Category: Stay healthy

“An inefficient system of public healthcare, lack of support for additional insurance, growing health debt as well as inflation, waves of refugees and many other modern disasters are a recipe for a health crisis in society”, says Dorota M. Fal from the Polish Chamber of Insurance (PIU). On the basis of these problems, there is a growing interest in private health insurance. At the moment, every tenth Pole has one.

According to the latest data of the Polish Chamber of Insurance (PIU), we spent PLN 880 million,
i.e. 12% more than a year earlier, on private health insurance policies in the first nine months of 2022. During this time, the number of people covered by such insurance increased by 10.6% and amounted to 4.08 million. Why such increases? The Chamber representing the interests of insurers points out that, on the one hand, there is a growing need to supplement the public system with additional solutions supporting healthcare. On the other hand, private policies cover an increasingly wide range of services. So, in addition to basic outpatient healthcare, they also include access to comprehensive tests and prophylaxis.

“We spend more than PLN 30 billion annually on health services outside the public system, not counting drugs and parapharmaceuticals. This year, we will spend over PLN 1 billion on private health insurance. Expenditure on health insurance, compared to how much we generally spend privately on health, is small. Efforts should be made to shift this proportion”, adds Dorota M. Fal, Advisor to the Management Board of PIU, in an interview for the industry portal money.pl.

Expensive health

According to the data of the Statistics Poland (GUS), total expenditure on healthcare (including from the National Health Fund (NFZ), budget and private wallets) in 2022 amounted to PLN 172.9 billion and accounted for 6.6% of GDP. It is around PLN 21 billion more than a year earlier. Expenditure increases have been observed in both public and private spending. According to the NFZ forecasts, expenditure will continue to grow (last year, it amounted to PLN 122 billion). However, this will not translate into
a greater number of benefits or improvement in the health of Poles because medical inflation is also growing – it exceeded 20%. According to insurers, private insurance policies constitute the cure for health debt. Looking at the relatively small expenditure on the public healthcare system, it offers quite a lot. There is no doubt that this expenditure is clearly insufficient, given how much we spend on health outside the system and how large our health debt is. According to the PIU expert, expenditure from private pockets will always be needed and will continue to grow.

It is important that money is spent efficiently. Moreover, according to Dorota M. Fal, healthcare should stand on two legs: public and private. However, it is not the case.

“Since we have been unable to combine these two systems at the functional level for many years,
e.g. we cannot go to a public hospital and pay with private insurance, it may be necessary to combine them at the fiscal level, e.g. by introducing reliefs for employers who finance private insurance for their employees”, suggests Fal.

She further comments that this is the case in many countries, including Spain or Romania. According to her, such solutions will improve the health of employees in Poland. In addition, according to the PIU expert, private insurance offers prophylactic measures that are clearly insufficient in the public system.

Health crisis on the horizon

It is never so bad that it could not get worse. According to insurers, the healthcare system will not be cured by legislation allowing for the transfer of financing of some services from the state budget to the National Health Fund (NFZ). This includes e.g. highly specialised procedures, medical rescue or medicines for pregnant women and people aged 75+. The NFZ budget is also related to GDP, which will decrease to 0.7% in 2023 according to the forecasts of the National Bank of Poland.

“An inefficient system of public healthcare, lack of support for additional insurance, growing health debt as well as inflation, waves of refugees and many other modern disasters are a recipe for a health crisis in society”, says Dorota M. Fal. According to the expert, the situation is further complicated by the shortage of medical staff, their professional burnout and the post-pandemic PTSD, which is becoming more and more common in this professional group. “Public funds are not enough to heal the system. It is no coincidence that health insurance is becoming increasingly popular, even though, it has not yet been included in the healthcare system in Poland”, Fal continues.

The problem is that private healthcare also leaves much to be desired. For instance the availability of services as part of private medical packages is … fiction. The backstage of making appointments is alarming. Patients without a subscription have easier access to doctors and tests than those who have a package. And this is one of many problems of private medical care.

Lack of time, fear of a negative diagnosis or shame of visiting the doctor’s office – no matter what stops us from doing preventive medical check-ups, it is worth overcoming fears to win health and even life.

The 8th day of March is not only a good excuse to celebrate, but also a great opportunity to think about how women themselves can successfully take care of their bodies, giving themselves the best possible gift.

It will be a great idea e.g. to prepare a personal calendar of preventive medical check-ups. Regular screening tests make it possible to ensure that the body is in good shape and nothing is wrong with it, or to detect a disease early enough to be able to completely cure it. You can ask your doctor to help you create such a “pro-health” schedule – the doctor will adjust the tests to your age and health.

What preventive medical check-ups should necessarily be included in such a calendar?

