BACKGROUND: An international comparison of health system performance is a popular tool of health policy analysis. However, the efficiency evaluation of health systems is a practical example of an international comparison in which non-homogeneity is expected. The objective of this paper is to evaluate the efficiency of health systems by models in which a degree of non-homogeneity among countries is considered. METHODS: We study the problem of non-homogeneity of health systems in the theoretical framework of the data envelopment analysis (DEA), which is a popular method of efficiency evaluation with hundreds of applications from various fields. DEA assume the homogeneity of production units and the homogeneity of the environment in which the production units operate. Hence, we compiled a summary of 14 recommendations on how to deal with the non-homogeneity in the DEA models. The analysed sample includes 38 OECD member countries. The data are from the year 2019. RESULTS: As an example, we evaluated the health system efficiency of the Czech Republic. We used the DEA models with the neighbourhood measure of distance and the constraint limiting the comparison of countries with different levels of economic development. The health system inputs were the numbers of physicians, nurses, and hospital beds. In the production of the intermediate outputs (doctor consultations, inpatient care discharges), the Czech Republic should look at Poland, Slovakia and Slovenia. In the production of health outcomes (life expectancy), the peer countries are France, Italy and Switzerland. CONCLUSIONS: The results of the DEA analysis are only indicative because no single analytical method can determine whether a health system is better or worse than others. We need to combine different methods, and DEA is one of them. We consider DEA as an exploratory method, not a method providing definitive answers.
- Klíčová slova
- Data envelopment analysis, Efficiency evaluation, Health systems, Non-homogeneity,
- MeSH
- efektivita organizační * MeSH
- lidé MeSH
- vládní programy MeSH
- výkonnost * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Francie MeSH
- Polsko MeSH
The main purpose of this paper is to point out a new approach in evaluating the preparedness of the population of a selected city for civil protection and its response to emergencies. Using new approaches, it evaluates a subjective questionnaire survey in combination with the objective state thanks to a mathematical approach and its subsequent verification on a specific example. The proposed approaches are then verified by experimental surveys in the selected city. The result is a highly adaptable tool that can be set up and adapted to different situations and different types of questionnaires to address the preparedness and safety of the population for emergencies. Thanks to this tool, it is possible to evaluate the subjective opinions of the population and thus gain insight into the assessment of the city's preparedness for emergencies. Subsequently, we can set the prevention and preparedness of the population in the city on the basis of the obtained outputs, which potentially has a fundamental influence on the response after the occurrence of an emergency. Improving preparedness in the area of civil protection shall not only be reflected in the response and minimization of the consequences of the emergency, but also in the emotional security of the population.
- Klíčová slova
- crisis management, disasters, emergencies, emergency preparedness, risk management, safety, security,
- MeSH
- civilní obrana * MeSH
- lidé MeSH
- náhlé příhody MeSH
- plánování postupu v případě katastrof * MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Bioterrorist threats and attacks are still an issue of concern in the world. Biological agents are divided into three categories. The highest priority agents classified in category A pose a massive risk to public health and national security. The society should be prepared for this risk. Health professionals in the Czech Republic should be aware of the diseases caused by category A agents, which are not common in the country. In this context, the project of the Ministry of the Interior of the Czech Republic “Decontamination of the injured persons” has been implemented at the Faculty of Health Sciences, Palacký University, Olomouc. The article provides an overview of selected serious infectious risks and information on the project the aim of which is to create certified methodical procedures and guidelines on situations related to bioterrorism.
