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The Effect of the Introduction of Fee-For-Service on the Demand for Outpatient Care
Žílová, Pavlína ; Votápková, Jana (advisor) ; Pavloková, Kateřina (referee)
The thesis estimates the effect of the 2008 introduction of regulatory fees for outpatient visits by using 2009 health reform, abolition of co-payments for children, as a natural experiment. To estimate this effect we use micro-level data from EU-SILC survey and two different econometric models - Multinomial logit (MNL) and Zero-inflated negative binomial (ZINB). As co-payments for examination were abolished only for children, we use children as a treatment group and adult part of the population as a control group in difference-in-differences approach. We found an insignificant effect, i.e. introduction of user charges was ineffective in reducing number of doctor visits in Czech Republic. Another important result from this analysis is the significant role of the socio-economic characteristics, associated with the tendency of health-care utilization.
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Ekonomická situace lázeňství v České republice
Cahová, Markéta
Diploma thesis on topic Economic situation of balneal care in the Czech Republic was arised as reaction to ordinance No. 267/2012. Many balneal equipment have caused the economic problems, although regulations was medical character. The aim of this Diploma thesis is evaluate economic situation balneal care in the Czech Republic, to assess the effectiveness of the legal change over time 2004 – 2013. Assessment of the balneal care is carried out by selected health indicators. A significant part of the practical part is also devoted to case study to compare disability benefits with balneal care paid from public health insurance. The aspect evaluated indicators was lower burden of public expenditure. The Diploma thesis ends with evaluated impacts ordinance No. 267/2012 and proposed references to support balneal care in the Czech Republic.
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The impact of the Regulation fees cancelation on demand for Ambulant healthcare
JACHNO, Ondřej
The bachelor thesis is dealing with the impact of the Regulation fees cancelation on demand of Ambulant healthcare. The introductory part of theoretical thesis is describing the development of health care in regards to various financial models within the medical environment. At the beginning of this thesis, all known health care financial models are named and described in the worldwide scope. After the initial description, the bachelor thesis focuses on specific models and their development during the important stages from the second half of the 19th century until current era of the Czech Republic. The current health care system in the Czech Republic is based on public services and financed mainly from public sources. The health care system has multiple sources that help sustain it financially. The prevalent form is indirect financing, specifically the mandatory health insurance. Health care financing has gone through important developments that should not be forgotten. Furthermore, the theoretical part of the thesis also contains a detailed description of regulatory fees. It shows different types and functionalities of regulatory fees since their implementation by the law number 261/2007 (stabilizing of public budgets), until their cancellation on January 1st, 2015. The regulation fee was implemented by the Ministry of Health of the Czech Republic in efforts to solve the increasing deficit of the state budget, and increase the efficiency of the health care system.) The income increase, caused by regulation fees, should serve as a starting point in an era of modernizing of medical facilities and maintaining the overall quality of health care for patients. In the scientific part of the thesis, the main scope and the two types of research are being set. The quantitative research is aimed on a group of patients. The hypotheses of the research are as follows. Hypothesis number 1: The cancellation of regulatory fees leads to the increase in demand of a specialized ambulant care. Hypothesis number 2: The cancellation of regulatory fees for a prescription leads to a higher demand of prescribed medication. A questionnaire was used to determine the results of the research, which will either confirm or deny the presented hypotheses. The method used to receive the results was a frequency analysis that was completed by a statistician. The secondary, qualitative, research is deliberately used to ensure the accuracy of the completed and compared data. This research, which was run simultaneously with the quantitative one, targeted a group of health care professionals, specifically medical doctors. The data collected in the form of a structuralized set of interviews were used to be analyzed as a key to answer the research questions: Research question number 1: After cancellation of the regulatory fees, was there an increase in the amount of visits of patients with a specific health care provider? Research question number 2: Does the health care demand need to be regulated? Based on the research displayed within the thesis, it is possible to predicate: The questionnaire method lead to a confirmation of hypothesis number 1 and also to the conclusion that the cancellation of 30 CZK fee lead to an increase in demand of health care services. The research question number 1 also confirms that after the 30 CZK fee cancellation there was an increase in patient visits of health care facilities. The results are contradicting the findings within the hypothesis number 2, as there was no higher demand in prescribed medication after the regulation fee for medication was cancelled. The comparison of the data that was collected through both types of the research does not prove a direct connection in the increased demand of patients for medicinal drug prescription after the 30 CZK regulation fee cancellation. We can safely state in regards of the research question number number 2 that regulation of health care is a necessity.
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The issues of the constitutionality of regulatory fees in health care
Svatoš, Jiří ; Suchánek, Radovan (advisor) ; Jirásková, Věra (referee)
Goal of this thesis was to assess the constitutionality of "regulatory fees" in healthcare, which were enacted in the Czech Republic in 2007. The first chapter goes through the two decisions of the Czech Constitutional Court concerning assessment of the constitutionality of regulatory fees and identifies five main areas to study: 1)General methodology of human rights interpretation and their collisions in the Czech constitutional system, 2)Genesis and interpretation of social rights. 3)Identification of a test to assess collision between social rights and public goods 4)Essence of the right to free healthcare 5)Empirical assessment of the regulatory fees impact Second chapter is an overview of the first area divided into two sections: traditional methods of interpretation in constitutional law and development of the proportionality principle based on an overview of the Czech and foreign jurisprudence and the previous decisions of the Czech Constitutional Court. Third chapter describes the genesis of the social rights as a specific area of human rights. Implication from both chapters are combined to create a universal proportionality test that includes specific intensity of review for social rights. Fourth chapter provides a case study that firstly identifies the essence of the right to free healthcare,...