– Cervical cytology – it is a simple test that is carried out during a standard gynaecological visit. The doctor uses a special brush to take a small sample of cells from the cervix. The specimen obtained this way is sent to the laboratory. Cervical cytology takes only a few minutes and is a painless test, which can only cause slight discomfort in some women. The patient does not need to specially prepare for cervical cytology but before scheduling a medical consultation, a few things should keep in mind: the test cannot be performed during a menstrual period and it is best to perform it 4 days before the start of the period or 4 days after its ending. It is also important that women using vaginal preparations temporarily stop the treatment a few days before the test (during the visit, the gynaecologist may also perform a transvaginal ultrasound to detect ovarian cancer).

When performed regularly, cervical cytology makes it possible to detect cervical cancer in its early stage, quickly start the right treatment and save the patient’s life. Regular visits to a gynaecologist are all the more important as the disease can develop in secret for several years and not send any alarming signals in its early stage.

And when alarming symptoms appear, e.g. bleeding between menstrual periods, bleeding after sexual intercourse or a gynaecological examination, heavy vaginal discharge, pain in the lower abdomen, or longer and heavier than usual bleeding during menstrual period, you should consult your doctor as soon as possible.

In the meantime, in order to sign up for cervical cytology, it is enough to take part in a publicly available and free-of-charge screening programme addressed to all women aged 25-59. Each of the women covered by this prophylactic project should necessarily undergo an examination once every three years. If the result is normal, the next cervical cytology can be performed only after 36 months. Patients who have been diagnosed with human papilloma virus (HPV), those taking immunosuppressants and women with a family history of cervical cancer have the right to more frequent examinations.

Cervical cytology can be performed in any gynaecological office that has a contract with the National Health Fund (NFZ). The examination can also be performed by a midwife who is authorised to take
a cell sample. This type of medical service can be used as part of primary healthcare. A referral from
a GP is not needed to make an appointment with a gynaecologist or midwife.

– Mammography – it is a radiological examination that makes it possible to detect breast cancer in its early stage, giving a chance for a 100% cure. During the examination, the doctor or nurse places the breast on the lower plate of the diagnostic device, presses the gland with the second plate and performs an X-ray. In some women, this method of examination may cause slight discomfort but it is necessary to make sure that during mammography, the individual structures of the organ do not overlap and make it difficult to notice even the smallest irregularities in the structure of the tissue. An optimal time to perform mammography is during or just after a menstrual period because the breasts are sometimes physiologically swollen before a period, which can make the examination difficult and the diagnosis less precise.

Especially women over the age of 50 should have regular mammography. This form of diagnostics is very accurate and makes it possible to capture even the smallest changes that are imperceptible during self-examination. Importantly, the risk of breast cancer increases with age: about 80% of cases concern women who have entered their fifth decade of life (it is important that women in this age group do not give up mammography for the ultrasound examination, which is less effective in their case. The latter form of diagnostics is recommended to younger patients).

Therefore, every Polish woman who is over 50 and has not yet celebrated her 69th birthday should necessarily go for a free-of-charge mammography. It can be carried out once every 2 years and the list of facilities that perform this type of diagnostic test can be found on the website of the National Health Fund (the NFZ website includes also a timetable of mammography buses). You can also ask your GP for help and suggestions in this matter.

– Self-examination – a mandatory point in the calendar. All women, regardless of their age, should carefully observe their body and self-examine their breasts once a month. It is best to do this a few days after the end of a menstrual period. During this time, the breasts are soft, relaxed and there is no thickening characteristic for other phases of the cycle, which could make it difficult to detect changes. It is best to carry out self-examination in the bathroom: standing in front of the mirror, you can carefully look at each breast and pay attention to irregularities in their appearance. Check if the skin does not tighten, wrinkle, is not red, and if the shape of the glands has not changed. This observation must be repeated by lifting the arms up. The breast examination itself must be performed with circular hand movements, starting from the nipple and then moving outward towards the armpit area.

If you feel any change in the breast area, e.g. a hard, painless lump or thickening, or if you observe blood leakage from the nipple, you should urgently consult an oncologist surgeon. In the case of younger women, the recommended complementary diagnostic test that helps to determine the nature of breast changes is ultrasound.

It is worth being systematic and making breast self-examination a monthly, healthy ritual that will allow you to take care of your health and maybe save your life.

When planning a personal calendar of preventive medical check-ups, it is worth making some space for a few additional tests, such as: basic blood count and checking the level of thyroid hormones. Women who smoke cigarettes should get interested in the National Programme for Early Detection of Lung Cancer; and all women over 55 should also remember about colonoscopy in order to diagnose colorectal cancer.