- Klíčová slova
- anthrax, bioterrorism, botulism, decontamination, ebola, plague, tularemia, variola,
- MeSH
- antrax MeSH
- bioterorismus * prevence a kontrola trendy MeSH
- civilní obrana * MeSH
- lidé MeSH
- mor MeSH
- pravé neštovice MeSH
- tularemie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVES: Our study focused on the impacts on health among adolescents who became members of illegal armed groups in Colombia and their attention within the specialized government programme as seen by the professionals who work directly with them. Previous research indicates that those victims of armed violence are usually highly affected on their emotional and social health, but with appropriate and timely support more serious mental health problems can be prevented. Therefore, the care provided to them should be based on broader and holistic approaches. METHODS: This cross-sectional study used the qualitative method based on semi-structured interviews with 42 professionals, and internal reports on the health condition of 165 adolescents, 57 (34.5%) females and 108 (65.5%) males, as a secondary source of information. All information was anonymous and confidential. RESULTS: The interviews with professionals and their reports demonstrated that about a half of the 165 adolescents, 35 of 57 (61.4%) females and 48 of 108 (44.4%) males, suffered from serious symptoms requiring therapeutic and psychiatric attention. About 20% of the adolescents presented clinically important post-traumatic stress symptoms, 27% admitted sexual abuse and 29% psychoactive substance abuse. The professionals stressed various obstacles to the attention of these multiple impacts related both to the administrative and institutional issues and the particular characteristics of this population. CONCLUSIONS: Our findings show the complexity of the psychosocial impacts among adolescent victims of the Colombian armed conflict and their attention. Highly trained professionals and alternative strategies including active listening, observation and art therapy activities seem to be vital for an effective care. The lessons learned from the Colombian reintegration programme serve as important inputs to be considered when attending children and adolescents from conflict-stricken areas also in other contexts.
- Klíčová slova
- Colombia, child soldiers, mental health, psychosocial attention, reintegration programme,
- MeSH
- hodnocení programu MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- mladiství MeSH
- oběti zločinu psychologie statistika a číselné údaje MeSH
- ozbrojené konflikty psychologie MeSH
- průřezové studie MeSH
- služby péče o duševní zdraví organizace a řízení MeSH
- vládní programy organizace a řízení MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Kolumbie MeSH
Currently, the territorial Radiation Monitoring Network (RMN) of the Czech Republic consists of seven laboratories equipped with gamma spectrometry High Purity Germanium (HPGe) detectors. From 2007 to 2018, five emergency exercises were carried out to test the sample throughput of these facilities and their staff. The main objective was to identify weaknesses and problem areas in the whole process from the moment of obtaining the samples to logging the results into the central RMN database. The long-term aim of these exercises is to optimize emergency response procedures. The most important factor limiting laboratory capacity is the lack of qualified personnel. The exercises showed that in the current state, these laboratories would be able to operate in 12-hour shifts for 14 days and analyze 1700 samples per day. Emergency exercises have highlighted the fact that this type of exercise should be repeated periodically in order to monitor the performance and analytical capabilities of RMN.
- MeSH
- civilní obrana normy MeSH
- germanium MeSH
- laboratoře normy MeSH
- lidé MeSH
- monitorování radiace normy MeSH
- náhlé příhody * MeSH
- plánování postupu v případě katastrof organizace a řízení MeSH
- spektrometrie gama přístrojové vybavení metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- germanium MeSH
BACKGROUND: Hepatitis E virus (HEV) infection is not notifiable at EU/EEA level, therefore surveillance relies on national policies only. Between 2005 and 2015, more than 20,000 cases were reported in EU/EEA countries. HEV testing is established in 26 countries and 19 countries sequence HEV viruses. OBJECTIVE AND STUDY DESIGN: WHO's European Action plan for viral hepatitis recommends harmonised surveillance objectives and case definitions. ECDC's HEV expert group developed minimal and optimal criteria for national hepatitis E surveillance to support EU/EEA countries in enhancing their capacity and to harmonise methods. RESULTS: The experts agreed that the primary objectives of national surveillance for HEV infections should focus on the basic epidemiology of the disease: to monitor the incidence of acute cases and chronic infections. The secondary objectives should be to describe viral phylotypes or subtypes and to identify potential clusters/outbreaks and possible routes of transmission. Seventeen of 20 countries with existing surveillance systems collect the minimal data set required to describe the epidemiology of acute cases. Eleven countries test for chronic infections. Twelve countries collect data to identify potential clusters/outbreaks and information on possible routes of transmission. DISCUSSION: Overall, the majority of EU/EEA countries collect the suggested data and meet the outlined requirements to confirm an acute case.
