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Regulation Fees in the Czech Health Care System
KYTLEROVÁ, Ivana
A large part of the work has been devoted to regulation fees as one of the health care systems regulating mechanisms. An essential place in the work is taken by elaboration of the topic of increase of costs for the health care systems functioning in the current world and the possibilities of their solution. The work also deals with an extensive and frequently discussed topic of justice in the physician-patient relationship. This topic has been processed in connection with historical circumstances and a philosophical dimension of perception of justice in health care. Further to this, ideas and ideological foundations of justice, which project into political ideologies, have been dealt with. Health care systems, the system of health insurance in the Czech Republic and its legal regulation have been briefly characterized. The aim of the work was to map an opinion of some ordinary citizens regarding perception of justice in the Czech health care and introduction of the regulation fees. Partial goals were to find out in what way political orientation reflects in the opinion on justice of the collected regulation fees and furthermore to map, in what way an amount of income of respondents influences an opinion that regulation fees represent an income for a health care facility. Two hypotheses were determined. Hypothesis no. 1: University graduates understand better the system of regulation fees. Hypothesis no. 2: More than 80% or respondents consider it unjust that regulation fees represent an income of a physician, health care facility, or pharmacy. A method of questioning was used for the processing, data collection was carried out by using a questionnaire technique. Statistical methods suitable for an analysis of categorical data were used for evaluation of information. 300 questionnaires were handed out, the return rate being 74%, the final research population consisted in 182 respondents from the city of Votice. Another employed processing method was the secondary data analysis. Results of the questionnaire research brought a number of intriguing facts relating to attitudes of the respondents as to the issue of justice and state of the Czech health care. Further to this, it has been confirmed that university educated respondents understand better the system of regulation fees. In more than 65%, respondents consider it unjust that the proceeds from the regulation fees collection represent income of a health care facility. One of the hypothesis was confirmed and the other was disproved. The acquired information can be used as a guideline for public discussion.
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Co-operation nurses and doctors within intensive care
HALAMOVÁ, Veronika
Jako téma bakalářské práce jsme zvolili problematiku spolupráce sester a lékařů na jednotce intenzivní péče. Práce ve zdravotnictví není práce pro jednotlivce. Jedná se o týmovou spolupráci, kde kaţdý člen týmu má svoje povinnosti, ale také práva a pravomoci. Sestry chtějí, aby byli v péči o klienty rovnocennými partnery, coţ se zatím na mnoha místech nedaří. Pro většinu lékařů je sestra stále ještě pomocnice, která pouze vykonává lékařské ordinace a její vlastní práce je povaţována za podřadnou a nedůleţitou. Toto téma jsem si vybrala také z osobních důvodů, protoţe na pracovišti, kde pracuji, se bohuţel setkávám se stejným postojem lékařů, o kterém jsem se zmiňovala výše. Pro sběr dat byla zvolena technika dotazníku. Byly vypracovány dotazníky jednak pro sestry a také pro lékaře, aby měly moţnost se vyjádřit obě strany. Dotazník pro sestry obsahoval 25 poloţek. Pro lékaře byl vytvořen podobný dotazník, který obsahoval 19 poloţek. Dotazníky byly pro obě skupiny respondentů dobrovolné a anonymní. Výzkum probíhal v Nemocnici Na Homolce na jednotkách intenzivní péče s chirurgickým zaměřením. Byly zvoleny 3 hypotézy. První z nich byla, ţe lékaři a sestry na JIP spolupracují. K této hypotéze se vztahovalo více otázek z dotazníku. Jednalo se o různé oblasti spolupráce a hypotéza byla potvrzena. Druhá hypotéza se vztahovala ke vzdělání sester. Předpokládala jsem, ţe sestry s vysokoškolským vzděláním jsou z pohledu lékařů vnímány jako rovnocenní partneři. Tato hypotéza byla zamítnuta. Zjistila jsem, ţe pro lékaře není rozhodujícím kritériem pro spolupráci výše vzdělání, ale praktické dovednosti sestry. Třetí hypotéza se týkala kompetencí sester. Předpokládala jsem, ţe sestry na JIP provádějí výkony v rámci svých kompetencí. Tato hypotéza byla zamítnuta, protoţe 85,85 % sester souhlasí s tím, ţe lékaři vyţadují výkony, které nejsou plně v sesterských kompetencích. Druhým cílem bylo zjistit oblasti, ve kterých mohou vznikat problémy. Z šetření vyplynulo, ţe jde v podstatě o problémy ve slušném chování a to u obou skupin ? jak u sester, tak u lékařů.
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Professional liability insurance
Hřeben, Tomáš ; Křížek, Tomáš (advisor) ; Zetek, Pavel (referee)
This bachelor thesis deals with issues of professional liability insurance in Czech Republic with a deeper focus on attorneys at law and private doctors -- providers of non-state health care facilities. The thesis concentrates on the actual possibilities of negotiation of professional liability insurance on the czech insurance market, it compares the differences between individual offers of professional liability insurance and the collective contracts negotiated by the professional chambers. After a brief basic characteristics of the general liability insurance comes a chapter devoted to the general introduction of the matter of liability and damages legislation. Next chapters closely deal with the particular specifics of professional liability - first generally then with a focus on the insurance product designated to attorneys at law and eventually with focus on professional liability insurance optimalized for the needs of the private doctors.
