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Implementation of Health Policy Reform in the Czech Republic.
RICHTEROVÁ, Andrea
The introduction of user fees and surcharges for medicinal products and foods for special medical purposes is considered to be one of the steps preceding the implementation of health policy reform. As of 1 January 2008, four basic fees were introduced in the Czech healthcare system with the objective of reducing unnecessary demand and misuse of health care. The objective of my Diploma Thesis was to map and evaluate the effects of the introduction of user fees on patients{\crq} number of visits to outpatient specialists. Three main objectives were formulated during my work on this thesis. The first objective was to provide a coherent overview of the issues related to the introduction and use of fees introduced on 1 January 2008 for outpatient specialists. The second objective was to compare patients{\crq} rate of visits to outpatient specialists with the year 2007. The third objective was to evaluate whether the patients{\crq} number of visits to outpatient specialists decreased in relation to age, gender, care provided, and kind of disease. Subsequently, four hypotheses were formulated. Hypothesis 1: The patients{\crq}rate of visits to outpatient specialists decreased compared to the year 2007 as a result of the introduction of user fees. Hypothesis 2: Compared to the year 2007, the introduction of user fees resulted in no considerable decrease in the rate of visits for patients with chronic diseases. Hypothesis 3: The impact of user fees on the rate of visits to outpatient specialists will be comparable for both genders. Hypothesis 4: The introduction of user fees will not result in a prolongation of the interval between the respective visits of patients to outpatient specialists. Quantitative research and method of questioning were used to achieve the goals and verify the hypotheses. The questionnaire technique was used for data collection. The research survey group for the questionnaire comprised physicians with outpatient specialties practicing in South Bohemia, Hradec Králové, Liberec,and Plzeň Regions, Capital City of Prague, Central Bohemia, Ústí and Zlín regions. The final research group comprised 79 specialist physicians with specialties as follows: allergology and clinical immunology, anesthesiology, dermatovenerology, gynecology, surgery, internal medicine, pneumology, ophthalmology, ENT, oncology, orthopedics, neurology, psychiatry, rehabilitation, and urology. The Diploma Thesis met its main objectives, as well as its partial objectives. The second, third, and fourth hypotheses were confirmed. The first hypothesis was not verified successfully in this research. The results of my research suggest that user fees had an impact on patients{\crq} rate of visits to outpatient specialists and can be used for publication in professional journals.

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