[Health care services for the elderly living in the rural area of Poland].
The aim of the paper was the indepth comparison of the health services use by the elderly living in rural and urban area of Poland. The representative survey of the 65-year old and older people was carried out in the year 2000, as a comparative study to the Piotrowski's survey from 1967. The sample (total N = 1821; consisted of 743 people living in rural and 1078 in urban area), was corresponding to the demographic structure of the general older population in Poland.


RESULTS
As far as concerning socio-demographic features there were found slightly higher percentage of 'old old' people in rural community, their much worse living conditions and material situation in comparison to counterparts in urban community. The elderly living in the countryside have shown the worse subjective and objective health and functional indices. The positive selfrated health was found only in 12% of respondents living in rural and in 22% living in urban area. 71% people living in villages declared three or more complaints simultaneously while in the cities much less (57%). Moreover, the impairment of vision, hearing, chewing were found significantly more frequently among rural inhabitants, as well as almost twice higher percentages of dependence on P-ADL. The use of health services by the elderly during the last 12 months, in term of doctor's outpatient consultations, dentist visits rehabilitation, except of nurse visits, was significantly lower in countryside than in the cities. Use of an emergency (17%) and hospital stays (22%) was the same in the both sites.


CONCLUSIONS
(1) Health status and functional ability of the older people living in rural area are dramatically worse than in cities. (2) Health care system for elderly people in Poland does not fulfill the geriatric standards in term of the commonness, availability and complexity. (3) The chance to improve health care on the elderly is an enhancement of knowledge and competence of practitioners in gerontology. The development of the geriatric base in the Medical Universities is a crucial for that.
Zakład Gerontologii Klinicznej i Społecznej Akademii Medycznej w Białymstoku, 15-230 Białystok, ul. Kilińskiego 1. bien@amb.edu.pl
Barbara
B
Bień
D000368:Aged; D000375:Aging / Q000502:physiology; D001294:Attitude to Health; D005260:Female; D006299:Health Services for the Aged / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008297:Male; D011044:Poland; D011788:Quality of Life; D019035:Rural Health Services / Q000458:organization & administration* / Q000592:standards; D011795:Surveys and Questionnaires