Population base dintegrated care in Poland- policy process

Poland has one of the lowest patient satisfaction ant it is manifestated in many international surveys, where Poland is one of the last countries in the rankings and where responsiveness assessment is the lowest. It is mainly due to high fragmentation of services, long waiting lists and low level of implementation of comprehensive prevention programs.

In 2013 Ministry of Health (MoH), the National Health Fund (NFZ) and The World Bank (WB) launched an integrated care discussion. The Project dedicated to the development of the 3 models of the population based integrations has been developed. The envisaged integrated delivery models will focus on two key areas: (i) reform on contractual arrangements between National Health Fund (Narodowy Fundusz Zdrowia- NFZ) and service providears to encourage service integration and coordination, (ii) The reform on provider contractual arrangements is coupled with reform on service organization solutions and structures to explore integrated care options.

The objective will be to present the process leading to integrated care population model for Poland, in the context of the lessons learned from Polish and international integrated care examples.

The new model of care will be composed of the regular primary health care services provided by the PHC/family doctors and nurses, with new in scope and volume of prevention and education activities, additional services for chronic patient’s, diagnostic tests and rehabilitation delivered in a coordinated, well managed and monitored way. The new tasks will be provided by the health teams and supported with the modern IT systems to facilitate the flow of information about the patients in real time. Within the new system, a set of monitoring and evaluation activities will be implemented reinforced with the capacity building systems for patient’s provides and health stakeholders.

Population targeted is 250 000- 500 000 people, who will be enrolled in the study starting January 2017.

Planned integrated care model in Poland is being perceived as a strategy towards patient’s centric health care system with the shift from hospital’s service delivery to the greater importance and wider implementation of prevention tools to meet the modern health challenges. This will be done in the long term, strategic approach towards the change of the health care system. As a result, it is expected that there will be: integration of care on primary and ambulatory level for the chronic patients, organizational integration of services tailored to patient’s needs with their active participation as well as integration of clinical pathways and higher patient satisfaction.

Based on the results of the pilot, further models of integrated care on different levels will be developed. After the four years of the implementation of the pilots, based on evaluation, a scaling up the integration of care is being planned for Poland. Due to the similarities in the epidemiological issues and health systems organization in Central Europe and historical approach towards the health care, it is very likely, that the models, after some adjustments could be transferable cross borders.