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Efficiency change in inpatient care provision under the DRG-based reimbursement mechanism in the Czech Republic
Jakubová, Barbora ; Bryndová, Lucie (advisor) ; Votápková, Jana (referee)
Expenses on inpatient care form the largest share of Czech health expendi- ture, which raises concerns about its efficiency. Efficiency improvement belonged to one of the motivations for the implementation of reimbursement mechanism based on diagnosis-related groups, under which hospitals are paid a fixed amount per hospital case. This thesis contributes to the existing literature on DRG by assessing the changes in efficiency of inpatient care under DRG in the Czech Republic, focusing on the length of stay as a measure of resource utilization as well as an indicator of hospital efficiency. Furthermore, it contributes to this topic by using a unique and relatively large dataset containing patient-level information from 15 Czech hospitals over 2015-2019. Employing models for count data, we observe the downward trend in length of stay over the examined period. This finding is in line with the intended effect of DRG. Moreover, the estimated result is robust when considering dif- ferent subsamples - based on hospital size (large and medium-sized) or severity level of a patient. The only group where the decline in length of stay was not estimated were the most severely ill patients with major complications and co- morbidities. Measured by the standard deviation of length of stay, the process of...
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Analgosedation of a child patient in pre-hospital emergency care and children's urgent care
MRÁZ, Štěpán
This bachelor's thesis is focused on the topic of analgosedation of an infant patient in pre-hospital emergency care and children's urgent care. It comprises two parts, the theoretical and the practical one. The theoretical part includes some information about pre-hospital and urgent emergency cares. Furthermore it is mainly focused on specifics of infant patients, analgosedation and last but not least on resuscitation of adults and children. For the practical part of this thesis was chosen one aim. It was to find out how urgent wards are ready to face intake of infant patients. Due to this target came out two investigative questions. The first one:"What facilities can be found in hospitals, which are ready for intake of infant patient?" The second question: "Are hospital workers prepared for infant patients within the framework of PNP and urgent care?" The research was carried by a quantitative method of gathering data through the half structuralized dialogues covering 12 questions. The research sample contained 6 paramedics of an emergency ambulance and 6 hospital employees from an urgent ward. The data obtained by this research are divided into 11 categories. After summarization of all information and data I found out that there is a high standard of facilities covering pre-hospital and hospital care, therefore an infant patient can be provided with a necessary help. Within the investigation was also proved the following fact. Hospital employees are well trained in issues of infant patient. Nevertheless they agreed that there are not so many practical training based on children emergency care organised, therefore they would really welcome them to be able to improve their practical skills in connection of this specific field.
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How to meet needs of seniors in hospital care.
Bláhová, Hana ; Holmerová, Iva (advisor) ; Macková, Marie (referee) ; Kisvetrová, Helena (referee)
The submitted dissertation of the PhD study programme Longevity Studies was prepared and financially supported by the project GAUK - Grant Agency of Charles University No. 760219 entitled "Met and Unmet Needs Of Particularly Vulnerable Older Patients in Home and Inpatient Care", of which I am a co-investigator. The mentioned research project is also in the intentions of the strategic plan and long-term activities of the research team CELLO (Center for the Study of Longevity and Long-Term Care), which is the scientific basis of the PhD study programme Longevity Studies. The main goal of the GAUK project is to provide a comprehensive overview of the needs of vulnerable older patients who are provided health care. The project is focused on three areas, which are: the needs of patients with dementia, the needs of geriatric patients at home and the needs of geriatric patients in hospital care. Partial goals are the exploration of current knowledge of the issue based on a review of Czech and foreign literature. The aim of the survey is to find out attitudes and opinions on satisfying needs from the perspective of patients and healthcare professionals. The practical goal is to create recommendations for good practice for the health care of these patients. The dissertation consists of a total of seven...
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Smoking cessation among patients in residential treatment for alcohol dependence
Adamíková, Žaneta ; Štěpánková, Lenka (advisor) ; Vacek, Jaroslav (referee)
Background: In the Czech Republic, alcohol and tobacco are the most widely used addictive substances. Although use of these substances is legal for those 18 years or older, they can lead to serious health consequences. Especially among alcohol (or other drugs) dependent persons in recovery, the prevalence of regular smoking compared to the general population is much higher. Nevertheless, in these settings within the Czech Republic, tobacco smoking is often overlooked and for the staff there is no standard approach for introducing the systematic programs for quitting smoking. It is often based on theory that these patients have no motivation or interest in professional assistance with quitting smoking. Objective: The primary objective of the research was to assess the motivation of patients dependent on alcohol and tobacco, currently undergoing the residential medium-term treatment to quit smoking. A secondary objective was to highlight the issue of smoking among these patients and find out what their view is on the possibilities of tobacco dependence treatment in the setting and whether they would be interested in professional assistance with quitting smoking. Methodology: Questionnaire-based research was conducted among patients in the 5 health care services for the addiction treatment throughout...
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Burn-out syndrome in thepre-hospital and hospital care forparamedicalpersonnel
ŠAŠKOVÁ, Jana
The "burn out "syndrom is the state of a physical, emotional and psychical exhaustion. There is a relatively big danger of the "burn out"syndrom emergence by the paramedics and that is why there should be given a big stress to its prevention. The aim of this bachelor´s work was to find out if there is a bigger "burn out" syndrom by the paramedics than by hospital paramedics. The next aim was to find out the influence of the practice´ lenght and of the workfalling in to the psychical point of view to the paramedics. It was used the investigation of quantity through the standartised quostionnaire to find out the "burn out" level. We created a quostionnaire that contained 11 questions to find out if the paramedics have the prevention against the "burn out" syndrom. The standartised questonnaire MBI was evaluated in the area of the South Bohemian region through the charts and graphs. It was found that the hospital paramedics are more inclinating to the "burn out" syndrom than the ambulance service paramedics. Followingly the investigation, there is a bigger risk of "burn out" syndrom by paramedics with the longer practice. The most of the paramedics try to prevent the "burn out" syndrom but the prevention didn´t appear to be efficient in comparison to the number of "burn out" paramedics.
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Care for an oncology patient
NOVÁKOVÁ, Markéta
The diploma thesis addresses in detail the issue of a terminally ill individual and things closely associated with this topic including spiritual direction of the bereaved after the death of a close relative. Based on information from the literature it tries to reflect the basic conditions of approach to an oncology patient and his relatives (including the necessity of truthful communication and abidance by basic ethic rules). In order to provide a comprehensive view of the topic, the work includes research among the patient?s relatives realized in 4 out of the 14 hospice centers in the Czech Republic. On the basis of this research some positive aspects have been revealed on one hand, which are worthy acknowledgement and appreciation. On the other hand, there are areas and restraints motivating and challenging both types of healthcare centres to take steps that would lead to a better quality of care provided in the future.
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Crisis management in hospital wards
KUKLOVÁ, Jana
The thesis looks at crisis management in the light of statute no. 240/2000 regarding crisis management and the amendments to some statutes (crisis statute) as well as medical catastrophes and mass accidents from the point of view of the health professionals. I also attempt to look at emergency medical care as an additional branch of the medical profession as a whole.
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