The results of the audit conducted by the Supreme Audit Office are ambiguous. In Poland, the geriatric care system for the elderly does not provide adequate and adequate care for the elderly. Geriatrics is a priority area of medicine, but unfortunately – as neatly put in the title of the announcement on the official website of the Chamber – only on paper.
The audit conducted by NIC covered the period from January 1, 2017 to October 6, 2021. It covered five provinces: Lubuskie, Łódzkie, Świętokrzyskie, Śląskie and Wielkopolskie. The study found that activities carried out in recent years by the Ministry of Health, provincial departments of the National Health Fund and the National Institute of Geriatrics, Rheumatology and Rehabilitation were uncoordinated and fragmented. As a result, they were insufficient, according to the NIC.
Despite the efforts, the elderly care system in Poland still works. Or worse
The audit focused on the most important indicators of the availability of geriatric treatment in Poland. This may include, for example, the number of hospital departments, clinics or staff. Unfortunately, the results showed that in the controlled voivodships, the indicators did not change or even deteriorated.
An important indicator was the ratio of the number of people over the age of 60 per one-year-old doctor. The results are presented in the form of infographics:
The biggest shortcomings in this regard were in Świętokrzyskie, where one specialist looked at more than 60,000 people. the elderly. The best was the province of Silesia. However, it was there that most patients waited for help – even more than two months.
Family medicine, surgery and dermatology are “on top”. Nobody is interested in geriatrics
Significant staff shortages are affecting geriatricians. According to the Supreme Audit Office, the main and unresolved problem in the development of geriatrics is the lack of specialists in this field. Resident physicians are not interested in specializing in geriatrics. A total of 101 doctors have graduated across the country over the past five years. In addition, interest in this field of medicine, unfortunately, is still declining.
The workload of professional geriatricians is not limited to the number of patients per doctor. NIC also investigated the working hours of medical staff. The audit found that contracted geriatricians in supervised facilities often performed their duties for more than 24 hours. It was often between 31 and 35 hours. In extreme cases, 120, 150 or even 240 hours without stopping (!).
Working for such an unbelievably long time, of course, has a negative impact on the quality of work performed by doctors. It can be dangerous for both patients and doctors. It should be noted that, unlike full-time employees, contract workers are not subject to standards and working hours.
Along with doctors, there is a shortage of qualified nurses in this field of medicine. During the period under review, the requirement to hire an appropriate number of nurses in the nursing home was not met by 60% of the hospitals inspected.
An important problem facing the geriatric care system in Poland is unequal access to it. To learn this, just look at the chart below.
For example, in 2020, Slaskie Voivodeship had 14 geriatric care units with 346 beds. In turn, the Warminsko-Mazurskie voivodeship did not have such a branch.
As a result of the inspection, the COVID-19 pandemic also had a negative impact on the availability of old-age care due to the need to discontinue treatment in the wards.
Why is geriatrics so important?
Geriatric care provides care for the elderly. It is important to note that it also treats many diseases. As many experts claim, it is more effective than traditional treatments that traditionally focus on specific diseases.
It is geriatric care that allows the elderly to function comfortably and independently for as long as possible. Statistics show that after a hospital intervention, an elderly person’s chances of improving their functional condition increase by 72%.
For 30 years, we have seen an increase in the percentage of elderly people in Poland. Life expectancy is already rising, and demographic growth forecasts show that by 2050, more than 32% of Poles will be 65 or older. This just proves how important geriatrics is. According to the Supreme Audit Office, as well as many medical experts, this should become a priority for the Ministry of Health. Therefore, real measures should be taken as soon as possible to help improve the geriatric care system in Poland.
How to improve geriatric care in Poland?
Following the audit, the Supreme Chamber of Control issued the following conclusions.
To the Minister of Health:
- establishment of a system of organizational and financial support of medical institutions, creating conditions for making decisions on the establishment of new departments and geriatric clinics;
- Increasing the attractiveness of the specialty in the field of geriatrics, which will increase the interest of doctors in choosing this specialty,
- to apply the generally applied organizational standards of geriatric care through normative documents on the basis of the delegation provided for in paragraph 22 sec. Article 5 of the Law on Medical Activity.
To the governing bodies of medical institutions:
- to take measures to eliminate cases of excessive (even several days uninterrupted) work of doctors hired under civil law contracts.