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Published byCharleen Carroll Modified over 9 years ago
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Czech Health Care System David Marx, MD, PhD
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2 Motto: Where there is no vision, people perish. Proverbs, 29,18
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3 Pre 1989 situation Centralized system State owned State employed No freedom of choice No quality incentives Political pressure head physicians + nurses investments
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5 Basic data – OECD 2009 Acute beds – 7,11/1000 population Norway 3,35; Germany 8,24; Greece 4,85 Long term care beds – 6,5/1000 popul Norway 9,3; Germany 10,3 Physicians – 3,5/1000 pop. Norway 4,02; Germany 3,6 Nurses – 8,06/ 1000 pop. Norway 14,2; Germany 10,9 % GDP : 8,2 Norway 9,6; Germany 11,6; Greece 9,6
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LEB (OECD 2008)
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7 Need for reform - General Demography Technologic changes Increasing No of providers Growing demand for quality HC Information assymetry rationing Cost increases
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9 Basic problems Structure Quality Cost efficiency
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Ownership State Regions Municipalities Private Other (church, charities) 10
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11 Financing Mandatory public health insurace (Bismarck) 13,5 % gross income Redistribution 100 % risk adjustement Reimbursement: capitation payment (GP) fee-for-service budgets
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13 Health care reimbursed in and outpatient care emergency care prevention drugs spa treatment occupational care medical transport
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14 Health insurance paid by the state children pensioners maternity leave unemployed social need prisoners
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Expenditure on health as % GDP 15
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16 Problems Extensive coverage co-payment Network of HC facilities Primary – Hospital care Acute – Long term care Communication skills/Bedside manners
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17 Co-payment regulatory outpatient examination – 30/90 CZK hospital day – 60 CZK Prescription – 30 CZK yearly maximum – 2500/5000 CZK
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18 Quality National accreditation body hospitals International hospital accreditation ISO certification No direct financial incentives
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19 Education - physicians 6 years medical school ( 8 medical schools) 5-7 years specialization training 84 specialties
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21 Education - nurses 3 years college/university training 3 years of working under supervision specialties - optional
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22 Average salaries in health care 2009 CategorySalary/month/ year (USD) Physicians2870 34440 Nurses1545 18540 Average CR1370 16440
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QUESTIONS ? 23
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