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This report examines the impact of a 2004 law in Poland intended to substitute medically-oriented, central government-funded institutional long-term care with social care-oriented welfare homes, market alternatives and increased informal and community-based alternatives. Data were extracted from recently published reports, government statistics and a survey of 69 social care homes in Poland. The results indicate the continued dominance of hospital-based long-term care, the lack of shift to social care provision, the anemic growth of privatization and the dearth of informal and community-based care. The 2004 law was insufficient in shifting the burden of long-term care from the national health insurance fund to local municipalities, the social assistance sector and consumers. [ABSTRACT FROM AUTHOR]