Many dangerous diseases, including cancer, do not give any symptoms in their initial stages. Therefore, it is so important that all women regularly use publicly available, free-of-charge diagnostics to detect abnormalities at an early stage, stop the development of the disease and start treatment which, at this stage, is relatively simple and very effective. Regular control of the body is a form of medical prophylaxis, the aim of which is to care for health and the best possible quality of life. You should also be aware that even the most embarrassing and uncomfortable preventive medical check-up is much less burdensome, complicated and stressful than cancer treatment.

Helpful and committed nurses but no respect for dignity and intimacy. Effective treatment but terrible or even no psychological support. Ensured sense of security but too difficult and convoluted language of doctors. Plus stuffy patient rooms and cold meals. This is how Poles assess the quality of hospital care in Poland. The latest report of the Healthcare Quality Monitoring Centre (CMJ) includes opinions of over 54,000 patients treated in a total of 134 Polish hospitals.

The PASAT OPEN 2022* survey shows that the vast majority of patients (80%) think that their hospital stay was effective, i.e. improved their health (although 7% of patients strongly disagree with this statement). At the same time, 88% of respondents would recommend the facility they stayed at to others. The authors of the report point out, however, that the assessment in this regard varied depending on the hospital – some hospitals were assessed positively by 100% of respondents but there were those that received significantly lower marks.

Even more respondents (because as many as 92%) had no reservations regarding the observance of patient rights. It is worth noting, however, that the “missing” 8% mean that at least some respondents admitted that such violations took place. When asked for details, they indicated that the violations most often concerned the right to intimacy, respect for dignity and contact with loved ones. Such areas were indicated by 4% of patients.

Another assessed area was the degree of pain relief that accompanied the hospital stay. Here the marks are not so unambiguous. Although every fifth patient did not feel such pain, every third rated it as greater than “5” (on a scale of 0-10) and almost every tenth felt the intensity of pain during hospitalisation at the highest level (“9” and “10” ). At the same time, three thirds of patients confirm that the medics tried to alleviate the pain, only 7% of patients deny it.

Nurses – helpful and committed

As for medical staff, nurses were assessed most positively – 80% of respondents gave them the highest mark (“5”), three thirds of respondents (75%) gave such a mark to doctors and slightly more, i.e. 77%, to physiotherapists. Negative marks for any representatives of the hospital staff were rare – they were given by only 3-4% of patients.

The survey included also questions about communication between patients and the medical staff. Most respondents assessed it positively, although, some answers suggest that it leaves much to be desired. 6% of patients indicate, for instance, that they did not understand what the doctor told them, while 8% resent the fact that decisions about their treatment and care were made without them, without taking into consideration their wishes.

As the authors of the report emphasise, communication between patients and those taking care of them is one of the key elements of good care. “Doctors are often reproached for their hermetic and incomprehensible language. In addition, proper understanding of the message is critical to achieving good treatment outcomes.” Although the group of patients dissatisfied with this communication is in the minority, the question remains: “What are the reasons for these negative responses.”

Despite the positive assessment of conversations with doctors about health and planned therapy, patients are not satisfied with the psychological support that they received or, more often, that they did not receive. Every fifth patient (22%) admitted that they felt depressed during hospitalisation. The people who most often helped patients during this difficult time were nurses – 39% of respondents indicated the possibility of talking to them.

93% of patients felt safe in the hospital, although, it is worth noting that as many as one in ten did not know who to contact if they had questions or doubts about their care or treatment.

Conditions in the hospital still leave much to be desired

Last but not least, patients commented on the conditions of care provided in the hospital. Here, the generally positive tone of the responses is clearly noticeable (as many as 70% of patients had no remarks about the conditions of the hospital stay). However, there were things that bothered them.

The problem that bothers patients the most is the high air temperature in the rooms and the lack of fresh air – 10% of respondents noted stuffiness in the patient rooms. The cleanliness of the bathrooms and rest conditions were also questioned.

As for the meals served in the hospital, the majority of respondents did not raise any objections but those who spoke negatively about them pointed to the same problems over and over again: no choice of meals (19%), too small portions (11%) and too cold food (10%).

* The survey was conducted in the form of an electronic questionnaire filled in directly before the patient’s discharge from the hospital or after their return home. The data was collected between
1st January and 31st December 2022 and covered 54,000 respondents. 383 online questionnaires were obtained from 134 hospitals. Based on the results, the key areas were assessed and a set of indicators was created in the following areas: medical care, nursing care, physiotherapist care, staff communication, care safety, conditions of stay and hospital recommendations.

Inflation drains not only our pockets. According to a survey, even up to half of Poles experience deterioration of mental health and well-being because of it.

An increase in inflation adversely affects health. Already 50.9% of Poles complain about the deterioration of their health due to rising prices. These are the results of the survey by UCE RESEARCH and the ePsycholodzy.pl platform, described by “Rzeczpospolita”.

