OECD Reviews of Health Care Quality: Czech Republic 2014

Raising Standards

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This book presents a comprehensive review of health care quality in the Czech Republic. It finds that over the past 20 years, the Czech Republic witnessed the unprecedented gains in quality of health care and life expectancy and successfully transferred its Semaschko system into the modern accessible health care system with private-public mix of providers. Nevertheless the health care system in the Czech Republic still has some way to go to achieve the outcomes of the best performing OECD members. While some of the gap might be caused by the one of the lowest levels of health care expenditures among OECD countries (7.2% GDP in 2011) there are possibilities to improve the outcomes without incurring much of the additional costs.

The Czech authorities should reach a consensus on the development of quality of care and data infrastructure and aim for sustainable long-term initiatives undisturbed by the political cycles in both of these areas. While the adverse events reporting and voluntary accreditation are the good steps towards the accountability of the providers, the government should do more in this area, undertake the effort to broaden the accreditation process and include outpatient care and link public health authorities to the quality agenda of inpatient care. In the area of data infrastructure more data should be gathered, the process of data gathering should be streamlined and administrative burden for the providers lowered primarily via the merging the data-collecting agencies. Finally, without the active participation of health insurance funds and proper reimbursement mechanisms in place the quality agenda will not be perceived as the priority.



Assessment and recommendations

The Czech Republic has made significant progress in improving the quality of health care in recent decades. The reduction in case-fatality rate after a heart attack, for example, is amongst the steepest in the OECD, more than halving from 15.7% in 2001 to 6.8% in 2011. At the same time, the country has one of the lowest levels of health care expenditure among OECD countries, at 7.2% GDP in 2011. But compared to its peers, quality monitoring and quality improvement activities remain at a basic level. There is great emphasis on ensuring that minimum standards are met, whilst initiatives to encourage continuous quality improvement are less developed. An important explanatory factor is the relatively immature data infrastructure that underpins Czech health care. This prevents more detailed, transparent and continuous quality monitoring of clinical processes and patient outcomes. A linked and perhaps deeper driver concerns the fact that frequent and extensive changes of government officials appear to hinder the design and implementation of new quality improvement initiatives. To move to the next stage of continuous quality improvement, the Czech Republic needs to use health information better, in particular by publishing more measures of the outcomes of care. Greater consistency of vision, policies, and co-ordination across key bodies, including the various state offices and institutes for safety, quality and information, insurers and health care providers is also needed. The health system should also develop a more proactive approach to managing chronic diseases such as diabetes, through better primary and secondary prevention work.


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