Assessment of the health care system functioning in Poland in light of the analysis of the indicators of the hospital emergency department (ED) and primary health care (PHC) – proposals for systemic solutions

Background
In the last three decades, in developed countries, the number of patients reporting to hospital emergency departments has dramatically increased. The number of visits to EDs can be an important indicator of the quality of primary health care.

Objectives
To analyse: 1) the frequency of admissions to EDs, 2) the type and number of medical procedures performed in EDs, and 3) the type and number of services provided by PHC in the Kedzierzyn-Kozle district.

Material and methods
A retrospective analysis of the statistical data regarding services provided by PHC in the Kedzierzyn-Kozle district within the National Health Fund (NHF) and data from the hospital emergency department in Kedzierzyn-Kozle (Opole Province, Poland).

Results
The results showed an annual increase in the number of hospitalisations (13,815 – 2012, 14,192 – 2013, 15,123 – 2014) and the number of medical procedures performed in the ED (mainly those from I–III categories), as well as the low rate of admission from the ED to ICU (Department of Anaesthesiology and Intensive Care). There was an increase in the overall number of consultations given by a primary health care doctor and the total number of healthcare services provided at night and during holidays.

Conclusions
Reducing the number of non-urgent visits to EDs can be achieved by making efforts to meet the needs of patients at the level of primary health care, in particular through better coordination of services provided by EDs and PHC and better motivation of primary care doctors to perform the role of gatekeeper to the health care system.