1. Older People in the Maze of the Health Care System ‐ Polish Experiences
Dr Katarzyna Miaskowska-Daszkiewicz
John Paul II Catholic University of Lublin,
Lublin, Poland
The Bureau of Research of the
Chancellery of the Sejm, Warsaw, Poland

2. Changes of the size of population aged 65 years and more; (in thous.) – Central Statistical Office
192,5
205,5
1123,0
995,3
457,5
270,4
512,6
772,0
896,0512,6

3. Share of population aged 65 years and more (in %) in 2013, 2020, 2035, 2050
14,7%
18,9%
24,5%
32,7%

4. Population aged 65 years and more per 1000 aged 0-14
2013
2020
2035
2050
983
1271
1966
2693

5. selected issues lack of geriatric care system
lack of increased reimbursement for medicinal products for seniors
long waits for health services
ageizm
violations of patients' rights

6. lack of geriatric care system
too few geriatricians, specialist outpatient clinics and hospital departments – Poland has 343 physicians specializing in the field of geriatrics (332 actively practices the profession; geriatrics does not occur as a compulsory subject of education in medical schools)
the lack of a universal, comprehensive and standardized procedures dedicated to elderly people: „normal track” – basic care physician – specialist (s) – treatment in narrow scope, often without paying attention to other, previously prescribed treatment
The key barrier is the method of settling medical services by NHF which assumes financing one disease, although elderly people usually suffer from several ailments at the same time.

7. Availability of medicinal products
the co-existence of many diseases is the need to buy multiple medicinal products
the minimum pension in Poland in it is 880,45 PLN net (about 200 Euro) …
older patients often resign from part of the prescription or divided medicinal product into smaller portions (!) to have enough for a long time
the solution could be increased refund or programs of pharmaceutical care for elderly patients

8. Examples of terms of expectations for health services – public system
knee endoprosthesis implantation
1 year - urgent case
to 15 years - stable case
excision of varicose veins – to 3 years
implantation of hip replacement – to 15 years
cataract surgery – 2-3 years

9. Ageizm - study

11. Violations of patients' rights

12. the Commissioner for Patients' Rights
since October 2009
a central body of governmental administration and is subordinated directly to Prime Minister
main aim is to guard and protect patients' rights
conducts investigation procedure regarding violation of patients' rights

14. Activity in year 2012
Commissioner opened 217 investigations in cases on persons over 60 years,
of which a violation of patients' rights was found in 24 cases
Additionally, in 421 cases the employees of the Bureau benefited from the opportunities referral queries and clarify the situation directly with service providers.
As a result of these actions in 381 cases among healthcare providers, they changed in favor of elderly patients the approach to provide a faster services.

15. Common examples recorded by the Commissioner
barriers in communication between doctor and patient or his guardian -brevity of the message, information incomprehensible for the patient - this results in misunderstandings between doctor and the patient or the patient causes a feeling of insecurity;
denial of the right of the patient to the presence of a relative during health services;
implementing a medical procedure in the presence of unauthorized persons;
disrespectful attitude of medical staff to the elderly

16. Thank you for your attention!
dr Katarzyna Miaskowska-Daszkiewicz