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

BACKGROUND: Multiple sclerosis (MS) is a progressive autoimmune disease of the central nervous system that is often disabling and for which there is currently no cure, though disease-modifying treatment is now available. The aim of this study is to describe the current values of the direct costs of multiple sclerosis (MS) in the Czech Republic. METHODS: Attention is focused on direct medical costs. The costs were monitored in the Czech Republic among 5673 patients in the period between 2011 and 2015. These costs included complex, special and targeted visits at the neurologist, blood collection and the costs of hospitalisation. The results refer to the diagnoses according to the International Statistical Classification of Diseases and Related Health Problems. The attention is focused on MS G35 (NS; brain stem; spinal cord; disseminated; generalised). RESULTS: The average total direct costs per patient per year are 4838.1 €. Not every patient has to be hospitalised during the year, and not every patient has prescribed medication. According to the above data, 12% of patients are hospitalised and 55% of patients are prescribed medication. The minimum average cost per patient without medication and hospitalisation is 54.1 €. CONCLUSION: Cost evaluation across countries is difficult due to the different evidence. If only selected direct costs considered in this study are compared, the absolute economics burden increases over time. The only statistically significant difference in the average price and the time spent is between 2012 and 2013, where the correlation value is 0.597.

• Klíčová slova
• Czech Republic, Direct costs, Multiple sclerosis, Neurological disease,
• MeSH
• hospitalizace ekonomika   MeSH
• lidé MeSH
• náklady a analýza nákladů MeSH
• osobní újma zaviněná nemocí * MeSH
• retrospektivní studie MeSH
• roztroušená skleróza ekonomika   epidemiologie   terapie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

OBJECTIVE: The aim of this study was to estimate the cost of dementia in the Czech Republic. METHODS: One hundred and nineteen patient-caregiver dyads participated in our multicenter observational cost-of-illness study. The modified Resource Utilization in Dementia Questionnaire was used as the main tool to collect data from patients and caregivers. Medical specialists provided additional data from medical records. The average costs of dementia were calculated and patients were then divided by the level of cognitive impairment. A generalized linear model was used to determine if differences were present for selected cost variables. RESULTS: The mean (standard deviation) for direct cost per a patient in a month was estimated to be €243.0 (138.0), €1727.1 (1075.6) for the indirect cost, and €1970.0 (1090.3) for the total cost of dementia in the Czech Republic. All of the costs increased as dementia severity increased. Both the indirect and total costs significantly (p < 0.05) increased if patients were living with their primary caregiver, and if the severity of cognitive impairment was increased. CONCLUSIONS: The indirect cost, which was represented mainly by informal care, comprised the main part of the total cost of care for patients with dementia in the Czech Republic. Both total and indirect care costs increased significantly the cognition declined.

• Klíčová slova
• Alzheimer’s disease, Direct medical care, Indirect expenses, Informal care, Social care,
• MeSH
• demence ekonomika   terapie   MeSH
• lidé MeSH
• náklady na zdravotní péči MeSH
• osobní újma zaviněná nemocí * MeSH
• osoby pečující o pacienty MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

The aim of this paper is to specify the cost of treatment and care for people with Alzheimer's disease (AD) in the Czech Republic and also with a view to the future. Data availability is evaluated as well as the quality of cost comparison with other developed countries. Data for the Czech Republic will include data from the health insurance company regarding medicines and treatment, as well as a selected home caring for people with dementia and, ultimately, the Social Security Administration. The basic methods include an analysis of data from publicly available sources, direct interviews with the representatives of nursing homes caring for people with dementia and the representative of the Social Security Administration of the Czech Republic. Items will be specified within the category of direct costs. For the study, the indirect costs related to the loss of patient as well as caring person productivity are not considered. Costs for treatment and care are based from the data on 4162 patients, the costs of a bed from data on 391 beds in homes for the elderly. The average annual cost per patient with AD in the Czech Republic was calculated and came to the amount of 12,783 EUR. These items include outpatient care, inpatient care in a medical facility, inpatient care in homes and medications. In terms of share of these items on the direct costs, the largest item are services provided by special homes which contributes to the direct costs by 94 %, medications create 1 % and treatment (both outpatient and inpatient) 5 %. In the case of home care the total costs are lower at 4698 EUR. The Czech Republic as well as other developed countries are faced with the problem of unified accounting cost of people suffering from Alzheimer's disease. This then causes the calculation of the economic burden to be very difficult and indicative values.

• Klíčová slova
• Alzheimer’s disease, The Czech Republic, The costs of treatment and care, The economic burden,
• MeSH
• Alzheimerova nemoc * ekonomika   epidemiologie   terapie   MeSH
• ambulantní péče MeSH
• antipsychotika ekonomika   terapeutické užití   MeSH
• hospitalizace ekonomika   MeSH
• lidé MeSH
• longitudinální studie MeSH
• náklady a analýza nákladů metody   MeSH
• náklady na zdravotní péči * MeSH
• osobní újma zaviněná nemocí * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• antipsychotika MeSH

BACKGROUND: Narcolepsy is a lifelong, rare neurological sleep disorder characterized by chronic, excessive attacks of daytime sleepiness. This disease is often extremely incapacitating, interfering with every aspect of life, in work and social settings. OBJECTIVE: The purpose of this study is to specify the treatment costs of patients in Central Europe (Czech Republic), while the attention is mainly paid to the drugs that were fully or partially covered by public health insurance. Furthermore, concomitant therapy is also evaluated, since it incurs a certain financial burden for patients and their family members. On the basis of the calculated costs, impact on the public budget is evaluated. PATIENTS AND METHODS: This study monitors the direct costs of the drugs for 13 patients, who represent ~1.3% of the total number of diagnosed patients in the Czech Republic, and evaluates the costs associated with their treatment during the period from January 9, 2011 to April 23, 2013. RESULTS: Most of the treatment costs (~80%) were covered by publicly available sources. This finding is also true for the concomitant therapy of comorbidities. Additional payments for the drugs constitute about 20% of the total costs.

