1. Reforming Health Care

2. Basic Data IndicatorResultCzech Republic Total costs of Health Care4 100 000 000 000 000 000 15 000 000 000 Annula costs/person6391382 Highest Costs/personUSA – 6103 Lowest costs per personBurundi – 2,90 Highest public costs per person Norsko – 4508 Lowest publiccosts per person Burundi 0,70 Highest annual household costs Švýcarsko 1787178 (osoba) Minimal recommendation/person( WHO) 35-50 2

3. Basic parts of HC system Health care services Human resources Information systems HC technologies Financing Governance, management 3

4. HC services Individual and population HC that is effective, safe, of high quality and is provided to those that need it at the time and place of need with minimal waste of resources. 4

5. Human resources Non judgmental Responsive Effective Aim: The best possible outcome of HC at the present resources and conditions. 5

6. Information systems Collection, analysis, sharing and use of reliable and timely information of health state indicators and of the outcomes of HC system and pupolation health. 6

7. Medical Technology Equal access to basic technology and drugs. HC technology must be of guaranteed quality, safety, effectivity and cost efficiency. Use of drugs and technology is evidence based and cost effective. 7

8. Financing Appropriate financing for use of needed services, prevention of bankrupcy. Incentives for effective use o services. 8

9. Governance, management Strategic documents Control/oversight Regulation Accountability 9

10. Motto: 10 Where there is no vision, people perish Proverbs, 29,18

11. 11

12. Reform drivers 12 Demographic changes Technologic progress Increased number of providers Increasing demend for (quality) health care Information assymetry  Increasing costs

13. Demographic changes Aging population Changing needs of patients/clients CURE x CARE Reaction:  Changeing the structure of hospitals  Changing the structure of human resources  Home care, Hospice 13

14. Technologic changes Regulation Pricing drugs Access Centralisation 14

15. Increasing No of providers Supply induced demand New types of providers 15

16. Information assymetry Physician/patient Patient rights/Family rights  Moral code  Legal code 16

17. Basic systém balance 17 Costs Quality Access

18. Physicians/1000 population – 2009 Graduates/1000 population - 2009 18

20. Citisens role WANTS NEEDS DEMANDS 20

21. 21

22. HC expenditure 22

23. Quality 23 Measurable outputs  Quality indicators  benchmarking External assessment of quality  akreditation  certification Patient/citizen rights