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Czech Health Care in the International Context
Cieslar, Jakub ; Cahlík, Tomáš (advisor) ; Votápková, Jana (referee)
Finance flowing to health care forms a significant part of total expenses in developed countries. This fact is closely related to efficiency of allocating health care resources. This thesis aims to estimate and compare efficiency of Czech health care system as well as 132 member states of World Health Organization in 2012, their development since the year 2000 and comparison and description of other papers focused on related topics. To acquire relative efficiency estimates (efficiency with respect to the sample), output oriented Data Envelopment Analysis specified with variable returns to scale is used. Obtained results can help with choosing role-model systems and to reduce ineffectiveness. Results also suggest which systems succeeded in improvement of the efficiency in allocating of resources.
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The Pharmacy-based Cost Group Model: Application in the Czech Health Care System
Hajíčková, Tereza ; Votápková, Jana (advisor) ; Paulus, Michal (referee)
The risk adjustment model currently used does not adequately compensate insurers for predictable differences in individuals' health care expenditures in the Czech Republic. It then leads to financial inequality in the redistribution of funds to the insurance companies and causes their financial problems. This study introduces a PCG model as another method for risk adjustment and determines to what extent the predictive performance of the model can be improved when applied to Czech data. We analyze 10% of population sample in the Czech Republic in years 2011 and 2012. Our results confirm the appropriateness of the PCG model for the Czech environment. When the PCG variables are added to the demographic model, R2 value of the prediction model increases from 2.03% to 13.87%.
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Costs and Usage of Medical Devices in the Czech Republic
Kaláb, František ; Paulus, Michal (advisor) ; Votápková, Jana (referee)
Geographic differences in healthcare costs, usage and practice are documented by research from the United States and Western Europe, yet, there is limited information on this topic in the Czech Republic. Spatial variation often seems unexplained by the demographic, health or economic characteristics of the population which points to inefficiencies in the healthcare system. We bring three main contributions: a first study dealing entirely with medical devices; we improve previously used models with a set of environmental indicators and; we work with an entirely new sample which has not been used before. Based on 2012 claims data on medical devices we present a geographic analysis of spending and further analyse spending and usage of three widely used and economically relevant devices. Further, we estimate regression model in order to assess the role of unwarranted variation in spending, which we subsequently expand on the three studied devices. We find significant variation in the per capita spending and usage of healthcare devices at the level of regions and districts, with more than a threefold difference in the relative spending between the regions in the lowest and the highest spending quintile. Moreover, only 38% of the district difference between the highest and lowest spending quintile was explained...
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Social and Medical Costs of Dupuytren's Disease
Losenický, Jakub ; Votápková, Jana (advisor) ; Paulus, Michal (referee)
The thesis investigates the relative cost-effectiveness of two treatment methods of Dupuytren's disease (DD) - surgical fasciectomy and injectable collagenase - and assesses the impact of the two health technologies on the budget of the Czech Republic. For this purpose, cost-minimization analysis (CMA) and budget impact analysis (BIA) are employed and, importantly, both social and medical costs are taken into consideration. Concerning the CMA, different patients are modelled with respect to personal characteristics such as occupation, type of work (manual, non-manual) and income. In the BIA, data on DD occurrence in the Czech Republic from the National Register of Hospitalised Patients (NRHOSP) are analysed. We found that collagenase is a cost-minimizing treatment for a big majority of employees and manually working SMEs. On the other hand, collagenase turned out to be more expensive than fasciectomy for most of the non-manual SMEs. All things considered, collagenase appeared to be cheaper for most of the model patients. We also discovered that if all the patients in the dataset were treated with collagenase, the Czech state budget would annually save 1,685,452 CZK. The average annual costs of fasciectomy and collagenase were 41,334,049 CZK and 39,648,597 CZK, respectively. Powered by TCPDF (www.tcpdf.org)
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Sibling Rivalry and Characteristics of Marriage
Klepetko, Tomáš ; Bauer, Michal (advisor) ; Votápková, Jana (referee)
Parents are involved in their children's marriage decisions in a large part of developing world. Resources are scarce, so sibling structure may affect individual marriage and human capital outcomes. Previous literature focused mainly on timing of marriage and education. The objective of this thesis is to test several hypotheses, concerning sibling structure effects on wider range of such characteristics, as spousal quality, domestic violence, polygamy and wealth. In general, we explore the hypothesis that in countries with arranged marriage tradition, women, whose next-youngest sibling is female, are disadvantaged to women, whose next-youngest sibling is male. The hypothesis is empirically tested, using data from five countries in Sub- Saharan Africa. The results show consistent sibling structure effects on early marriage and childbearing across the countries. The effects on education, spousal quality, domestic violence and wealth are less robust. No effect on literacy and polygamy was found. Keywords Sibling Rivalry, Marriage, Childbirth, Education, Spousal Quality, Domestic Violence, Polygamy, Wealth 1
