Primary Health Care PLUS project in Poland: health check-ups and patients’ engagement

Introduction: In Poland the health and social care operate independently. Public healthcare expenditures in 2017 accounted for 4,73% of gross domestic product (GDP). The target for public funding level to be achieved in 2025 was set at 6%. Polish health care system is focused on stationary and specialist care. People are rather passive, with low health awareness, and participation in prevention programs, what results in low detectability of diseases in early stage of development. Description of policy context and objective: Health check-ups are the components of "Preparation, testing and implementation of coordinated care in the healthcare system” - pilot phase: Primary Health Care PLUS (PHC PLUS) project ongoing in Poland, co-financed by European Social Fund, and is targeted at strengthening patient-centered care and increasing the role of primary health care. The main objective of health check-ups is to stratify the population to healthy and potentially ill patients to manage the number and type of services planned. Patients receive support from a team of medical professionals: doctors and coordinators, accompanied by dietitians, health educators and physiotherapists. Targeted population: Health check-ups are planned to be performed every five years to patients at the age of 20 to 65 years, who do not or rarely use PHC services (did not visited a doctor during last 12 months due to a chronic disease, not hospitalized in that time and did not have diagnostic tests within another prophylactic program). Performed at the very beginning of patient’s participation in the project, health check-up includes a set of tests aimed at stratification of the entire population included to one of 4 clusters: (1) healthy, without risk factors, (2) healthy, without symptoms but having risk factors, (3) chronic, without current symptoms but stable, (4) chronically ill,currently with symptoms and requiring stabilization. Check-ups can be performed as a basic or in-depth one. An integral part of the health check-up visit is referral for education in areas related to identified risk factors, to strengthen self-management skills and patient engagement in the treatment. As an outcome, an Individual Health Care Plan (IHCP) is prepared, during. IHCP recommendations include educational activities and referrals for diagnostic tests. Health check-ups started on 1st July 2018; until today, 7672 patients have participated in 45 medical entities. 1414 basic and 6258 in-depth check-ups were carried out. The target number within the project Primary Health Care PLUS is currently 41402. Transferability: The scheme used in the project may be adapted to other projects having the purpose of strengthening patient-centered care at the level of PHC and tailoring the care to patient`s needs. Conclusions: Health check-ups are of preventive nature and can be performed by the PHC staff in health centers with an elementary degree of coordinated care. However, the proposed check-up scheme requires further observation in a larger scale and in centers with different levels of coordinated care.