Comparison of different approaches for estimation of prevalence of type 2 diabetes mellitus in the Czech Republic.

Prevalence of type 2 diabetes in the Czech Republic can be estimated from data reported by health care providers either to the statistical office or to health insurers. The latter include both diagnosis and prescribed drugs. Patient classification to a certain chronic condition based on consumption of drugs (Pharmacy-based Cost Groups classification) has been used in the Czech Republic for the purpose of redistribution of collected funds among health insurers since the beginning of 2018. This article compares prevalence of diabetes estimated from statistical data and from data reported to health insurers, and discusses current and future advantages and disadvantages of all methodologies. Diagnoses reporting in outpatient care are considered to be inaccurate, on the other hand peroral antidiabetics do not seem to be prescribed to all indicated patients. The appropriate approach to prevalence estimation from data reported to health insurers is becoming even more important after the creation of National Diabetes Register based on insurance data and the related abatement of direct reporting to the statistical office.

Czechia: Health System Review.

This analysis of the Czech health system reviews developments in governance, organization, financing and delivery of care, health reforms and health system performance. Czechs have enjoyed a statutory health insurance system with a high level of financial protection, a broad benefits package and universal membership for over 30 years. The central level of the state, mostly represented through the Ministry of Health and its subordinated bodies, takes on the various roles of legislator, steward and even owner of various providers of care, while also making insurance contributions for the sizeable part of the population classified as economically inactive. Health insurance funds are responsible for contracting sufficient care provision for their members. The Czech health system has traditionally derived a majority of its financing from public sources, which stood at 81.5% of current health expenditure in 2019, as the latest available year of reference, with the rest coming from private sources. While health spending in Czechia is below the European Union (EU) average, the densities of acute care beds and primary care physicians are above respective EU averages. Ageing and a lack of qualified staff (for example, nurses in hospitals) are already putting pressure on the Czech health workforce, a bottleneck further exposed by the COVID-19 pandemic. Additionally, Czechia has embarked on a reform process to modernize and centralize specialized tertiary care and psychiatric care. Patients enjoy free choice of primary and specialized outpatient providers, though there are signs that accessibility is limited in some regions and for some specialties. Overall, health outcomes in terms of life expectancy, mortality and survival rates of stroke and cancer have improved in recent years, though these improvements have been slower in Czechia than in other countries. However, life expectancy dropped considerably due to heightened mortality resulting from the COVID-19 pandemic in 2020 and 2021. There remains considerable room for improvement in strengthening disease prevention and health promotion, particularly for dietary habits and health literacy. Various efforts to advance evidence-based interventions in the health system, such as the initiation of health care quality monitoring and health system performance assessment, will assist in further analysing Czechia's health outcomes.

The abolition of user charges and the demand for ambulatory visits: evidence from the Czech Republic.

This paper estimates the effect of the abolition of user charges for children's outpatient care (30 CZK/1.2 EUR) in 2009 on the demand for ambulatory doctor visits in the Czech Republic. Because the reform applied only to children, we can employ the difference-in-differences approach, where children constitute a treatment group and adults serve as a control group. The dataset covers 1841 observations. Aside from the treatment effect, we control for a number of personal characteristics using micro-level data (European Union Statistics on Income and Living Conditions). Using the zero-inflated negative binomial model, we found no significant effect from the abolition of user charges on doctor visits, suggesting either that user charges are ineffective in the Czech environment or that their value was set too low. On the contrary, personal income, the number of household members and gender have a significant effect. A number of robustness checks using restricted samples confirm the results.

Czech Republic: health system review.

This analysis of the Czech health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The Czech health-care system is based on compulsory statutory health insurance providing virtually universal coverage and a broad range of benefits, and doing so at 7.7 % of GDP in 2012 - well below the EU average - of which a comparatively high 85 % was publicly funded. Some important health indicators are better than the EU averages (such as mortality due to respiratory disease) or even among the best in the world (in terms of infant mortality, for example). On the other hand, mortality rates for diseases of the circulatory system and malignant neoplasms are well above the EU average, as are a range of health-care utilization rates, such as outpatient contacts and average length of stay in acute care hospitals. In short, there is substantial potential in the Czech Republic for efficiency gains and to improve health outcomes. Furthermore, the need for reform in order to financially sustain the system became evident again after the global financial crisis, but there is as yet no consensus about how to achieve this.

Czech Republic: health system review

This analysis of the Czech health system reviews recent developments inorganization and governance, health financing, health-care provision,health reforms and health system performance. The Czech health-caresystem is based on compulsory statutory health insurance providing virtuallyuniversal coverage and a broad range of benefits, and doing so at 7.7% ofGDP in 2012 – well below the EU average – of which a comparatively high85% was publicly funded. Some important health indicators are better than theEU averages (such as mortality due to respiratory disease) or even among thebest in the world (in terms of infant mortality, for example). On the other hand,mortality rates for diseases of the circulatory system and malignant neoplasmsare well above the EU average, as are a range of health-care utilization rates,such as outpatient contacts and average length of stay in acute care hospitals. Inshort, there is substantial potential in the Czech Republic for efficiency gainsand to improve health outcomes. Furthermore, the need for reform in order tofinancially sustain the system became evident again after the global financialcrisis, but there is as yet no consensus about how to achieve this.

Czechia: health system summary, 2023

This Health system summary is based on the Czechia: Health System Review published in 2023 in the Health Systems in Transition (HiT) series. Health system summaries use a concise format to communicate central features of country health systems and analyse available evidence on the organization, financing and delivery of health care. They also provide insights into key reforms and the varied challenges testing the performance of the health system.