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Factors Impacting the Health Insurance Company in the Years 2004-2012 in the Context of the Health Insurance System in the Czech Republic
SCHUSTEROVÁ, Tereza
The main aim of my dissertation Factors influencing the management of health insurance in 2004 2012 in the context of health insurance in The Czech Republic - was to identify and categorize the factors that affect the management of the chosen health insurance in 2004 2012 with the respect to existing system of health insurance. The first assessed year was 2007 because of unavailability of data in 2004 - 2007. My dissertation is divided into two parts, theoretical and practical. The theoretical part is devoted to the principles of health insurance, the legal relations of health insurance, the current system of public health insurance and the effects influencing the health insurance balance. The practical part deals with designated health insurance and its organizational structure, its management methods, the income side of the balance sheet, the expediture side of the balance and finally the ratings balance of the specific health insurance. The factors which affect this side of the balance were analysed in detail at the income side. Among these factors were included: trends in the number of policyholders, the development of receivables, the problems of "state policyholders", macroeconomic index and the redistribution system. The expediture balance was mainly focused on the cost of health care and preventive care. In conclusion the balance of one of the health insurance companies was evaluated in the selected years.
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ECONOMIC ASPECTS OF HEALTH PROMOTION
Kůrková, Kateřina ; Chytil, Zdeněk (advisor) ; Rod, Aleš (referee)
The main aim of this thesis is to point out the economical aspects of health promotion and prevention as an investment in health. The teoretical part is based on concepts of economists, who dealt with human capital and investment in health. Because of problems with rising costs in health care and demographic changes in Czech Republic, there is an analysis of health promotion programs, which enforce healthy lifestyle in population. Health prevention can have a positive effect on reducing costs in health care. To demonstrate this effect, the model of relationship between obesity and diabetes type 2 is created. The positive correlation between rising of number of people with obesity and rising of number of people with diabetes type 2 is detected on the set of time series data for Czech Republic. The positive correlation is proved for men, women and the entire Czech population aged 15 years and over with Cochrane-Orcutt estimation. The quantification of the cost reduction in health care because of health prevention is made in the conclusion.
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Identifikace a kvalifikovaný odhad nákladů na léčbu cévní mozkové příhody v ČR na základě farmakoekonomické analýzy a návrh alternativního řešení
Pokorná, Hana
Background: Stroke is the second most frequent cause of death in developed countries and the most frequent cause of permanent disability. This way this illness creates high costs for society which should be minimized as much as possible. One of the possibilities is to administer cost-saving drugs which are at the same time from the medical point of view of the top quality and their economic effectiveness can be identified by means of pharmacoeconomic analysis. Objective: The objective of the work is to identify and carry out a quantified estimate of costs connected with the stroke treatment in the Czech Republic. Next is the necessary to confront the results with the alternative solution to the treatment (taking drug Xarelto instead of Warfarin) and to carry out comparison of the both the possibilities from the quantitative point of view. Methods: Costs of stroke treatment are evaluated from the social point of view. From their determination COI method with type of bottom-up approach has been picked out which includes all-life cost-of-illness. For comparison of costs both the treatment vari-ants the Cost-Minimization Analysis (CMA) has been chosen, the results of which shows net cost savings. Data are taken from non-public data of the provider (St. Anne 's Uni-versity Hospital Brno), Institute of Health Information and Statistics of the Czech Republic, Czech Statistical Office, foreign studies and consultations with neurologists as well. Results: Total social costs of treatment of stroke were 12 991 273 843,65 CZK. COI method was used to calculate average costs for one patient with Warfarin in the amount of 1 203 423,68 CZK, in case of alternative treatment with Xarelto in the amount of 1 465 963,32 CZK. Relaps creates the biggest item of the costs. CMA method was used to identify savings when Warfarin is administered in the average amount of 262 539,64 CZK per patient. The hypothesis that Xarelto is more effective from the economic point of view has not been confirmed. Conclusion: Because of high cost of Xarelto, this drug has not beaten the economic effectiveness of Warfarin with lower quality. It is possible to search for savings in other items of identified costs as well.
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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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