• Klíčová slova
• cataplexy, cost, narcolepsy, orphan drug, rare disease, sodium oxybate,
• Publikační typ
• časopisecké články MeSH

BACKGROUND: The incidence of diabetes is rising across the world. This global problem significantly affects the economic and social development in the 21st century. If the disease is diagnosed in time, the number of complications as well as the costs of therapy will be lower. Modern technologies permeate all spheres of medicine, and diabetes treatment is no exception. Therefore, the aim of this article is to analyze patients' attitudes to the use of modern technologies in the treatment of diabetes (type 1 diabetes mellitus [T1DM] and type 2 diabetes mellitus [T2DM]). METHODS: A total of 313 respondents from the Czech Republic in the period from June 24, 2015, to July 24, 2015, participated in a questionnaire survey. The target group was diabetics regardless of the type of illness. Collected data were analyzed using descriptive statistical methods, Z-test, and test of independence (Pearson's chi-squared test). RESULTS: Although in other areas mobile applications are used to monitor patients' health condition in ~30% of cases, in the case of diabetes they are used by only 4% of respondents. Approximately 8% of participants use an application, but they do not like it. The rest of the respondents have never used any mobile application. These low figures are due to a lack of knowledge about the availability and possibilities of mobile applications. A positive correlation was proven between technical skills and methods of entering data. Gender and age show only a weak dependency of the method of writing data on their own health condition. Furthermore, the monitored parameters show that patients with T1DM control and know more about their health condition than patients with T2DM, which is reflected, for example, by more frequent blood glucose measurements or larger track of their physical activity. Conversely, the relationship between the associated complications and self-care activities has not been demonstrated. CONCLUSION: Despite the current fast development of modern technologies, these technologies are not frequently used in treating patients. The principal problem lies in patients' low technological knowledge and their higher age, which makes learning new skills, including the use of modern technologies, more difficult.

• Klíčová slova
• diabetes mellitus, modern technologies, patients’ attitudes, survey,
• Publikační typ
• časopisecké články MeSH

Recent demographic trends indicate that older people appear to be one of the fastest growing population groups worldwide. In the year 2000, people older than 65 years represented 12.4% of the population. This number is expected to rise to 19% by 2030, particularly in developed countries. Therefore, there is sustained effort at both national and international levels to prolong the active life of these people as long as possible. Since the present older generation at the age of 55 years is already digitally literate, the use of technologies is one of the solutions. The purpose of this study is to discuss the role of the Internet in the prevention of cognitive decline in normal aging. The author examines clinical studies that exploit the use of the Internet, including online training programs, in the prevention of cognitive decline in healthy older individuals. The findings of the clinical studies indicate that the use of the Internet, especially online cognitive training programs, may have a positive effect on the improvement of cognitive functions in healthy older adults. Nevertheless, larger sample longitudinal randomized controlled clinical trials aimed at the prevention of cognitive decline among healthy older adults are needed.

• Klíčová slova
• Internet, cognitive functions, healthy older individuals, prevention, training,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

INTRODUCTION: Alzheimer's disease (AD) is a slowly progressing neurodegenerative brain disease with irreversible brain effects; it is the most common cause of dementia. With increasing age, the probability of suffering from AD increases. In this research, population growth of the European Union (EU) until the year 2080 and the number of patients with AD are modeled. AIM: The aim of this research is to predict the spread of AD in the EU population until year 2080 using a computer simulation. METHODS: For the simulation of the EU population and the occurrence of AD in this population, a system dynamics modeling approach has been used. System dynamics is a useful and effective method for the investigation of complex social systems. Over the past decades, its applicability has been demonstrated in a wide variety of applications. In this research, this method has been used to investigate the growth of the EU population and predict the number of patients with AD. The model has been calibrated on the population prediction data created by Eurostat. RESULTS: Based on data from Eurostat, the EU population until year 2080 has been modeled. In 2013, the population of the EU was 508 million and the number of patients with AD was 7.5 million. Based on the prediction, in 2040, the population of the EU will be 524 million and the number of patients with AD will be 13.1 million. By the year 2080, the EU population will be 520 million and the number of patients with AD will be 13.7 million. CONCLUSION: System dynamics modeling approach has been used for the prediction of the number of patients with AD in the EU population till the year 2080. These results can be used to determine the economic burden of the treatment of these patients. With different input data, the simulation can be used also for the different regions as well as for different noncontagious disease predictions.

• Klíčová slova
• Alzheimer’s disease, population modeling, prediction model, system dynamics,
• Publikační typ
• časopisecké články MeSH