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The attitude of doctors towards the nurse competences according to the act.
SLADKÁ, Iveta
In the Czech Republic all activities of individual groups of health care workers are defined by various regulations and laws. All nurses' competences are stipulated by 424/2004 Decree of Coll. of Laws and that defines activities and responsibilities for health care workers as well as other professionals and experts in the medical field. In my thesis three goals and hypotheses were set. The first goal of my thesis was to find out what level of awareness of the existence and of the content of the 424/2004 Decree doctors and nurses was. For that purpose the hypothesis Hl was set. It was worded as the following: ,Doctors are aware of the existence and the content of the 424/2004 Decree. The second goal was to find out what doctors' opinoions on the relevant competences were. To reach this goal hypotheses H2 were set. They were worded as the following:" Doctors have not become familiar with the importance of a qualification study that is backed up with having the relevant competences stipulated in 424/2004 Decree. H3 was worded as the following : "Activities required by doctors for nurses to be carried out go over their competences stipulated in 424/2004 Decree. H4: Activities going beyond nurses' competences do not enable the nurses providing relevant nursing care which should be focused on saturation and meeting patients' needs. The third goal was to find out what doctors think of the Decree's implementation in everyday life. I set a hypothesis that doctors do not feel any need to change nurses competences.
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The most usual conflicts in hospital from the point of nurses view during cooperation with the physician
SCHAFFELHOFEROVÁ, Lucie
To keep good and non-conflict relationships between doctors and nurses is not an easy task their stressful working environment. Despite the fact that both doctors and nurses have a common goal, and that is to provide the best care of their patients, there are situations leading to conflicts between doctors and nurses. Good relationships between nurses and doctors are a guarantee of a harmonized cooperation in the entire medical team. That is why it is important to avoid conflicts and, if any conflict has already occurred, it is important to use it for the benefit of the whole team. The goal of our work was to define the most frequented conflicts in hospitals from a point of nurse's view in a cooperation with doctors, and what impact these conflicts have on nurses' work. To process the data in the first part of my thesis, the quality method for a research survey was used. The data collection was implemented by interviews. The research sample group was composed of eight nurses working in bed departments of different hospitals. On the grounds of the quality survey I set four hypotheses which I tried to verify in the quantity survey. To collect the data in the quantity part a questionnaire survey was used and the research sample group was also composed of nurses working in bed departments. The data were being collected in the period of March through May. To assess the results 175 questionnaires were used. The hypothesis 1 - The most frequented conflicts between nurses and doctors root in a wrong communication, has been proven on the grounds of our findings. The hypothesis 2 - Conflicts between nurses and doctors result from increasing competences for nurses has been proven, too, as well as the hypothesis 3 - Conflicts between nurses and doctors result from misunderstanding nurses' and doctors' roles. The hypothesis 4 - Conflicts between nurses and doctors have a negative impact on nurses' work was proven, too. The results have also revealed that the second most frequented reasons for conflict situations represent personal qualities of doctors, which was not included in the hypotheses. In the summary of the thesis I incorporated some recommendations how to handle conflict situations effectively. This work should be a foundation for a potential follow- up research not only in this field, but it can also serve management teams in medical institutions. They should take actions to improve the situation to some extent.
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Community care versus nurses in primary pediatric care
VAŇKOVÁ, Soňa
Paediatricians and nurses belong to primary health care providers in the in child care while nurses have been taking over a key role in the primary health care. Their position is becoming stronger under the conditions of growing demands in the current health system. This survey was carried out as a combination of quantity and quality research. A questionnaire and an interview for nurses and parents was worked out as a major tool of the research. The survey included 102 nurses in paediatricians' offices. 112 parents and five nurses were interviewed in the range of the research work. There were six objectives set for the thesis. The first objective was to find out whether nurses in primary paediatricians' offices use nursing procedures. The hypothesis set up for the first objective was as of the following: nurses in primary paediatricians office do not use nursing procedures. This was proven on the grounds of the answers received in the survey. The second objective was to find out whether nurses keep their own nursing books and records. The second hypothesis set up was worded as of the following: Nurses in primary paediatricians' offices do not keep their own nursing records. This hypothesis was proven as well. The third objective was to find out whether nurses from primary paediatricians' offices visit families as a part of their service to families. The hypothesis for the third objective was worded as of the following: Nurses from primary pediatricians' offices visit patiens in their homes. The hypotehsis was proven on the groundsof the survey. The fourth objective was to find out whether nurses in primary paediatricians' office observe children in familes with bad socio-economic backgrounds. The hypothesis was worded as of the following: nurses observe children in familes with bad socio-economic;backgrounds. This hypothesis was proven as a fact. The fifth objective was to find out whether nurses are informed about community care. The fifth hypothesis was worded as of the following: nurses in primary paediatricians' offices are not informed about community care. This hypothesis was not proven. The sixth and the seventh objectives were to find out what the range of awareness about community care in parents' minds exists and whether parents are satisfied with nursing care provided by paediatricians and nurses. The hypotheses were worded as of the following: parents are not aware of community care and they consider paediatricians' and nurses' care substantial. The sixth hypothesis abot the range of parents' awareness of commuinity care was not proven, while the seventh hypothesis about satisfaction of nursing care by paediatricians and nurses was proven. In the frame of quality reasearch and on the grounds of four research questions two hypothese were set up. The first one is worded as of the following: Paediatric nurses in primary paediatric care consider community care as necessary and inevitable to provide a thourough care in familes with bad socio-economic backgrounds. The second one is worded as of the following. Paediatric nurses consider cooperation with nurses in other fields of the system as necessary and that eduaction towards well-being is desperately needed. Nurses should be aware of their roles within the health care system. They are no longer just nurses providing care and doers of doctors' commands. They have to learn how to operate successfully in other roles such as: managers, researchers, legislative assistants, advisors, educators and etc.