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The Effect of the Introduction of Fee-For-Service on the Demand for Outpatient Care
Žílová, Pavlína ; Votápková, Jana (advisor) ; Pavloková, Kateřina (referee)
The thesis estimates the effect of the 2008 introduction of regulatory fees for outpatient visits by using 2009 health reform, abolition of co-payments for children, as a natural experiment. To estimate this effect we use micro-level data from EU-SILC survey and two different econometric models - Multinomial logit (MNL) and Zero-inflated negative binomial (ZINB). As co-payments for examination were abolished only for children, we use children as a treatment group and adult part of the population as a control group in difference-in-differences approach. We found an insignificant effect, i.e. introduction of user charges was ineffective in reducing number of doctor visits in Czech Republic. Another important result from this analysis is the significant role of the socio-economic characteristics, associated with the tendency of health-care utilization.
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Funding of Drugs in the Czech Republic
Lukášová, Alena ; Stará, Dana (advisor) ; Dittrich, Oldřich Ludwig (referee)
The bachelor thesis focuses on the issue of the drugs funding in the Czech Republic. The literature review briefly describes the history of pharmacy. However, the main orientation is centered on the drugs organization and distribution, providing details of the process that has to be completed by each and every drug before it is allowed to be offered in pharmacies. The thesis also focuses on the state health care policy, and drugs policy. The following section analyzes the drugs pricing and payment policy, public health insurance with orientation on the health insurance providers, private sector, and specifically on additional payments for drugs and regulatory fees, representing direct payments of the households.
The thesis examines total expenses and funding sources connected with the health care, specifically connected with the aforementioned drugs funding policy. This part of the thesis also addresses the topic of the expenses of the health insurance providers according to the type of the provided care and households expenses, with regard to the topic of the thesis. Finally, a general drugs consumption and number of pharmaceutical units are provided.
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Regulative payments in Czech healthcare system - analysis of the period 2008 - 2014
Ullmann, Jan ; Lukášová, Tereza (advisor) ; Strejček, Ivo (referee)
This bachelor´s thesis analyzes the impact of regulative payments on Czech healthcare system in years 2008 - 2014, mainly on effectiveness of the healthcare system and on the total costs of the Czech healthcare system. On the basis of official data from the years before implementation of regulative payments, the author compares the real effects of their implementation with the those expected and also predicts the possible effects of abolishing majority of regulative payments since January the 1th 2016. In this thesis, the author also analyzes the impact of regional politics on regulative payments in the year 2009, on the basis of changes in years 2007 - 2009 researches whether the introduced regional legislations had any impact on effects of regulative payments.
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Analysis of financing the Czech healthcare system in 2015 and the impact of the abolition regulatory charges on its sustainability
Krupičková, Karolína ; Loužek, Marek (advisor) ; Bartůsková, Lucia (referee)
The final thesis analyzes funding of Czech healthcare system in 2015 and shows its sustainability in future years in order to answer the question, what is the impact of the abolition of regulatory fees, which were introduced in 2008, subsequently in 2014 and cancelled in 2015. Many demographic changes, specifically age structure of the nation, occurred over recent decades in the Czech Republic. This fact caused disproportionate changes on the expenditure side and the revenue side of the health system. The state tried to balance this disparity with short-introduced charges, but those were abolished due to the political pressure. The final thesis assesses the appropriateness of this measure. The theoretical part explains the healthcare system in the Czech Republic and all its entities, explains different approaches to the concept of health and issues of regulatory charges. The practical part is devoted to analysis of statistical data. There is the state of health care through the last of the statistics and demographic prognosis described. Following part talks about the issues of charges in a broader context of health care. There are also global trends and the biggest problems that the Czech Republic faces in that direction defined. The conclusion evaluates the role and effectiveness of regulatory charges and the impact of their abolition, offers possible solutions or recommendations, which are formulated on the basis of evaluated data. The final thesis concludes that regulatory charges are suitable complement to the overall reform, but this arrangement is not capable of comprehensively addressing current and possible future problems by itself.
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Analysis of healthcare financing in the Czech republic with particular regard to assessment of reasons and impacts of introducing regulatory fees in the years 2008--2015
Matláková, Eliška ; Chmelová, Pavla (advisor) ; Lukášová, Tereza (referee)
The topic of this bachelor s thesis is healthcare financing in the Czech Republic. It predominantly focuses at the impact of regulatory fees introduced in 2008. The theoretical portion defines healthcare politics, its models as well as various ways of healthcare financing. The practical portion covers the issue that arose with the introduction of regulatory fees and especially aims at analyzing their impact at certain parameters of the healthcare market in the Czech Republic. The goal of this paper is to find out whether the aforementioned regulatory fees fulfilled their planned expectations, especially considering that the whole policy ended up being canceled seven years later. The analysis showed that its impacts were indeed positive and as predicted, which makes their cancellation questionable. This suggests that there must have been a different motive for the cancellation, because their effectiveness was demonstrable. The paper also contains a comparison to Slovakia, where regulatory fees were also introduced in the past and the development of their cancellation can be analogous in the Czech Republic. Analysis of certain parameters of the Slovakian healthcare market proved that the cancellation was not effective, because the observed parameters are slowly shifting back to their original values and the issue of healthcare overuse has also started reappearing.
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