PURPOSE: The global health workforce suffers long-term understaffing in remote and underserved areas. To attract young doctors for rural work, it is necessary to identify the main motivating factors. MATERIALS AND METHODS: The pilot survey with 201 general practitioner trainees in the Czech Republic was conducted using a structured questionnaire. The response rate was 67%. RESULTS: Not only financial support motivates general practitioner trainees for rural work. A combination of incentives from sources other than medical would greatly increase the chance for general practitioner trainees to work in rural regions. CONCLUSIONS: To what extent can the survey outcomes relate with other European regions needs to be investigated further.

• Klíčová slova
• Motivating factors, rural general practice, young GPs,
• MeSH
• lidé MeSH
• pracovní síly MeSH
• praktičtí lékaři * MeSH
• průzkumy a dotazníky MeSH
• venkovské obyvatelstvo MeSH
• zdravotnické služby pro venkov * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

• Klíčová slova
• GENERAL PRACTICE *,
• MeSH
• lidé MeSH
• praktické lékařství * MeSH
• praktičtí lékaři * MeSH
• rodinné lékařství * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Given the critical role of general practitioners (GPs), their insufficient medical density and the adverse effects of burnout on both practitioners and the quality of care provided, the prevalence estimates of GP burnout reported in the literature are highly concerning. This nationwide study builds on a 2023 survey that revealed a significant burden of burnout among Czech GPs. The primary objectives were to analyse the prevalence and determinants of burnout and to examine potential trends over time. METHODS: In April 2024, 2,500 randomly selected GPs were emailed the Maslach Burnout Inventory - Human Services Survey for Medical Personnel, supplemented with sociodemographic and job-related questions. The statistical analysis included a comparison with an identical study conducted a year earlier. RESULTS: Of the 765 completed responses (542 females, 223 males; mean age 55.5 years), 19.7% of the GPs experienced burnout in all three dimensions, 23% in two, 28.5% in one, and 28.8% in no dimension. Similar to 2023, the most common burnout dimension was a lack of personal accomplishment (PA, 52.2%), followed by emotional exhaustion (EE, 45.9%) and depersonalization (DP, 35.7%). Male and employed GPs experienced greater degrees of DP, while practice owners were more susceptible to EE. A positive dependence of burnout on the number of listed patients was identified. The proportion of GPs experiencing burnout across all dimensions decreased by 2.1% from 2023 to 2024 (p = 0.232), primarily in DP. Additionally, a 6.7% increase in GPs showing no signs of burnout in all dimensions (p = 0.002) further supported this positive trend. CONCLUSIONS: Between 2023 and 2024, the prevalence of burnout among GPs exhibited a modest decline. Nonetheless, it persists at almost 20%. Ensuring a sufficiently dense network of GPs, providing adequate resource allocation, and raising awareness of their importance are essential measures.

• Klíčová slova
• Burnout, Depersonalization, Emotional exhaustion, General practitioner, Personal accomplishment,
• MeSH
• depersonalizace epidemiologie   psychologie   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• pracovní uspokojení MeSH
• praktičtí lékaři * psychologie   MeSH
• prevalence MeSH
• profesionální vyhoření * epidemiologie   psychologie   MeSH
• průzkumy a dotazníky MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

The aim of this paper is to explore general practitioners' (GPs) prescribing intentions and patterns across different European regions using the Theory of Planned Behavior (TPB). A cross-sectional study was undertaken in selected geographically defined Primary Health Care areas in Cyprus, Czech Republic (CZ), France, Greece, Malta, Sweden and Turkey. Face-to-face interviews were conducted using a TPB-based questionnaire. The number of GP participants ranged from 39 to 145 per country. Possible associations between TPB direct measures (attitudes, subjective norms (SN) and perceived behavioral control (PBC)) and intention to prescribe were assessed by country. On average, GPs thought positively of, and claimed to be in control of, prescribing. Correlations between TPB explanatory measures and prescribing intention were weak, with TPB direct measures explaining about 25% of the variance in intention to prescribe in Malta and CZ but only between 3% and 5% in Greece, Sweden and Turkey. SN appeared influential in GPs from Malta; attitude and PBC were statistically significant in GPs from CZ. GPs' prescribing intentions and patterns differed across participating countries, indicating that country-specific interventions are likely to be appropriate. Irrational prescribing behaviors were more apparent in the countries where an integrated primary care system has still not been fully developed and policies promoting the rational use of medicines are lacking. Demand-side measures aimed at modifying GPs prescribing behavior are deemed necessary.

• Klíčová slova
• General practitioner, Prescribing, Primary care, Theory of Planned Behavior,
• MeSH
• dospělí MeSH
• lékařská praxe - způsoby provádění statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• praktičtí lékaři psychologie   statistika a číselné údaje   MeSH
• průzkumy a dotazníky MeSH
• úmysl MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Francie MeSH
• Kypr MeSH
• Malta MeSH
• Řecko MeSH
• Švédsko MeSH
• Turecko MeSH

BACKGROUND: Since 2010, the Czech Republic has been experiencing a spontaneous phenomenon in which General Practitioner (GPs) practices have been transferred to a legal limited liability company as defined by the Commercial Code. OBJECTIVES: Our research attempted to ascertain the reasons that induced GPs to change their legal form, thereby opting for an entrepreneurial orientation (EO). A second objective was to measure the impact of this change on the healthcare performance of GP practices. METHODOLOGY/APPROACH: We used exploratory research to examine this phenomenon in healthcare service provision. Data from 131 questionnaires was evaluated using an exploratory survey with descriptive statistics. To assess the healthcare performance of GP practices, we used secondary data from the Institute of Health Information and Statistics of the Czech Republic. FINDINGS: The GPs interviewed considered their practices to be businesses. Their decision to change to a limited company form was influenced by the possibility of selling or transferring the business, employment sustainability and job security, and advantages related to cost structure and taxation. Our study shows that, in a generational exchange, the change in legal form enhances the sustainability and operation of the practice within the context of the current demands for high-quality healthcare.