The respondents reported deterioration of their mental health, mental condition, well-being or mental functioning.

The data discussed by the journalists of “Rzeczpospolita” come from the third edition of the survey. In the previous, July edition, less respondents (43.7%) mentioned the deterioration of mental health. In turn, the result from the first edition carried out in March this year was 38.5%. It is clear that the situation is still worsening.

Billions in costs

“More than half of Poles associate the issue of personal finances with the deterioration of their mental state. The observed phenomenon is no longer just
a social problem but, above all, it takes on an economic dimension. Here we can recall, for instance, a wave of sick leaves due to depression, stress or simply bad mental well-being”, says Michał Pajdak from ePsycholodzy.pl, co-author of the survey, quoted by the daily.

According to “Rzeczpospolita”, UCE RESEARCH estimates that such a situation may cost the state and the economy even more than PLN 2 billion annually. We are talking here about payments for sick leaves or losses of companies caused by
a reduction in the attendance of employees and deterioration of their efficiency.

Moreover, the problem will not end with inflation slowing down.

“The problem grows in society along with the increase in inflation, which affects all market participants, however, with different strength and at different times. It seems that this is only the beginning of many human dramas. Purely financial issues will also affect marital relations, which may result in a greater number of divorces or separations”, comments Pajdak in “Rzeczpospolita”.

In general, the survey shows that young people, less educated people and residents of small towns complain most frequently about health deterioration, the daily reads.

As many as 60% of employees are willing to participate in the costs of personalised medical packages. This number rises to 67% if the solution includes additional dental services. The latest IR Center report, which was created in cooperation with the Enel-Med Medical Centre, shows how the priorities and expectations of Polish employees have changed. Still less than half of them are provided with medical care at their workplace.

Due to the fact that Polish employees care about their own health and the health of their family, the medical package becomes quite an effective tool in the competition for employees. 60% of employees declare that they are willing to participate in the cost of personalised medical packages. Unfortunately, most of them do not have such a possibility anyway because this solution has not yet become a standard.

Poles focus on health

Health matters to Poles and they want to take care of it – this is the conclusion of
a survey. The authors conducted a comprehensive analysis on a sample of almost 900 people, which clearly shows that Poles primarily focus on their health and the health of their loved ones. 97% of the survey participants emphasise the importance of caring for the health of other family members, 94% indicate that it is important for them to take care of their own mental and physical health. The quality of services is definitely important when taking care of health – as many as 68% of respondents are willing to pay more if it allows them to use the services of a better specialist. This trend is particularly visible among people aged 25-34, residents of large cities and among white-collar workers and IT specialists.

Employment – preferably with a guaranteed medical package

The survey indicate that employees attach great importance to whether their current or potential employer offers them medical care. The medical package is important for 73% of respondents and very important for 28% of them. 24% of respondents consider the medical package to be a standard.

Although employees appreciate this type of benefit, it has not yet become
a standard among employers in Poland. Currently, 43% of people declare that they have a medical subscription.

Such packages are especially popular in companies and large enterprises employing over 250 people. Here, 63% of respondents have such packages. 49% of people employed in medium enterprises declare that they have a package. In small enterprises, less than one third of respondents (29%) have medical care provided.

Medical package – yes and preferably personalised

As many as 83% of respondents would like to have a package tailored to their needs, however, most of them do not want the employer to conduct analyses regarding package profiling. Only 28% of people are open to this type of survey. At the same time, employees more and more often express their willingness to participate in the costs of profiled medical services. As many as 60% of respondents could pay extra for the package and 67% are willing to do so if the employer includes dental services in the package.

White collar workers and people employed in small enterprises are the least willing to pay extra for a tailor-made medical subscription. Employees in the construction and IT business as well as those working in large enterprises are more interested in a tailored package (but without dental services).

The medical package and the image of the employer

77% of respondents declare that for them, the medical package is an expression of care for employees. 69% of people consider an employer offering this type of benefit recommendable. And 65% of them believe that the guaranteed medical package affects the commitment and motivation of employees.

Every tenth Pole has private health insurance

Fear of illness, concerns about losing health or lack of access to medical care are the reasons why the number of people covered by private health insurance increased by 10.6%, reaching 4.08 million at the end of the third quarter of 2022. Poles spent nearly PLN 880 million on private insurance policies, which is 12.45% more year on year. Poles are increasingly willing to take advantage of the opportunities offered by the additional healthcare products available on the market. The offered products are more and more extensive and thus comprehensive. They facilitate health monitoring, which translates into reducing the health debt. Health insurance, which is more and more popular, has become an indispensable support for the public healthcare system.