The problem of inequalities in health on the basis of organization and financing of obstetric care in the Masovian and Subcarpathian voivodeships

Introduction: The phenomenon of inequalities in health is a major concern of the population of Poland. To date, no single pattern of financing health care has been developed in Poland. Objective: 1. Evaluation of the organization of care for women at birth and the neonate in the Masovian and Subcarpathian voivodeships. 2. Comparison of the administered funds for both voivodeships to provide obstetric and neonatal care. 3. Determination of the consistency of the system of care including epidemiological and demographic data of the inhabitants of both voivodeships. Material and method: Data concerning the demographics of the population of the Masovian and Subcarpathian voivodeships was obtained from the official GUS (Central Statistical Office of Poland) website: http://stat.gov.pl/. The aggregate values of contracts in the years 2010 – 2014 in the Masovian and Subcarpathian voivodeships were obtained from the official NFZ (the Polish National Health Fund) website at: http://www. nfz.gov.pl. Conclusions: 1. The values of contracts attributable to a single obstetric bed are comparable only in I reference level centres. II and III reference level centres receive higher funds in the Masovian voivodeship. 2. In the Subcarpathian voivodeship there is a smaller number of highly specialized neonatal care stations in III reference level centres per number of inhabitants and the number of births. 3. Higher values of contracts concluded in the Masovian voivodeship with II and III reference level centres do not correlate with the decrease in perinatal mortality rate and the preterm birth rate, registered in this voivodeship.

Wstęp: Zjawisko nierówności w zdrowiu jest poważnym problemem ludności Polski. Do chwili obecnej nie opracowano w Polsce ujednoliconego wzorca finansowania służby zdrowia. Cel: 1. Ocena organizacji opieki nad kobietą rodzącą i noworodkiem w województwach mazowieckim i podkarpackim. 2. Porównanie wielkości środków finansowych dysponowanych do obu województw w celu zapewnienia opieki położniczo-noworodkowej. 3. Określenie spójności systemu opieki z uwzględnieniem danych epidemiologicznych i demograficznych mieszkańców w obu województwach. Materiał i metoda: Dane dotyczące demografii ludności zamieszkującej województwa mazowieckie i podkarpackie pozyskano z oficjalnej strony internetowej GUS: http://stat. gov.pl/. Sumaryczne kwoty kontraktów w latach 2010–2014 w województwach mazowieckim i podkarpackim, uzyskano