Policy Document

National Health Fund President’s Ordinance of 19 September 2007 (No. 61/2007/DSOZ) on the Terms and Conditions of the Agreements Concluded on Long-term Care*








Long-term care

Main implications

LTC in-kind benefits from the National Health Fund were provided either in inpatient settings in LTC institutions/hospital wards, or in outpatient settings as home-based care1. Both forms of care were provided to people who were unable to live independently because of age or disability.

Inpatient care (warunki stacjonarne/ambulatoryjne) included:

palliative and hospice care (opieka paliatywna i hospicyjna), which was provided in: (a) palliative care wards (maximum stay of 45 days) or (b) hospices (unlimited stay)2;

nursing care (opieka pielęgniarska), which was provided in: (a) hospital wards for the chronically ill, (b) Nursing Care Centres (NCCs), and (c) Medical Care Centres (MCCs). The maximum stay in NCCs and MCCs was six months, although in MCCs the stay could be extended indefinitely3.

Outpatient care (warunki domowe) included:

palliative and hospice care, which provided in-home hospices (domowe hospicjum) (24-hour care for patients living up to 30 km from the hospice’s main office, with visits by carers at least two times per week);

nursing care provided at home for:

mechanically ventilated patients (wentylowanych mechanicznie) and

elderly people (unlimited period based on six-month physical examinations)4.

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

Biuletyn Informacji Publicznej. Zarządzenie Nr 61/2007/DSOZ Prezesa Narodowego Funduszu Zdrowia z 19 Września 2007 [Public Information Bulletin. National Health Fund President’s Ordinance of 19 September 2007 (No. 61/2007/DSOZ)]

Original full text web source in native language


Comments & Clarifications

* This regulation was enacted as a result of an earlier Act of 27 August 2004 (No. 210, Item 2135, Art. 102 and 146) (link below), which appointed the Chair of the National Health Fund to supervise the organisation of arrangements related to particular healthcare services; in this case, to LTC. 1The aim of outpatient care was to provide systematic and intensive nursing care for those who were not in need of hospitalisation, provided they were referred by a general practitioner. 2Until 31 July 2008, places in free hospices were mainly offered to patients with cancer. Since 2008, this situation has changed, and patients with other specific diseases (all related to old age), such as bedsores or malfunction of the kidneys or lungs, were also eligible to receive hospice care. There had to be one doctor per ten patients in the hospice, compared to one doctor per 30 patients in home hospice. 3Although these two types of in-patient nursing care centres had historically different missions (to provide personal care in NCCs and medical care in MCCs), today their function is nearly the same. Their main goal is to provide 24-hour treatment for:

chronically ill patients
patients recently discharged from hospitals
or those who are unable to live independently in their home environment because of age or disability (they need to have a maximum of 40 points on the Barthel scale, which measures performance in basic activities of daily living using ten variables).

The healthcare system does not cover all of the costs related to patients’ stays in NCCs and MCCs. Only nursing and medical treatment are covered, while the other costs related to accommodation and food have to be paid by the patients (in 2009, the daily cost of a patient’s stay was calculated for 71 PLN = 16 EUR) (Koettl and Więckowska 2010). 4Nursing care at home was provided only if the patient was unable to live on his or her own (but was not hospitalised), had 0-40 points on the Barthel scale, and needed specialised treatment provided over a period of at least two weeks (e.g. intravenous feeding or catheter insertion). Nevertheless, nursing care at home is not very popular in Poland, and is mostly used in big cities (which have better infrastructure and greater awareness among the residents of their legal rights to this kind of care). Other problems are the long waiting lists for patients and the rapid decline in the number of qualified nurses in Poland (the average age of a nurse in Poland in 2008 was 44.6) (Koettl and Więckowska 2010). According to the Act from 2011:

Patients entitled to in-patient care (warunki stacjonarne/ambulatoryjne) are:

patients with chronic illness, which require 24-hour care following the examination;
patients continuing a treatment after diagnosis and intensive treatment that require rehabilitation and nursing, but do not need to remain in the hospital;
patients requiring assisted feeding and care, or mechanical ventilation.

Out-patient care included (warunki domowe):

patients requiring assisted respiration or respiratory therapy but not necessarily in a hospital or in a 24-hour medical care unit – if dwelling conditions are sufficient;
intensive and systematic nurse care at home, depending on the prognosis.

Secondary Literature & Sources

Secondary literature

- Koettl, J., & Więckowska, B. "Polska: Kto będzie świadczyć oraz finansować opiekę nad osobami starszymi w przyszłości?" Pogłębiona analiza obecnych oraz przyszłych wydatków publicznych na opiekę długoterminową Raport Banku Światowego. Warsaw, sierpień (2010).
- Buss, T., & Lichodziejewska-Niemierko, M. "Opieka paliatywna w Polsce — od idei do praktyki (również lekarza rodzinnego)" [Palliative Care in Poland - from theory to practice (including family doctors)]. Forum Medycyny Rodzinnej 2 (4) (2008): 277–285. Available at: http://www.fmr.viamedica.pl/darmowy_pdf.phtml


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: "National Health Fund President’s Ordinance of 19 September 2007 (No. 61/2007/DSOZ) on the Terms and Conditions of the Agreements Concluded on Long-term Care*" (Information provided by Agnieszka Chłoń-Domińczak, Anna Matysiak & Irena Kotowska). Available at: https://splash-db.eu [Date of access].