Policy Document

Minister of Health Regulation of 30 August 2009 (No. 140, Item 1147) on Long-term Care Guaranteed Services








Long-term care

Main implications

Guaranteed long-term care services (i.e., services financed from public resources) were provided in both inpatient and outpatient settings1:

Inpatient care services were provided in both Nursing Care Centres and Medical Care Centres, and were delivered by doctors2, nurses, and psychologists, as well as in the form of general rehabilitation services at the basic level, activity sessions, pharmacological therapies, and dietary treatments. Patients were also provided with diagnostic treatment, medicines, medical products, equipment, and health education. All of these services were provided to patients who needed 24-hour care (on the Barthel scale3 40 points or less), excluding those with advanced cancer, psychiatric illnesses, or addictions;

Outpatient care services were delivered by nurses4 or LTC teams (zespół długoterminowej opieki domowej) when mechanical ventilation was needed, and were provided together with adequate equipment. Patients were given not just personal care, but also education services (e.g., self-care methods, family care at home). To be provided with home-based LTC services, patients had to fulfil at least one of the medical condition requirements listed in the regulation (e.g., the need for tracheotomy care) and to have fewer than 40 points on the Barthel scale. The patient’s need for services also had to exceed the stated period of 14 days. Home-based care was offered only to patients who had not already been granted a place in a care centre or home hospice, and who did not suffer from a psychiatric disease. 

Recipients could be also provided with a less expensive form of medical transport; the regulation outlined the conditions (16 different types of diseases, disabilities or dysfunctions) under which up to 40% of the cost of transport would be financed from public resources.

Benefits & Requirements

Coverage: Eligible groups or beneficiaries

Insured people unable to live independently because of age or disability.

Read the Law

Original full text source in native language

Dziennik Ustaw z 30 Sierpnia 2009 (Nr 140, poz.1147) [Journal of Law, 30 August 2009 (No.140, Item 1147)]

Original full text web source in native language


Comments & Clarifications

1Other palliative and hospice services guaranteed by the healthcare system were included in a separate Act of 29 August 2009 (No. 139, Item 1138) (link below), and were no longer combined with LTC care services, as was the case in the National Health Fund President’s Ordinance of 19 September 2007. They were delivered to the patients suffering from incurable diseases, and were provided in in- and out-patient settings. 2In attachment No. 4 to the regulation, the exact number of doctors per patients was defined, together with the frequency of their visits. In care centres (MCCs and NCCs), there had to be one doctor per 35 patients, and patients had to be visited by a doctor at least two times per week. Separate procedures for patients who were on ventilators, and the minimum education levels and qualifications of medical personnel providing LTC services, were also defined. 3The Barthel scale measures performance in basic activities of daily living using ten variables. 4In the section related to home services, the phrase “nursing services” was used in the regulation, and was then changed to “services delivered by a nurse” in an amendment to this regulation of 16 December 2009 (No. 217, Item 1688) (link below). This amendment of December 2009 also introduced another change regarding the number of patients per nurse (included in attachment No. 4 to the regulation). Along with the new definition, the amendment specified that there could be no more than six patients per nurse if they lived in different places (e.g., at home), and 12 per nurse if they were being treated in a single location (e.g., a care centre). The home-based services were provided by nurses from Monday to Friday, 8 a.m.-8 p.m. (and during the weekends/holidays, but only in medically justified cases), at least four times a week.

Secondary Literature & Sources

Secondary literature

Mokrzycka, A. "Long Term Care - Guaranteed Service Basket". Health Policy Monitor (15). Institute of Public Health, Krakow (2010). Available at: http://www.hpm.org/en/Surveys/Jagiellonian_University_-_Poland/15/Long_Term_Care_-_Guaranteed_Services_Basket.html


Agnieszka Chłoń-Domińczak, Anna Matysiak & Irena Kotowska
Institute of Statistics and Demography
Warsaw School of Economics

Data collected in the framework of the Population and Policy Database

Cite as

SPLASH-db.eu (2012): Policy: "Minister of Health Regulation of 30 August 2009 (No. 140, Item 1147) on Long-term Care Guaranteed Services" (Information provided by Agnieszka Chłoń-Domińczak, Anna Matysiak & Irena Kotowska). Available at: https://splash-db.eu [Date of access].