TYPES OF HEALTH CARE & HEALTH SERVICE SYSTEM AND ITS CHARACTERISTICS
There are both state and non-state health facilities in the Czech Republic. All of these facilities have, as a rule, a contract for the provision and reimbursement of health care with health insurance companies and can therefore provide health care without direct reimbursement. Healthcare services in the Czech Republic are provided by a system of state and non-state health facilities. This system consists of:
Outpatient primary facilities
Practitioners: Patients can choose a GP and then register with them. Registration obliges the physician to provide ongoing care for the patient (basic care including visiting services). The doctor may reject a new patient only because of full capacity. The doctor must not refuse emergency care. The insurer may change the registration and thus also the doctor after three months.
Contributors of contracted health insurance do not register with doctors. Their treatment is performed by contract physicians, or health facilities of the insurance company where the health insurance was contracted out!!
Outpatient professional care
The specialist in the Czech Republic can be visited even without the recommendation of a physician – general practitioner.
If the nature of the illness requires, a primary care physician or an outpatient specialist recommends hospitalization in a hospital medical facility. About the type of health care facility, the patient is informed and has the option of consulting and choosing a health care facility with regard to the performance or care required by the patient. Upon release from the facility, the patient receives a medical report (including the course and results of hospitalization or recommendations for other procedures) for the general practitioner. The patient also receives medication for three days.
Emergency and rescue service
Healthcare is provided in the Czech Republic even in the event of a sudden illness and accident during the off-hours or the absence of the attending physician. Emergency care has a character by location in the Czech Republic. In larger cities, there is a medical emergency department. In smaller locations, there is a collaboration of outpatient doctors who represent each other. Emergency treatment is co-financed from the patient’s side by a fee of 90 Kč / 24 hrs.
For cases of sudden severe illnesses and conditions where the patient cannot be transported to a doctor and when rapid treatment and transportation to a medical facility is necessary, a Rescue Service is established in the Czech Republic and can be called by special telephone line free of charge: 155 or 112 (here they also communicate in English and German)
These services provide medicines and medical devices in the Czech Republic on the basis of a medical prescription (medicines covered by insurance or with additional payment) and without it (the patient pays himself).
The issued medical prescription has a time limit of validity:
- The prescription from emergency is valid for 24 hours
- The prescription for antibiotics is valid for 5 days
- The prescription for opiates is valid for 3 days
- Other prescriptions are usually valid for 1 week
At the expiry of these deadlines, the prescription is invalidated. If a pharmacy does not have the drug, another medicinal product with the equivalent effectiveness may be delivered in the same way.
It is the duty of a doctor to offer the patient a treatment that is fully covered by public health insurance. All of these performances are included in the reimbursement notice valid for the relevant period. This is a list of diagnostic and therapeutic procedures using standard materials. For these treatments, any reimbursement by the patient is inadmissible, ie. the doctor may not require a surcharge for the patient.
The doctor can also offer a treatment using the above-standard materials. This treatment is no longer covered by general health insurance, the patient pays for it. The prices of these performances are calculated on the basis of an individual calculation of the surgery. The patient has the right to be informed before the treatment with the cost of performance.
Hospitals usually provide both inpatient and outpatient care. In general, the director is in charge of the hospital. The hospital consists of economic sections, personnel department, technical backgrounds, individual departments, laboratories, hospital pharmacies. Individual departments of hospitals are interdisciplinary. Physicians interact with other departments in order to provide as much care as possible. The departments of hospitals are also composed of nursing units of standard and specialized care. Standard units provide care to patients who are not at risk of life. Nursing care is usually provided by a group or functional care system. In group care, the nurse is in charge of a group of patients. In functional care, nurses are divided according to the performance they perform in all patients. Specialized beds focus on intensive (patients with life threatening vital functions, necessary monitoring) and intermediary care (stabilized life functions under supervision). The most specialized care is provided in anaesthesiology resuscitation departments where patients with more than one life function failed are. Individual care is provided there (one patient to one nurse).
1/ Typologie zdravotních služeb. Available from: http://www.mzcr.cz/dokumenty/typologie-zdravotnich-sluzeb_2131_1065_3.html ( 2018-02-14)
2/ Druhy zdravotní péče. Available from: https://www.mzcr.cz/Cizinci/obsah/druhy-zdravotni-pece_2627_22.html ( 2018-02-14)
3/ Zdravotní služby: zákon o zdravotních službách a podmínkách jejich poskytování, zákon o specifických zdravotních službách, zákon o zdravotnické záchranné službě : nové prováděcí vyhlášky k reformním zákonům : podle stavu k 14.5.2012. Ostrava: Sagit, 2012. ÚZ, č. 905.