- Klíčová slova
- EU/EEA, Hepatitis E virus, Surveillance, Testing,
- MeSH
- epidemický výskyt choroby MeSH
- epidemiologické monitorování MeSH
- Evropská unie MeSH
- hepatitida E diagnóza epidemiologie MeSH
- incidence MeSH
- lidé MeSH
- RNA virová analýza MeSH
- surveillance populace MeSH
- Světová zdravotnická organizace MeSH
- virus hepatitidy E genetika MeSH
- vládní programy normy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
- Názvy látek
- RNA virová MeSH
Despite the increase in awareness of chronic disease, little is known about whether multimorbidity-defined as two or more coexisting chronic conditions-has had a diminished impact on health in Europe in the past decade. We used multiple cross-sectional data from the Survey of Health, Ageing and Retirement in Europe to estimate changes in the prevalence of multimorbidity and in its association with health outcomes in ten European countries between 2006-07 and 2015. We found that the prevalence of multimorbidity rose from 38.2 percent in 2006-07 to 41.5 percent in 2015. Over the ten-year study period we also found a marginal reduction of the impact of multimorbidity on primary care visits and functional capacity. We did not find a reduction of its impact on hospital admissions and quality of life. Austria, the Czech Republic, Germany, and Spain were the countries that showed the largest reduction in the impact of multimorbidity on health outcomes. Multimorbidity continues to pose challenges for European health care systems, with only marginal improvement on health care use and health outcomes since 2006-07.
- Klíčová slova
- Chronic disease management models, Elderly, Europe, Functional capacity, Healthcare utilisation, Quality of life, multimorbidity,
- MeSH
- chronická nemoc MeSH
- databáze faktografické MeSH
- geriatrické hodnocení metody MeSH
- hodnocení rizik MeSH
- hodnocení výsledků zdravotní péče * MeSH
- kvalita života MeSH
- lékařská podpora ekonomika statistika a číselné údaje MeSH
- lidé MeSH
- multimorbidita trendy MeSH
- poskytování zdravotní péče organizace a řízení MeSH
- prevalence MeSH
- příjem pacientů statistika a číselné údaje MeSH
- průřezové studie MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- vládní programy ekonomika MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Česká republika MeSH
- Evropa MeSH
- Německo MeSH
- Španělsko MeSH
The aim of this paper is to identify a break in the development trend of the time series of the number of fatal, light and heavy injuries in traffic accidents and compare the progress caused by the media campaign named "Think or you'll pay! "in the Czech Republic over the period 2000-2015. The campaign focuses on the age group of drivers under the age of 25 and the most common cause of their traffic accidents as the drivers in this age category are the most vulnerable group in road traffic. The campaign uses a method in which it tries to influence behaviour by negative action, or by causing negative emotions. The authors concentrate on the effects of mass media campaigns in the long-term development of accidents in the Czech Republic and a financial evaluation of the road safety campaign "Think or you'll pay! "by comparing the campaign costs, the cost of road fatalities, and the cost savings from the perspective of government expenditures. The secondary source data for the chart analysis and interpolation according to the criteria of analytical and mechanical balancing time series, the Chow test and Quandt Likelihood Ratio test, choosing the appropriate model trend of accidents and consequences of traffic accidents were obtained from the Czech Ministry of Transport, the database of The Losses due to Traffic Accident Rates (CZRSO) and the Czech Association of Victims of Traffic Accidents (CSODN, 2015) from period of 1990 till 2016. The impact of the media campaign "Think or you'll pay!", measured by enumerating the costs was compared with the number of fatalities in the years immediately after the campaign and the impact of the media campaign was evaluated and recognised. The conclusion and the highlights summarize the findings of research and the limits of media campaign evaluation approach.
