Primary and specialist diabetes care three years after introduction of health care system reform in Poland.
The authors discuss epidemics of diabetes in the world and in Poland. In the Lublin region (eastern Poland), for instance, they found type 2 diabetes (DM 2) in 15.6% of the examined aged over 35 (according to the WHO criteria of 1985). The health care system reform in Poland has made more difficult the access of the diabetic to a specialist that treats this disease. Therefore doctors and nurses of primary health care have become more responsible for diabcare than before. The authors believe that the systematic education of primary health care doctors by specialists so that they can treat patients according to the modern standards of practical diabetology as well as sharing of tasks and responsibilities between primary and specialist diabetologic care, are very important. Primary health care would be in charge of prevention and early diagnosis of DM 2 as well as prevention and early diagnosis of concomitant complications of the disease. Specialists would have consultation on the patients at the moment of diagnosis and then at least once a year. They would also take care of search for and diagnosis of remote diabetes complications. Primary health care doctors would still treat most of diabetics with DM 2; specialist centres doctors would treat most of diabetics with DM type 1, patients with complications and from special risk groups (e.g. women with gestational diabetes).
Mardarowicz
Grazyna
G
Primary Health Care Department of Family Medicine Department, Medical University of Lublin.
Łopatyński
Jerzy
J
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D011044:Poland; D011247:Pregnancy; D011320:Primary Health Care; D012307:Risk Factors; D013038:Specialization