur between nursing staff, and may translate into inequities of access, with impact on health results. A more homogeneous human resources allocation should be implemented. Key messages Human resources in the Portuguese primary health care services are not homogeneously allocated. A better and more homogeneous allocation of human resources should be implemented to reduce access health inequities.


2005 ◽  
Vol 15 (2) ◽  
pp. 137-155 ◽  
Author(s):  
Debra Rickwood

AbstractFor young people still at school, the school setting is vital to their mental health and wellbeing. Not only does the school environment have a direct and indirect impact on mental health, it provides an opportunistic setting in which to identify and respond to emerging mental health problems. To do this effectively, schools and school staff must work in collaboration with the young people themselves, their families, and other support services within the community, particularly primary health care services, including general practice. The importance of developing effective partnerships and care pathways between schools and the primary health care sector is being increasingly acknowledged, and initiatives such as MindMatters Plus GP have advanced our understanding in this area.


1994 ◽  
Vol 9 (2) ◽  
pp. 155-160 ◽  
Author(s):  
W KIPP ◽  
AA KIELMANN ◽  
E KWERED ◽  
G MERK ◽  
T RUBAALE

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