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Analyze of migration Czech doctors abroad
Svoboda, Jakub ; Gráf, Václav (advisor) ; Loužek, Marek (referee)
The main aim of the work is analysis of labour migration of czech doctors.Work is divided to several parts. At first for clearing up the situation is czech health-care system compared with other OECD countries. After that the work is focused on migration of high skilled labour, which is group where doctors belogns to. Next part is survey among doctors and students of medicine. The aim of the survey is find out their migration potentional, their target countries and migration barriers. At the and the work is focused on situation in czech health-care system in the end of the year 2010. The result of analysis is clear. Number of czech doctors migrating abroad is not increasing dramatically. Mass exodus of czech doctors abroad will not happen.
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Commercial Communication in Czech Pharmaceutical Industry
Kadlecová, Barbora ; Mikeš, Jiří (advisor) ; Hrubá, Kamila (referee)
Thesis titled Commercial communications in czech pharmaceutical industry is about how to use marketing communication tools (advertising, public relations, sales promotion, personal selling, etc.) in the pharmaceutical industry. A specific feature of pharmaceutical marketing is separate communication to public (patients) and to professionals (doctors) which requires using different communication messages and also different channels to each target group. Pharmaceutical marketing is regulated by advertising law, by the Council for Radio and TV Broadcasting and by the provisions of the State Institute for Drug Control which control the ways how two target groups are addressed. Possible marketing tools are described from both theoretical (legal) and also practical (marketing communication of specific pharmaceutical company) terms.
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Cooperation between nurses and physicians from the perspective of nursing management
KADLECOVÁ, Ivana
Cooperation of nurses and physicians from the perspective of nursing management Master's thesis was focused on the cooperation of nurses and physicians from the perspective of nursing management. Nursing care and nursing management has an irreplaceable role in health care. The world of medicine, nursing care and health care is an extremely complex organizational system, which is not surely represented only by physicians and nurses, but these, however, are still the dominant persons on the scene. The first objective of this thesis was to make a survey of cooperation between nurses and physicians during the nursing process in the care of patients from the perspective of nursing management in departments of surgery and internal medicine. The second objective was to identify problem areas in cooperation between nurses and physicians from the perspective of nursing management in departments of surgery and internal medicine, and the third objective was to find out the way the nursing management tackles problem situations in cooperation between nurses and physicians in departments of surgery and internal medicine. To meet these objectives four research questions were stated: 1. In what areas do nurses and physicians cooperate during the nursing process while providing care for patients from the perspective of nursing management in their respective departments? 2. How do nurses assess and perceive cooperation with physicians from the perspective of nursing management in their respective departments? 3. Are there problem areas in cooperation of nurses and physicians from the perspective of nursing management in their respective departments? 4. How does nursing management tackle problem situations in cooperation between nurses and physicians in their respective departments? The research was conducted in the hospital, where I was given information under the condition of anonymity of the respondents interviewed. The responders were chief nurses and senior staff nurses working in departments of surgery and internal medicine. The investigation conducted is a qualitative research. Interviews with the structure of questions to non-standardized interviews were conducted with the respondents according to question structures of the non-standardized interview. Subsequently, transcripts of interviews and data categorization in tables according to the Ritchie and Spencer´s framework analysis were made. The survey suggests the following conclusions. Nurses and physicians cooperate within the nursing process in providing care for patients from the perspective of nursing management in departments of surgery and internal medicine at the stage of problem solving. Nurses appreciate cooperation with physicians on the basis of mutual respect, but they still feel the prevailing dominance of physicians. From the perspective of nursing management there are problematic areas in cooperation between nurses and physicians. Nursing management tackles problem situation in cooperation between nurses and physicians by seeking common solutions. It will be possible to provide the health care facilities, where the research was conducted, with the outcomes of the research. Thinking about the possible improvement in mutual cooperation as early as during physicians´ and nurses´ studies, to introduce various measures to improve cooperation between nurses and physicians by organizing joint seminars and cultural events could lead to meeting the purpose. It is necessary to raise physicians´ awareness of nursing process and to carry out further research on this topic.
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