Migrants' health and access to healthcare in the Czech Republic

The article is dealing with current state of Czech health policy in relation to migration. Overall migration information, available data on migrants' health status as well as accessibility of healthcare are provided. Some health risks connected with migration are mentioned and discussed. Authors concluded that the most urgent problem of Czech health policy in relation to migrants remains the insufficient guarantee of legal entitlement to health care. This concerns a large group of migrants with long-term residence, since the current legal regulation is disadvantageous to migrants coming from countries outside the EU.     

Social costs of obesity in the Czech Republic

The European Journal of Health Economics - Increasing prevalence of obesity (BMI > 30) is a pressing public health issue in the Czech Republic as well as world-wide, affecting up to 2.1...     

Smoking attributable hospital treatment, treatment costs and smoking attributable mortality in the Czech Republic in 2002

OBJECTIVES: The main objective of this work is to quantify the number of hospitalizations caused by smoking, estimate the costs of hospital treatment and to estimate contribution of smoking to mortality in the Czech Republic (CR) in 2002. METHODS: The estimate of the proportion by which smoking contributed to hospitalizations and to mortality in the CR was computed using the method of smoking-attributable fractions (SAF). The SAF was computed from relative risks established in the American study Cancer Prevention Study II and from estimates of the prevalence of smoking in the CR from a nationwide study conducted in 2002. RESULTS: In 2002, based on data provided by the General Health Insurance Company, there were 145,336 hospitalizations, and the total cost of hospital treatment was estimated as 4.727,612 (in thousands) CZK. The total number of deaths caused by smoking was 20,550 (95% CI: 18,851-22,262), 14,525 in men and 6,025 in women. Deaths caused by smoking represented 19% of the total nationwide mortality for 2002. Earlier estimates were published by Peto and Lopez for 1995 (22,300 deaths caused by smoking) and 2000 (17,746 deaths). The estimate arrived by authors using the SAF method for 2002 corresponds quite well with that by Peto and Lopez for 2000. CONCLUSIONS: The high morbidity and mortality rate related to smoking is directly connected to high prevalence of smoking in the Czech Republic. An effective tobacco control policy, including restrictive measures on availability of tobacco products combined with preventive programmes and smoking cessation programmes, could contribute to the reduction of smoking and save lives and treatment costs caused by smoking.     

Health-care reforms in the Czech Republic

Health-care reform is everywhere. Although different countries are moving at different speeds, using somewhat different means and different routes, they are all trying to arrive at the same place. The place is called "better value for money in health care". Presents details of the health-care reforms taking place in the Czech Republic, identifying and discussing the main strands of Czech reforms: the dissolution of the regional health authorities; the reorientation of district health authorities; the move to a pluralistic semi-competitive insurance-based system; hospitals receiving funding by winning contracts with purchasers; contracts becoming more sophisticated and being based on cost, volume and quality factors; changes in the incentives and rewards for GPs; the drive towards a primary-care-led health-care system; and privatization.     

Tobacco control in the Czech Republic

Main points of tobacco control measures in the country are mentioned: smoking prevalence among population and health professionals (both about one third), smoking cessation availability (about 70 smoking cessation clinics), education of health professionals, both pre- and post-gradual, public-oriented actions, advertising, tobacco prices, legislation, cigarette consumption, mortality.     

Smoking-attributable mortality in the Czech Republic

Objectives The main objective of this work is to quantify the contribution of smoking to mortality in the Czech Republic (CR) in 2002. Methods The estimate of the proportion by which smoking contributed to mortality in the CR was computed using the method of smoking-attributable fractions (SAF). The SAF was computed from relative risks established in the American Cancer Prevention Study II and from estimates of the prevalence of smoking from a nationwide study conducted in 2002. Results In 2002, there were 20,550 (95% confidence interval: 18,851–22,262) deaths in the CR that could be attributed to smoking (14,525 men and 6,025 women). Deaths caused by smoking represent 19% of the total nationwide mortality for 2002. Earlier estimates were published by Peto and Lopez for 1995 (22,300 deaths caused by smoking) and 2000 (17,746 deaths). The estimate arrived at using the SAF method for 2002 coincides with that reported by Peto and Lopez for 2000. Conclusions The high mortality rate related to smoking is the result of the high prevalence of smoking and an insignificant change of smoking habits in the adult population in recent years. An efficient tobacco control policy could contribute to the reduction of smoking and save lives and costs expended to treat diseases caused by smoking.     

Evolution of the international intellectual property rights system: patent protection for the pharmaceutical industry and access to medicines

This article discusses the evolution of the international intellectual property rights system in three phases and the implications for public health, especially for the implementation of policies for access to medicines. During the first phase, characterized by the Paris and Berne Convention, signatory countries defined which technological fields should be protected (or not). Under the second phase, with the enforcement of the WTO TRIPS Agreement, countries are obliged to grant patent protection for all technological fields, including for the pharmaceutical industry. Within their national legislations, countries also have the opportunity to implement access to TRIPS flexibilities for medicines. With the third phase, characterized by the negotiation and signing of bilateral and regional free trade agreements, countries will have to implement TRIPS-plus provisions which may have negative implications for the TRIPS flexibilities as well as for policies for access to medicines. The authors conclude that the currently proposed international intellectual property rights system favors patent-holder rights and that a balance is needed between patent holders' and health rights.     

