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OECD Reviews of Health Care Quality: Czech Republic 2014

Raising Standards

image of OECD Reviews of Health Care Quality: Czech Republic 2014

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.

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Screening and prevention programmes in the Czech Republic

The Czech Republic has established a range of preventive health care initiatives and has made substantial progress in reducing mortality from cancer and from cardiovascular disease. Yet, not all the outcomes linked to the prevention and early diagnosis programmes are reassuring – indeed the country faces a substantial epidemiological challenge in terms of increasing rates of smoking, obesity and alcohol abuse, even among children. There are also governance challenges. In particular, a biennial universal general health check is unlikely to offer value for money and not enough is known about adherence to guidelines for secondary prevention of stroke and heart attacks. A priority therefore is to develop the information infrastructure underpinning preventive health care. Where value for money cannot be demonstrated, consideration should be given to dropping programmes such as general health checks and redirecting this investment to other health care activities. At the same time, the low rates of uptake of interventions proven to reduce mortality – such as cancer screening – point to the need to widen access to professionals and the public and incentivise both to engage in preventive health care more actively.

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