Risks occurring in public health care institutions in Poland

Introduction: This paper analyses whether health care institutions in Poland create and implement management programmes targeting identified risks and whether risk management concentrates solely on restricting adverse consequences of those risks or if it also tends towards systemic integration and coordination of activities to neutralize them. Material and methods: The analysis was conducted in the years 2005 and 2006. The study was performed on 70 entities of all reference levels selected with proportional sampling method. It involved interviews with directors and particulars of examined facilities. Results: It has been found that the most hazardous threat was the financing system inadequate to facility needs, thus aggravating the growing debt. Objections in relation to legal regulations include lack of cohesion, mutual exclusion of coexisting laws and continuous legislative amendments. Other risks pointed out are “legal discrimination” of public establishments as compared with the non-public ones, legal provisions concerning working time and employment norms, low practical ability to implement management decisions, and civil liability, which displays highdamage potential for service providers. A growing threat to public health care institutions is also the deficit in medical personnel caused by job emigration. Conclusions: Health care institutions usually limit risk management to insurance purchases, which is one of the least economically effective management strategies. Only a comprehensive programme for risk management enabling early identification of risks and their effective neutralization ensures secure operation of health care facilities. (Clin Exp Med Lett 48(2): 105-110)

Keywords: risk policy, Risk Management, specific risk, non-specific risk, threat, public health care facility