Influence of practice location on prescribing, diabetes care, and colorectal cancer screening among Czech general practitioners during the COVID-19 pandemic.

OBJECTIVES: The provision of primary health care was not interrupted during the coronavirus disease 2019 (COVID-19) pandemic in Czechia, although the capacity and resources of providers changed. We examined how the pandemic affected individual general practices throughout 2017-2021, focusing on differences between urban and rural practices. METHODS: We analysed data from the largest health insurance company in Czechia, which provides care to 4.5 million people (60% of the population). We evaluated the prescription volume, diabetes care procedures, and faecal immunochemical test (FIT) in preventive care and new pandemic-related procedures (remote consultations, testing, and vaccinations). For the spatial distribution of practices, we adapted the Organisation for Economic Cooperation and Development typology. RESULTS: We observed minimal declines in 2020 in the rate of prescribing (-1.0%) and diabetes care (-5.1%), with a rapid resumption in 2021, but a substantial decline in FIT (-17.8% in 2020) with slow resumption. Remote consultations were used by 94% of all practices regardless of location, with testing and vaccinations more commonly performed by rural general practitioners (GPs). CONCLUSIONS: Primary care in Czechia rose to the challenge of the COVID-19 pandemic, as shown by the finding that the volume of healthcare services provided through primary care did not decrease across most of the monitored parameters. This study also confirmed that rural GPs provide more care in-house, both in terms of prescribing and procedures performed in their practices. Future studies will need to focus on preventive care, which the pandemic has dampened in GP practices in Czechia.

Using selected POCT methods by general practitioners in the Czech Republic.

Point-of-care tests allows for the more effective and rapid diagnosis of acute conditions, better management of chronic disease and the rational use of prescribed medicines. The use of selected non-mandatory tests was analysed in relation to their availability across urban and rural general medical practices in Czechia. Data for 2016 were obtained from the largest health insurance company in Czechia. To categorise the different types of surgery, a spatial model was created applying the OECD regional typology to primary care in Czechia. International normalised ratio (INR) was the most commonly available test, with 53.1 %. In acute care, C-reactive protein (CRP) testing was most extensively present, with 50.9 %. In practice, though, 90 % of these surgeries performed these tests. Both INR and CRP accounted for 42.7 %, whereas 61.3 % used at least one. Contracts of haemoglobin A1c amounted 14.8 %, 38.6 % of practices were not contracted to perform any of three tests, and 43.4 % reported no usage at all. Around half of all general practitioners in Czechia are contracted to provide the most popular non-mandatory point-of-care tests. Reported usage differed among the various surgery typologies, with more peripheral surgeries reporting higher rates.

Urban or Rural GP? In the Czech Republic It Is not just Distances That Matter.

This article proposes a combined mixed methods approach to categorising GP practices. It looks not only at location but also at differences in the nature of the work that rural GPs perform. A data analysis was conducted of the largest health insurance company in the Czech Republic (5.9 million patients, 60% of the population, 100% coverage within the Czech Republic). We performed two data analyses, one for 2014-2015 and one for 2016, and divided GP practices into urban, intermediate, and rural groups (taking into account the OECD methodology). We compared groups in terms of the total annual cost in CZK per adult registered insurance holders. The total volume of data indicated the financial costs of €1.52 billion and €2.57 billion respectively. Both analysis showed differences between all groups of practises which confirmed the assumption that the work of the GP is influenced by regionality. A multidisciplinary hospital is the main factor that fundamentally affects the way a GP's work in that area. The proposed principle of categorising general practices combines geographical and cost characteristics. This requires knowledge of the cost data of healthcare payer and on the basic demographic knowledge of the area. We suggest this principe may be transferrable and particularly suitable for categorising general practice.