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The impacts of regulatory fees in health care on public health insurance
PRAŽMOVÁ, Věra
The Public health insurance system in the Czech Republic was established more than 20 years ago. During this period, the public health insurance system has gone through many transformations. A lot of reform proposals have been submitted with the aim of keeping the increase of healthcare expenses under control but simultaneously not limiting the quality and the accessibility of healthcare. The introduction of the regulatory fees was a part of the healthcare reformation and its purpose was to reduce the demand for healthcare and thus regulate the consumption of health services. Secondarily, the regulatory fees should bring private funds into healthcare system. In the theoretical part of the research, the author describes healthcare systems of several European countries mainly from the point of view of cost sharing by patients. The funding of healthcare in the Czech Republic is then evaluated in more detail. The research characterises all the types of regulatory fees including all the legal changes they have undergone prior to their implementation. The author summarizes the amounts of funds received from the different types of fees which patients have paid since the introduction of regulatory fees in 2012 on the basis of data received from health insurance companies. In the practical part of the research, the author analyses and statistically processes data which were taken from one specific bureau of employee health insurance company. On the basis of this data, the author maps the development of average visits of healthcare institutions per patient in the chosen fields of ambulant care specializations. The author compares the number of average visits in 2007, which is the year before the introduction of regulatory fees, with the number of average visits after the regulations implementation that means during the 2008-2013 period. The aim was to discover whether the fees had any effect on the amount of healthcare services and whether they led to decrease in the number of patients´ visits (at the doctor). The development of the number of patients´ visits was studied in 22 different fields of ambulatory specialization in total. The collected results have been statistically processed using one sample, one-tailed T test. Furthermore, the influence of fees on the healthcare expenses was surveyed in the respective ambulatory fields. In the similar manner as with the patients´ visits, the author compares the average expenses per one patient before the introduction of regulatory fees in 2007 with the average value after the implementation of regulatory fees to the healthcare system. The research offers a comprehensive overview of these issues and can be used as a basic material for further research about regulatory fees and patient cost sharing in healthcare.
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