Strengthening primary healthcare is crucial in the face of increasing health needs among patients, who, due to an aging population, are more frequently affected by multimorbidity and chronic diseases. Numerous studies confirm that a strong primary healthcare system can lead to improved health indicators and greater patient satisfaction. Traditional service delivery models, focused on specialist care and hospital treatment, are insufficient to adequately address complex health conditions. Therefore, the development of multidisciplinary care tailored to specific health and social needs is essential, requiring proper coordination.
To ensure patients receive preventive interventions, regular health assessments, education, psychosocial support and counseling, healthcare providers must take a more proactive role in patient care. This shift will inevitably lead to an increased demand for medical personnel, which is already in short supply. The shortages in healthcare personnel can be mitigated by introducing new professions into the healthcare system and redistributing competencies among existing professionals.
International research suggests that in the 21st century, the success of primary healthcare depends on delegating some physician responsibilities to other healthcare workers. This requires new professional skills and the development of competencies, including collaboration and communication between various healthcare providers, familiarity with digital health tools, coordination and smooth transitions between different levels of care, as well as fostering self-care skills and independent decision-making among patients. While skill mix can help strengthen healthcare systems, it should not be seen as a universal solution to all their challenges. Such changes should be based on solid scientific evidence and carefully planned.
In recent years, various coordinated care initiatives have been undertaken in Poland; however, most have targeted patients with specific conditions, and only a few have been based on population-wide models. One example of this approach was the POZ PLUS pilot program, which preceded the implementation of coordinated care in primary healthcare in 2022. As part of the pilot, the role of a care coordinator was tested in selected facilities nationwide. Following the pilot program’s completion, this role was formally introduced as a new component of primary healthcare contracts, enabling all service providers to take on additional responsibilities.
The coordinator proved to be a valuable support for other members of the primary healthcare team, handling both administrative and organizational tasks, as well as activities related to patient education and encouraging participation in preventive programs. Relieving medical staff of non-medical duties contributed to improved workflow organization and allowed for better utilization of the competencies of individual team members within primary healthcare.