Abstract

Introduction: Health resort medicine functions in the environment of dynamic changes referring to the health system, demographic, economic and mentality changes. More and more self-paid patients are now becoming regular clients of health resort medicine. Who are they and what factors decide to choose this kind of therapy. This study is the second stage of the study carried out 10 years ago. Aim: The aim of the study was to evaluate the changes that took place in the last decade, connected with the characteristic of self-paid in-patients of health resort treatment, their motivations to pay for this treatment by themselves, to assess their expectations of this kind of treatment and to describe how the health resort system in Poland looks like in their eyes. Material and Methods: Two hundred randomized self-paid in-patients of four sanatoria and health resort hospital in Ciechocinek were surveyed. The patients were treated in the same health resort centres as 10 years ago. There were four, the same, pre-set questions in an anonymous questionnaire. Patients were also asked to determine their sex, age, occupational status and education. Data were analysed in the same way as 10 years ago and compared with them. Results and discussion: The analysis of collected data shows that, similarly as 10 years ago, major group of in-patients of the health resort treatment consisted of women of middle and tertiary education levels. At present there are more patients aged 60-79 years and 80 years and above, as well as old age pensioners and disability pensioners. This data are similar to demographic changes observed in Poland. Similarly to the data from the previous study, the most common reason for choosing the health resort centre was to improve the health status. But now, the percentage of these answers was higher, fever patients said that their aim was to relax and regenerate their organisms. The main expectation of health resort centres was to obtain good treatments and the percentage of these answers was higher than 10 years ago. The percentage of patients who preferred to choose the medical procedures all by themselves was significantly lower. It shows that the role of health resort centres as typically medical centres is growing. The main reason, why the patients decided to pay by themselves for the treatment was, similarly as 10 years ago, that it usually takes too much time to be referred to the health resort centre within the National Health Found. The percentage of patients for whom the possibility of choosing the time and the place of health resort treatment was the main reason that made them pay for the treatment by themselves was significantly higher than 10 years ago. This data confirm widely known drawback of the National Health Found and its lack of money. For the majority of respondents, paying for the treatment was a slight financial burden, but now the percentage of these answers was higher. There were fever responders for whom the payment for health resort therapy was no problem. Conclusions: 1. The self-paid in-patients of health resort treatment search now for more comprehensive medical services in health resorts, less the prophylactic and spa services. This obliges health resort centres to improve their health services. 2. There is significantly more health resort self-paid patens in elderly age. This is a signal to focus on the specificity of the treatment of this group of patients. 3. The main disadvantages of contemporary system of referral to health resort centres within the National Health Found, which are the reasons why patients decided to pay for the treatment by themselves, are long queues and no possibilities of choosing the place and the term of health resort treatment. The second disadvantage could be removed without any financial expenses.

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