• Klíčová slova
• Entrepreneurial orientation, General medical practice, Performance, Transfer of legal forms,
• MeSH
• kvalita zdravotní péče MeSH
• lidé MeSH
• postoj zdravotnického personálu MeSH
• praktické lékařství * MeSH
• praktičtí lékaři * MeSH
• průzkumy a dotazníky MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

• Klíčová slova
• GENERAL PRACTICE *, GERMANY, EAST *, PREVENTIVE MEDICINE *, RURAL HEALTH *,
• MeSH
• lidé MeSH
• praktické lékařství * MeSH
• praktičtí lékaři * MeSH
• preventivní lékařství * MeSH
• rodinné lékařství * MeSH
• zdraví venkovských oblastí * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Německo východní MeSH
• Německo MeSH

• Klíčová slova
• LEGISLATION, MEDICAL *,
• MeSH
• lidé MeSH
• praktičtí lékaři * MeSH
• zákonodárství lékařské * MeSH
• znalosti * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: A wide range in prevalence rates of burnout among general practitioners (GPs) has been reported in various regions, with an increasing trend. This nationwide cross-sectional study aimed to estimate the prevalence and associated determinants of burnout in Czech GPs. METHODS: 1000 randomly selected physicians from the Czech Society of General Practitioners (through a pseudorandom number generator) were emailed an online survey based on the Maslach Burnout Inventory - Human Services Survey. Data collection was performed between January and February 2023. RESULTS: 331 questionnaires were obtained (227 females and 104 males, mean age - 49.9 years, the mean number of registered patients - 1951). 21.8 % of GPs scored a high level of burnout in all three of its dimensions and 23.9 % in no dimension at all. The most prevalent dimension was reduced personal accomplishment (PA, 56.2 %) followed by emotional exhaustion (EE, 50.2 %) and depersonalization (DP, 40.5 %). Reaching burnout in all three dimensions was significantly more frequent in males and in GPs registering a number of patients above the median. Increasing age and years of practice were protective factors for DP but risk factors for reduced PA. Employed GPs had lower EE scores than GP practice owners. The respondents' basic characteristics reflected their presence among Czech GPs, which testifies against selection bias. CONCLUSIONS: The high rate of burnout (∼22 %) should be addressed by promoting personal resources along with the perception of the importance of GPs in society. A sufficiently dense network of GPs should allow them to register a lower number of patients.

• Klíčová slova
• Burnout, Depersonalization, Emotional exhaustion, General practitioner, Job demands-resources model, Personal accomplishment, Prevalence,
• Publikační typ
• časopisecké články MeSH

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.

• Klíčová slova
• Primary care, general practice, point-of care, primary care, rural health,
• MeSH
• chronická nemoc MeSH
• glykovaný hemoglobin MeSH
• lidé MeSH
• praktičtí lékaři * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• glykovaný hemoglobin MeSH

BACKGROUND: The prevalence of diabetes and the use of electronic health (eHealth) are increasing. People with diabetes need frequent monitoring and follow-up of health parameters, and eHealth services can be of great value. However, little is known about the association between the use of eHealth and provider-based health care services among people with diabetes. OBJECTIVE: The objective of this study was to investigate the use of 4 different eHealth platforms (apps, search engines, video services, and social media sites) and associations with the use of provider-based health care visits among people diagnosed with type 1 diabetes mellitus (T1DM). METHODS: We used email survey data collected from 1250 members of the Norwegian Diabetes Association (aged 18 to 89 years) in 2018. Eligible for analyses were the 523 respondents with T1DM. Using descriptive statistics, we estimated the use of eHealth and the use of general practitioners (GPs) and somatic specialist outpatient services. By logistic regressions, we studied the associations between the use of these provider-based health services and the use of eHealth, adjusted for gender, age, education, and self-rated health. RESULTS: Of the sample of 523 people with T1DM, 90.7% (441/486) had visited a GP once or more, and 61.0% (289/474) had visited specialist services during the previous year. Internet search engines (such as Google) were used for health purposes sometimes or often by 84.0% (431/513), apps by 55.4% (285/514), social media (such as Facebook) by 45.2% (232/513), and video services (such as YouTube) by 23.3% (118/506). Participants aged from 18 to 39 years used all forms of eHealth more than people aged 40 years and older, with the exception of social media. The use of search engines was positively associated with the use of somatic specialist services (odds ratio 2.43, 95% CI 1.33-4.45). GP visits were not associated with any kind of eHealth use. CONCLUSIONS: eHealth services are now widely used for health support and health information by people with T1DM, primarily in the form of search engines but often in the form of apps and social media as well. We found a positive association between the use of search engines and specialist visits and that people with T1DM are frequent users of eHealth, GPs, and specialist services. We found no evidence that eHealth reduces the use of provider-based health care; these services seem to be additional rather than alternative. Future research should focus on how health care services can meet and adapt to the high prevalence of eHealth use. Our results also indicate that many patients with T1DM do not visit specialist clinics once a year as recommended. This raises questions about collaboration in health care services and needs to be followed up in future research.

• Klíčová slova
• Norway, cross-sectional study, diabetes mellitus, type 1, eHealth, general practitioners, health care utilization, internet, specialist,
• MeSH
• diabetes mellitus 1. typu terapie   MeSH
• dospělí MeSH
• internet trendy   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• praktičtí lékaři MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• specializace MeSH
• telemedicína metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH