Nejvíce citovaný článek - PubMed ID 16902697
Primary health care in the Czech Republic: brief history and current issues
Health is one of the Sustainable Development Goals. The importance of health promotion is growing in the context of an aging population and increasing life expectancy. Prevention is often underestimated and neglected by citizens. This article aims to identify the socioeconomic predictors of preventive health check-ups by general practitioners in the Czech Republic, focusing on selected age groups. An original dataset is prepared based on data for 2010-2019 provided by the largest health insurance company in the Czech Republic, the General Health Insurance Company. Correlation and regression analysis methods are used to achieve the objectives. Two models are built and tested: (1) preventive examinations model and (2) preventive examinations in age group 65+ model. Based on the results, preventive medical examinations in the pensioner group depended on economic indicators, such as the average wage, employment, and gross domestic product, in the analyzed period. For the total population, overall population size, the average age, urbanized area, and level of education play a key role. The results reveal a difference between the general population group and the 65+ population group. Government interventions and health policies promoting prevention should consider using appropriate incentive policy instruments targeting the 65+ population to prolong active life in senior age.
- Klíčová slova
- Czech Republic, aging, preventive examinations, seniors, socioeconomic indicators,
- Publikační typ
- časopisecké články MeSH
In contrast to the decreasing burden related to cardiovascular disease (CVD), the burden related to dysglycemia and adiposity complications is increasing in Czechia, and local drivers must be identified. A comprehensive literature review was performed to evaluate biological, behavioral, and environmental drivers of dysglycemia and abnormal adiposity in Czechia. Additionally, the structure of the Czech healthcare system was described. The prevalence of obesity in men and diabetes in both sexes has been increasing over the past 30 years. Possible reasons include the Eastern European eating pattern, high prevalence of physical inactivity and health illiteracy, education, and income-related health inequalities. Despite the advanced healthcare system based on the compulsory insurance model with free-for-service healthcare and a wide range of health-promoting initiatives, more effective strategies to tackle the adiposity/dysglycemia are needed. In conclusion, the disease burden related to dysglycemia and adiposity in Czechia remains high but is not translated into greater CVD. This discordant relationship likely depends more on other factors, such as improvements in dyslipidemia and hypertension control. A reconceptualization of abnormal adiposity and dysglycemia into a more actionable cardiometabolic-based chronic disease model is needed to improve the approach to these conditions. This review can serve as a platform to investigate causal mechanisms and secure effective management of cardiometabolic-based chronic disease.
- Klíčová slova
- adiposity, cardiometabolic risk, cardiovascular disease, chronic disease, dysglycemia, insulin resistance, nutrition, obesity, type 2 diabetes,
- MeSH
- adipozita etnologie MeSH
- běloši statistika a číselné údaje MeSH
- chronická nemoc epidemiologie etnologie MeSH
- diabetes mellitus 2. typu epidemiologie etnologie MeSH
- dieta škodlivé účinky etnologie MeSH
- disparity zdravotního stavu MeSH
- dospělí MeSH
- dyslipidemie epidemiologie etnologie MeSH
- hypertenze epidemiologie etnologie MeSH
- kardiometabolické riziko MeSH
- kardiovaskulární nemoci epidemiologie etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- metabolický syndrom epidemiologie etnologie MeSH
- obezita epidemiologie etnologie MeSH
- porucha glukózové tolerance epidemiologie etnologie MeSH
- prediabetes epidemiologie etnologie MeSH
- prevalence MeSH
- sedavý životní styl etnologie MeSH
- sociální determinanty zdraví etnologie MeSH
- stravovací zvyklosti etnologie MeSH
- zdravotní gramotnost MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
BACKGROUND: In this paper, we analyse the economic burden of elder care in the Czech Republic by assessing how family members of senior citizens engage in caregiving. To do this, we examined the time and cost associated with caregiving as a function of age, gender, and income of the caregiver. METHODS: A questionnaire comprising 17 items was used to gather data from 155 informal caregivers whose seniors are affiliated with 200 registered home care agencies. Spearman rank correlation was adopted to analyse how caregivers' income, age and gender influences the costs accrued and time spent in caring for elders. The expenses are divided into direct and indirect. Publicly available sources are used to establish expenses on treatment and medication, which cannot be determined by the questionnaire survey. RESULTS: Results show that around-the-clock care is the most common. Spouses of care recipients make up the highest number of caregivers, and women represent the largest portion of this group. Additionally, the more the time spent caring for an elder, the higher the cost associated with such care. The total annual burden of informal caregivers is determined by the sum of annual average indirect costs, amounting to € 36,888, and annual direct costs, amounting to € 2775, resulting in a total of € 39,663 per year. CONCLUSION: Czech social policymakers should begin to consider better packages for caregivers in the form of incentives and other monetary benefits to improve living standards and care for ageing seniors.
- Klíčová slova
- Burden, Disease, Family caregivers, Home care, Seniors,
- MeSH
- lidé MeSH
- osobní újma zaviněná nemocí * MeSH
- osoby pečující o pacienty * MeSH
- průzkumy a dotazníky MeSH
- rodina MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
In 2008, the Czech Republic instituted a new policy that requires most patients to pay a small fee for some inpatient and outpatient healthcare services. Using the Survey of Health Aging and Retirement in Europe, this article examines the changes in healthcare utilization of Czechs 50 years and older following the new fee requirement by constructing difference-in-differences regression models focusing on four outcome measures: any visits to primary care physician, any hospitalization, number of visits to the primary care physician and number of nights hospitalized. For this population, I find that the likelihood of having any primary care visit decreased after the policy was instituted. The likelihood of reporting any hospitalization was not significantly changed. The predicted number of primary care visits per person declined, but the predicted number of nights spent in a hospital did not. I find only mixed evidence of greater effect of the user fees on some subpopulations compared with others. Those 65 or older reduced their use more than those between 50 and 64, and so did those who consider their health to be good, and the less educated.
- Klíčová slova
- Czech Republic, User fee, access, inequality, primary care,
- MeSH
- dostupnost zdravotnických služeb ekonomika MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- pacientův souhlas se zdravotní péčí * MeSH
- platba za výkon * MeSH
- primární zdravotní péče ekonomika statistika a číselné údaje MeSH
- senioři MeSH
- zdravotnické přehledy MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Česká republika MeSH