The Use of Diagnosis-Related Group-Based Reimbursement in the Czech Hospital Care System

(1) Background: Diagnosis-Related Groups (DRG), one possibility of a hospital payment system, are currently used in most European countries. Introduced to the Czech system in the 1990s,the DRGs are currently used mainly for care reporting and partly for reimbursement. According to most experts, the use of DRG remain controversial. The goal of this paper was to study the effects of the current Czech DRG system on hospitals financing and, on this basis, to propose possible changes to the reimbursement mechanism in the Czech Republic. (2) Methods: Qualitative research methods were used for evaluating DRG mechanisms of application in three selected healthcare establishments in the CR in the period of 2012–2018. (3) Results: Our study shows that the current implementation of the DRG system is set up in a way that is very similar to traditional flat rates and is unlikely to yield major positive effects of the DRG mechanism, such as redictability of payments for hospitalisation cases, care quality and efficiency and transparent financing. (4) Conclusions: Based on our results,deep systemic change of the reimbursement mechanism in the Czech Republic is necessary. We propose five partial measures leading to the cultivation of the Czech DRG

Post-COVID health policy responses to healthcare workforce capacities:A comparative analysis of health system resilience in six European countries

A cross countries in Europe, health policy is seeking to adapt to the post-pandemic ‘permacrisis’, where high demands on the healthcare workforce and shortages continue and combine with climate change, and war. The success of these efforts depends on the capacities of the healthcare workforce. This study aims to compare health policy responses to strengthen the capacities of the healthcare workforce and to explore the underpinning dynamics between health systems, policy actors and health policies. The study draws on a qualitative, comparative analysis of Austria, the Czech Republic, Denmark, Germany, Italy and the Netherlands. The findings suggest that policy responses at the national level focused on hospitals and absorptive capacities, while policy responses at local/regional levels also included general practice and adaptive capacities. There were only few examples of policies directed at transformative capacities. The underling dynamics were shaped by health systems, where individual parts are closely connected, by embeddedness in specific service delivery and areas, and by power dynamics. In conclusion, sub-national health policy responses emerge as key to effective responses to the post-pandemic permacrisis, where health professions are central policy actors. Sub-national health policy responses build on existing power relations, but also have the potential to transcend these power relations.</p

Post-COVID health policy responses to healthcare workforce capacities:A comparative analysis of health system resilience in six European countries

A cross countries in Europe, health policy is seeking to adapt to the post-pandemic ‘permacrisis’, where high demands on the healthcare workforce and shortages continue and combine with climate change, and war. The success of these efforts depends on the capacities of the healthcare workforce. This study aims to compare health policy responses to strengthen the capacities of the healthcare workforce and to explore the underpinning dynamics between health systems, policy actors and health policies. The study draws on a qualitative, comparative analysis of Austria, the Czech Republic, Denmark, Germany, Italy and the Netherlands. The findings suggest that policy responses at the national level focused on hospitals and absorptive capacities, while policy responses at local/regional levels also included general practice and adaptive capacities. There were only few examples of policies directed at transformative capacities. The underling dynamics were shaped by health systems, where individual parts are closely connected, by embeddedness in specific service delivery and areas, and by power dynamics. In conclusion, sub-national health policy responses emerge as key to effective responses to the post-pandemic permacrisis, where health professions are central policy actors. Sub-national health policy responses build on existing power relations, but also have the potential to transcend these power relations.</p

Trust matters: The Addressing Vaccine Hesitancy in Europe Study

The article presents the design of a 7-country study focusing on childhood vaccines, Addressing Vaccine Hesitancy in Europe (VAX-TRUST), developed during the COVID-19 pandemic. The study is comprised of 1) situation analysis of vaccine hesitancy (examination of individual, socio-demographic and macro-level factors of vaccine hesitancy and analysis of media coverage on vaccines and vaccination), 2) participant observation and in-depth interviews of healthcare professionals (HCPs) and vaccine hesitant parents. These analyses were used to design interventions aimed at increasing awareness on the complexity of vaccine hesitancy among HCPs involved in discussing childhood vaccines with parents. In this article, we present the selection of countries and regions, the conceptual basis of the study, the details of the data collection and the process of designing and evaluating the interventions as well as the potential impact of the study. Laying out our research design serves as an example of how to translate complex public health issues into social scientific study and method