National pharmaceutical policy in Colombia and social security reform: access and rational use of medicines

Based on the new social security system in Colombia (1993), which establishes equity and mandatory care as the basis for public health care provision, the authors analyze whether the formulation and implementation of pharmaceutical policy promote accessibility, availability, and rational use of medicines, thereby contributing to equity in health. Two approaches were used: a macro approach centered on the legal framework and various actors in the reform process and a micro approach related to the processes and results in the drug supply system. The authors studied the legal instruments backing the country's pharmaceutical policy and evaluated their application, using indicators and a specific disease (diabetes mellitus) as a marker. Although there is a legal framework providing the people's right to access health care services and essential medicines, the country lacks a comprehensive pharmaceuticals policy. Most of the institutions experience problems in distributing the medicines listed under the Mandatory Health Plan, a low percentage of medicines is dispensed at zero cost, and a major portion of patients purchase medicines through associations of diabetics or rely on alternative medicine. The study unveiled several obstacles to equity in health care coverage and access to essential medicines.     

Pornography and sex crimes in the Czech Republic

Pornography continues to be a contentious matter with those on the one side arguing it detrimental to society while others argue it is pleasurable to many and a feature of free speech. The advent of the Internet with the ready availability of sexually explicit materials thereon particularly has seemed to raise questions of its influence. Following the effects of a new law in the Czech Republic that allowed pornography to a society previously having forbidden it allowed us to monitor the change in sex related crime that followed the change. As found in all other countries in which the phenomenon has been studied, rape and other sex crimes did not increase. Of particular note is that this country, like Denmark and Japan, had a prolonged interval during which possession of child pornography was not illegal and, like those other countries, showed a significant decrease in the incidence of child sex abuse.     

Personal exposure to volatile organic compounds in the Czech Republic

Personal exposures to volatile organic compounds (VOCs) were measured in the three industrial cities in the Czech Republic, Ostrava, Karvina and Havirov, while the city of Prague served as a control in a large-scale molecular epidemiological study identifying the impacts of air pollution on human health. Office workers from Ostrava and city policemen from Karvina, Havirov and Prague were monitored in the winter and summer of 2009. Only adult non-smokers participated in the study (N=160). Radiello-diffusive passive samplers were used to measure the exposure to benzene, toluene, ethylbenzene, meta- plus para-xylene and ortho-xylene (BTEX). All participants completed a personal questionnaire and a time-location-activity diary (TLAD). The average personal BTEX exposure levels in both seasons were 7.2/34.3/4.4/16.1?μg/m(3), respectively. The benzene levels were highest in winter in Karvina, Ostrava and Prague: 8.5, 7.2 and 5.3?μg/m(3), respectively. The personal exposures to BTEX were higher than the corresponding stationary monitoring levels detected in the individual localities (P<0.001; except m,p-xylene in summer). The indoor environment, ETS (environmental tobacco smoke), cooking, a home-heating fireplace or gas stove, automobile use and being in a restaurant were important predictors for benzene personal exposure. Ostrava's outdoor benzene pollution was a significant factor increasing the exposure of the Ostrava study participants in winter (P<0.05).     

Breastfeeding promotion and protection in the Czech Republic

The purpose of the article is to present the National Breastfeeding Promotion Programme in the Czech Republic in the course of the last decade. It summarizes the main strategies, education and training activities of the National Breastfeeding Committee, its collaboration with the Government, Parliament, IBFAN and UNICEF. The article reviews the relevant studies on infant feeding which illustrate the increase of the prevalence of breastfeeding in the course of the 1990's and reflect the effect of the programme. Recent negotiations with the Ministry of Health have outlined the implementation of the WHO global strategy for infant and young child feeding in the Czech Republic.     

Occupational respiratory diseases in the Czech Republic

This paper presents the profile of occupational respiratory diseases in the Czech Republic. In a retrospective study the author analyzes structure, causes, occurrence, and trends of occupational diseases. Between 1996 and 2000, a total of 2,127 new cases were recorded, of which 62.0% were pneumoconioses caused by dust containing free silica, 21.0% were occupational asthma or allergic rhinitis and the rest were divided between lung cancer (10.0%), asbestos-related disorders (4.4%) and variety of other respiratory diseases (2.7%). During the period of the investigations, the decreasing trend of occupational respiratory diseases, which began in 1992, has continued.     

Costs of dementia in the Czech Republic

Objective

The aim of this study was to estimate the cost of dementia in the Czech Republic.

Methods

One hundred and nineteen patient-caregiver dyads participated in our multicenter observational cost-of-illness study. The modified Resource Utilization in Dementia Questionnaire was used as the main tool to collect data from patients and caregivers. Medical specialists provided additional data from medical records. The average costs of dementia were calculated and patients were then divided by the level of cognitive impairment. A generalized linear model was used to determine if differences were present for selected cost variables.

Results

The mean (standard deviation) for direct cost per a patient in a month was estimated to be €243.0 (138.0), €1727.1 (1075.6) for the indirect cost, and €1970.0 (1090.3) for the total cost of dementia in the Czech Republic. All of the costs increased as dementia severity increased. Both the indirect and total costs significantly (p < 0.05) increased if patients were living with their primary caregiver, and if the severity of cognitive impairment was increased.

Conclusions

The indirect cost, which was represented mainly by informal care, comprised the main part of the total cost of care for patients with dementia in the Czech Republic. Both total and indirect care costs increased significantly the cognition declined.