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Health care: necessity or luxury good? A meta-regression analysis
Iordache, Ioana Raluca ; Votápková, Jana (advisor) ; Háva, Petr (referee) ; Gerry, Christopher J. (referee)
When estimating the influence income per capita exerts on health care expenditure, the research in the field offers mixed results. Studies employ different data, estimation techniques and models, which brings about the question whether these differences in research design play any part in explaining the heterogeneity of reported outcomes. By employing meta-regression analysis, the present paper analyzes 220 estimates of health spending income elasticity collected from 54 studies and finds that publication bias is of marginal concern for the literature. The model specification choices, more exactly whether a study accounts for institutional factors and advancements in medical technology, have a negative effect on reported outcomes. Moreover, the "economic research cycle hypothesis" finds support in our analysis. Lastly, the research finds that the true income elasticity of health spending is situated around unity level, which makes health care neither a luxury, nor a necessity. Keywords: meta-regression analysis, aggregate health expenditure, income elasticity 1
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Decision about family size
Melcerová, Eva ; Mlčoch, Lubomír (advisor) ; Votápková, Jana (referee)
The aging population of the Czech Republic is a very acute problem. While the increase in life expectancy and the related need for reform of overshadow. In the theoretical part of my bachelor theses I am concerned with issues that affect fertility. More specifically, I focus on the perceived size of the family and its changes over time, the cost of children, parenthood postponement to a later age, and especially the combination of work and family. I also concern with the functions of family policy of the Czech Republic and major social benefits for families with children. In the practical part I define my own model with aspects affecting fertility and trying to point out the unfriendly family policy of the Czech Republic, which focuses more on families with some problems or specifics than on standard families. My model builds on the already well-known model of Gary Becker and enriches him on other important variables. Furthermore, I analyze the tax benefits for families with children, and especially already canceled joint taxation of married couples. Here by simple calculations I point to the fact that although it was canceled because of meaningless after uniform income tax for some of the families could make sense it even at the present level of income tax. Finally, a simple model shows the option...
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Measuring the Index of Constructive External Engagement: ICEE for the Czech Republic
Svitáková, Lucie ; Janský, Petr (advisor) ; Votápková, Jana (referee)
In this thesis we compute the Index of Constructive External Engagement (ICEE) for the Czech Republic. First, we introduce the theory of the index and discuss its differences with Commitment to Development Index from which ICEE originates. Second, we find the necessary data and compute the score of ICEE for the Czech Republic. Third, we discuss the overall result and subsequently the score of each component separately. Finally, we create an original comparison of ICEE with other related works to ascertain its current data validity. Powered by TCPDF (www.tcpdf.org)
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Determinants of generic drug substitution in the Czech Republic
Žílová, Pavlína ; Votápková, Jana (advisor) ; Bryndová, Lucie (referee)
This study uses logistic regression to estimate the probability of choosing the brand-name drug despite the presence of cheaper generics given patient and drug characteristics in the Czech pharmaceutical market in the period 2009-2013. Results of the analysis may help guide policies to decrease pharmaceutical costs. In order to motivate people who are more likely to choose the original version of drug, policy makers may impose higher copayments and lower subsidies on the original drugs which they use. Additionally, two supplementary analyses were applied to sub-sectors of the pharmaceutical market: antihypertensive drugs and antibiotics. Fixed effects logistic regression is employed to test the robustness of the results.
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Determinants of pharmaceutical expenditures on cardiovascular diseases
Gogilashvili, Nino ; Chalupka, Radovan (advisor) ; Votápková, Jana (referee)
The thesis analyzes the determinants of pharmaceutical expenditures on cardiovascular diseases with particular focus on Central Europe. We show how the pharmaceutical expenditure varies across the countries. We try to empirically verify that factors such as age, GDP, total health expenditure, education and prevalence of a particular disease cause the variation. Applying the fixed effect model on selected countries in the period 2000-2009, we find that the increase in pharmaceutical expenditures on cardiovascular diseases is explained mainly by aging population and prevalence of the diseases. Additionally, countries with higher GDP tend to also have somewhat higher pharmaceutical expenditures on cardiovascular diseases. Key words Pharmaceutical expenditures, cardiovascular diseases, GDP, health expenditure, fixed effect model, prevalence of a disease, aging of population.
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