- Klíčová slova
- Cost analysis, Road and traffic safety, Time series models, media campaign,
- MeSH
- analýza nákladů a výnosů * MeSH
- bezpečnost * MeSH
- databáze faktografické MeSH
- dopravní nehody prevence a kontrola MeSH
- dospělí MeSH
- emoce MeSH
- hromadné sdělovací prostředky * MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- náklady a analýza nákladů MeSH
- podpora zdraví * ekonomika MeSH
- přesvědčovací komunikace * MeSH
- rány a poranění etiologie MeSH
- riskování MeSH
- řízení motorových vozidel * MeSH
- vládní programy MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: It is estimated that over one billion persons worldwide have some form of disability. However, there is lack of knowledge and prioritisation of how to serve the needs and provide opportunities for people with disabilities. The community-based rehabilitation (CBR) guidelines, with sufficient and sustained support, can assist in providing access to rehabilitation services, especially in less resourced settings with low resources for rehabilitation. In line with strengthening the implementation of the health-related CBR guidelines, this study aimed to determine what workforce characteristics at the community level enable quality rehabilitation services, with a focus primarily on less resourced settings. METHODOLOGY: This was a two-phase review study using (1) a relevant literature review informed by realist synthesis methodology and (2) Delphi survey of the opinions of relevant stakeholders regarding the findings of the review. It focused on individuals (health professionals, lay health workers, community rehabilitation workers) providing services for persons with disabilities in less resourced settings. RESULTS: Thirty-three articles were included in this review. Three Delphi iterations with 19 participants were completed. Taken together, these produced 33 recommendations for developing health-related rehabilitation services. Several general principles for configuring the community rehabilitation workforce emerged: community-based initiatives can allow services to reach more vulnerable populations; the need for supportive and structured supervision at the facility level; core skills likely include case management, social protection, monitoring and record keeping, counselling skills and mechanisms for referral; community ownership; training in CBR matrix and advocacy; a tiered/teamwork system of service delivery; and training should take a rights-based approach, include practical components, and involve persons with disabilities in the delivery and planning. CONCLUSION: This research can contribute to implementing the WHO guidelines on the interaction between the health sector and CBR, particularly in the context of the Framework for Action for Strengthening Health Systems, in which human resources is one of six components. Realist syntheses can provide policy makers with detailed and practical information regarding complex health interventions, which may be valuable when planning and implementing programmes.
- Klíčová slova
- Community-based rehabilitation, Delphi study, Human resources, Low resource settings, Realist synthesis, Rehabilitation,
- MeSH
- dostupnost zdravotnických služeb * MeSH
- kvalita zdravotní péče MeSH
- lidé MeSH
- postižení rehabilitace MeSH
- pracovní síly MeSH
- rehabilitace MeSH
- veřejné zdravotnické služby * MeSH
- vládní programy MeSH
- zdravotní pomocníci v komunitě MeSH
- zdravotnické zdroje * MeSH
- zdravotnický personál * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
The vast number of outbreaks of tension on the planet shows that it is impossible to underestimate the preparation level of population protection in emergencies. The possibility of a terrorist attack, including the use of particularly toxic or biological substances cannot be excluded or totally prevented at this point. In fact, there may not only be a terrorist attack. Rampant population migration increases the risk of the transmission of infectious diseases, even to considerable distances from the states where the epidemiological situation might not be completely under control. The current state of the Czech healthcare system in terms of preparedness for mass emergencies is insufficient and requires prompt correction, though not through hastily adopted measures. Ideally, looking into the success of the Israeli preparedness system, where the public has been exposed to high levels of threat from a variety of causes for decades, could greatly aid the Czech Republic in moving forward effectively. The number of victims of terrorist attacks there outpaces 10000, a fact that shows Israel is experienced in responding to emergency incidents.
- Klíčová slova
- protection of the population - extraordinary event - preparedness - Gertner Institute.,
- MeSH
- biologická válka MeSH
- chemická válka MeSH
- civilní obrana organizace a řízení MeSH
- emigrace a imigrace * MeSH
- hromadné neštěstí * MeSH
- infekční nemoci epidemiologie MeSH
- lidé MeSH
- terorismus * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
