An integrated approach to health services and manpower development: The experience of Poland

Jan Kostrzewski
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引用次数: 2

Abstract

After World War II, a new socio-economic policy stimulated development of industry and the socio-economic reconstruction of Poland. One of the main objectives of the new social policy was to develop the national health service so that it was available to the whole population. The most important decisions made for the health services and health manpower development in Poland were the following:

  • 1945

    Ministry of Health appointed as superior body responsible for organization and administration of national health services;

  • 1951

    Medical and Pharmaceutical Faculties become Medical Academies under the administration of the Minister of Health. Medical schools for nurses, midwives, sanitary instructors, and allied health personnel placed under supervision of the Ministry of Health;

  • 1954

    Sanitary epidemiological services organized and State Sanitary Inspection Act passed;

  • 1956

    Industrial health service organized;

  • 1960

    Minister of Health and Social Welfare appointed and charged with the administration of social welfare as well as rehabilitation and employment of invalids;

  • 1971

    Medical care and medical aid made available free of charge for the entire population, including the rural popualtion previously not covered by health insurance system.

In the years 1946–1960, a tendency towards vertical centralization prevailed in the organization and administration of the health services. Subsequently, decentralization has dominated, with a tendency to integrate health services with the social services, especially at the provincial and county levels and, more recently, in the form of the Integrated Health Service Institutions at the local level.

保健服务和人力发展的综合办法:波兰的经验
第二次世界大战后,新的社会经济政策刺激了波兰工业的发展和社会经济的重建。新的社会政策的主要目标之一是发展国家保健服务,使其面向全体人口。在波兰为保健服务和保健人力发展作出的最重要决定如下:1945年任命卫生部为负责组织和管理国家保健服务的上级机构;1951年医学和药学院成为卫生部长管理下的医学院。医学院培养护士助产士卫生教练1954年,组织了卫生流行病服务机构,并通过了《国家卫生检查法》;1956年,组织了工业卫生服务机构;1960年,任命卫生和社会福利部长,负责管理社会福利以及残疾人的康复和就业;1971年,向全体人民免费提供医疗保健和医疗援助。包括以前未纳入医疗保险制度的农村人口。在1946年至1960年期间,保健服务的组织和管理普遍倾向于纵向集中。随后,权力下放占主导地位,有将保健服务与社会服务结合起来的趋势,特别是在省和县一级,最近在地方一级以综合保健服务机构的形式。
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