Navigating vaccine hesitancy: Strategies and dynamics in healthcare professional-parent communication

Understanding the communication dynamics between vaccine-hesitant parents and healthcare professionals (HCPs) is vital for addressing parent concerns and promoting informed decision-making. This paper focuses on strategies used by HCPs to communicate with vaccine-hesitant parents. It draws on empirical evidence generated as part of the international project VAX-TRUST. More specifically, 60 hours of observations were carried out in three different pediatric practices during vaccination-related visits, and 19 physicians and nurses were interviewed. We focused on the specific context of the Czech Republic, which represents a country with a mandatory vaccination system and in which children’s immunization is the responsibility of pediatric general practitioners. We demonstrate that the dynamics between parents and HCPs and their willingness to invest time in the vaccination discussion are influenced by how HCPs categorize and label parents. Furthermore, we outline some of the different strategies HCPs employ while addressing concerns regarding vaccination. We identified two different strategies HCPs use to manage the fears of vaccine-hesitant parents. The first strategy focused on the communication of risks associated with vaccination (and lack thereof). HCPs used a variety of discursive practices to familiarize the unfamiliar risks of vaccine-preventable diseases (by mobilizing representations that are part of collective memory, incorporating personal experiences to materialize the presence of risk and the confidence in the safety of vaccines and by situating risk as embedded in everyday processes and integral to the uncertainty of the global world). The second strategy involved the conscious employment of medical procedures that may contribute to reducing vaccination fears

Efficiency of Public Procurement in the Czech and Slovak Health Care Sectors

Health systems in most (if not all) countries perpetually struggle with financial problems and search for resources to cover health care needs. Increased efficiency of health procurement has the potential to save a lot of money and to reallocate them to treatments. The aim of our study is to analyze technical efficiency (efficiency/economy dimension) and allocation efficiency (effectiveness) of public procurement in health care facilities in the Czech Republic and Slovakia, countries whose health systems are governed by the principle of universal access to high quality health services. Concerning the technical efficiency, the results show a low rate of competitiveness whereby the potential of competition is not exploited. In terms of allocation efficiency, our research also sufficiently illustrates the criticality of the situation; however, compared to the element of technical efficiency the situation in the evaluated countries is different. In Slovakia, purchases are usually decided by doctors and procurement is prepared without the necessary ex-ante analysis. In the Czech Republic, the ex-ante evaluation of purchasing of medical equipment is regulated, however, the decision-making process is non-transparent and does not guarantee allocative efficiency. The study has critical policy implications – both countries should urgently adopt measures to improve their respective procurement processes.</p

Health policy in the Czech Republic: General character and selected interesting aspects

Transformation of the health care system was a task faced by all formerly socialist Central and Eastern European countries. The years of changes revealed a large number of problems, including those induced by the limited capacity of governments to formulate and implement health care reforms. The goal of this article is to reflect the Czech situation. We start by summarizing the historical development of the Czech health care system in the context of government capacity for implementing health policy. In the core parts of this article, we highlight the main features of Czech health policy making and implementation and present an in-depth analysis of two selected country-specific issues - a low level of patient co-payments and a pluralistic insurance-based financing of health services

Trust matters: The Addressing Vaccine Hesitancy in Europe Study

This article presents the design of a seven-country study focusing on childhood vaccines, Addressing Vaccine Hesitancy in Europe (VAX-TRUST), developed during the COVID-19 pandemic. The study consists of (a) situation analysis of vaccine hesitancy (examination of individual, socio-demographic and macro-level factors of vaccine hesitancy and analysis of media coverage on vaccines and vaccination and (b) participant observation and in-depth interviews of healthcare professionals and vaccine-hesitant parents. These analyses were used to design interventions aimed at increasing awareness on the complexity of vaccine hesitancy among healthcare professionals involved in discussing childhood vaccines with parents. We present the selection of countries and regions, the conceptual basis of the study, details of the data collection and the process of designing and evaluating the interventions, as well as the potential impact of the study. Laying out our research design serves as an example of how to translate complex public health issues into social scientific study and methods.info:eu-repo/semantics/publishedVersio