Statistical Yearbook of the Czech Republic

       Act No. 48/1997 Coll., on General Health Insurance, as last amended, regulates public health insurance and the extent of and conditions for providing the health care.

       The health establishments are founded, administered, operated and abolished according to standard nation-wide principles set out by the Ministry of Health of the CR for establishing the network of health establishments. This network is based on the above-mentioned Act No. 20/1966 Coll., as last amended (Article 42 and Article 70(1)(c)) and Act No. 160/1992 Coll., on Health Care in Non-state Health Establishments, as last amended. The network is also regulated by Decree No. 242/1991 Coll., on the System of Health Establishments Founded by District Authorities and Municipalities and Decree No. 394/1991 Coll., on the Position, Organisations and the Activity of Teaching and Other Hospitals, Chosen Specialized Therapeutical Institutions, and Regional Hygiene Stations Governed by the Ministry of Health of the CR. This network of health establishments is updated as necessary by methodological measures of the Ministry of Health of the CR (Methodological Measures No. 7/2002 and No. 8/2002, Journal of the Ministry of Health of the CR).

       From the founder's point of view the health establishments are split into:

• state health establishments, founded by the Ministry of Health of the CR and other central and district authorities; and
• non-state health establishments, founded by regions, municipalities, including towns, churches, other legal persons, and natural persons.

       Data on the state of health of the population and on the health establishments are contained in the National Health Information System. The fulfilment of the task of this system is ensured by the Institute of Health Information and Statistics of the CR - see the Act No. 20/1966 Coll., on Public Health Care, as last amended (Article 67(c)(d)).

       The Czech Statistical Office measures data on incapacity for work and selected indicators on the financial performance of health insurance companies. Figures on expenditures from state and local budgets (administered by district authorities and municipalities) are derived from financial statements on incomes and expenditures of budgetary organizations, received by the CZSO from the Ministry of Finance of the Czech Republic. All other data concerning health service are taken over by the CZSO for its publications from the above-mentioned Institute. Some data released in this chapter are labelled as temporary due to updating the methodology and terminology used in this area.

Notes on tables

Tables 23-1 and 23-3. Health establishments

      Beds in the health establishments refers to the approved bed stock, excluding makeshift beds.

      Places are given for health establishments, which are not run round the clock and for children's establishments such as institutions for infants, homes for children, etc.

      Physicians (f/t equivalent) - the sum of work loads of individual workers of the health establishments converted according to the full number of working hours per week laid down for a given establishment or workplace. According to relevant regulations, there are 40 working hours in normal operation, 38.75 and 37.5 working hours in shift operation, and 33.5 /30.0 or 39.5 working hours at dangerous workplaces per week per physician.

      Specialized therapeutic institutions include therapeutic institutions for long-term patients, therapeutic institutions for TB and respiratory diseases for children and adults, mental hospitals for children and adults, physiotherapeutic institutions, balneological institutions for children and adults, convalescent homes, hospices and other in-patient institutions for children and adults.

      Independent out-patient care establishments include policlinics, joint out-patient health service establishments, health centres, independent surgeries, independent non-medical establishments (e.g. specialized in psychology, speech therapy, rehabilitation, home care health services, etc.), independent specialized laboratories, first-aid medical establishments, haemodialysis stations, and other out-patient care establishments.

      Special health establishments include institutions for infants, homes for children, day clinics for children, creches and other establishments for children, day clinics for adults, short-term rehabilitation centres for disorderly alcoholics, transport health and ambulance service establishments, and other special health establishments.

      Pharmaceutical service establishments include pharmacies, dispensaries (both for drugs and medical aids), the State Institute for Drug Control, and a medical supply storing facility.

      Establishments of hygienic service include regional, district and municipal hygienic stations, the State Health Institute, and a reference laboratory.

      Other health establishments include establishments for in-service training of medical personnel and other unspecified health establishments.

      Figures given under the indicators of the "Other health establishments" type are not comparable in individual years because their coverage was changing along with creating and updating the network of health establishments.

Table 23-4. Beds in hospitals: by department

       "Other departments" includes departments of rheumatology, diabetology, gastroenterology, clinical pharmacology, allergology, independent neonatal units, speech therapy, nefrology, prosthetics, intensive care, subsequent nursing care, and other departments unspecified in detail.

Table 23-7. Cases of treatment (examination) in out-patient care establishments:
        by department

       "Others" includes the following departments (branches): geriatrics, occupational diseases, neurosurgery, cardiosurgery, traumatology, X-ray oncology, physical training medicine, medical genetics, and first-aid medical service.

Table 23-13. Incapacity for work due to disease or injury

       Listed are selected results produced by processing the CZSO statistical questionnaire. The questionnaire had to be filled in by all businesses and/or their lower organizational components, which independently fulfil duties concerning health insurance. The processing also included total figures submitted by the District Administrations of Social Security for entities that do not settle health insurance claims themselves.

      Average percentage of incapacity for work per year is calculated from calendar days of incapacity for work due to disease or injury divided by the average number of the sickness insured, multiplied by the number of calendar days in a year.

      Average number of sickness-insured persons - the methodological coverage of this indicator is identical to that in Table 24-1 in the chapter Social Security.

      Cases of incapacity for work - figures refer to new notified cases of incapacity for work due to disease or injury.

      Calendar days of incapacity for work - number of calendar days on which employees insured for sickness were on sick leave (based on the reported beginning and end of sick leave).

       Since 1997, imputation for non-response has been made as a rule in processing the questionnaire. Imputation has been made for all questionnaires not submitted by reporting units with 25+ employees (records on health insurance for organizations with 24 employees and under are kept by district social security administrations as dictated by the law), using relevant statistical methods.

Table 23-16. Expenditure on health service

       The table shows two main sources for funding the health service in the Czech Republic: (i) state plus local budgets and (ii) general health insurance premiums collected by health insurance companies (including the state budget contribution to health insurance companies to pay the premium for citizens for whom it is paid by the state).

       Data on expenditure of state and local budgets on health service fully respect the functional breakdown of expenditure and include data from the budgetary structure on health (Part 35) in greater detail given in the table.

       The table heading complies with the classification by kind of the budgetary structure in force.

      Expenditure of health insurance companies on health service refers to full or partial payments, for reported cases of treatment within the framework of health service, made by health insurance companies to health service establishments under contract.

      Direct private expenditure of population on health service includes expenditure of the population on medicines, medical goods and supplies and rendered health services (financial participation of patients, payments for medical procedures not covered at all or only partially covered by public health insurance, etc.).

Table 23-17. Financial indicators of health insurance companies

       In 2001, the methodology of the financial indicators was adjusted to comply with the accounting procedures used by health insurance companies.

      Financial investments include long-term financial assets as well as short-term ones, which are traded in the market. The financial investments in 1999 and 2001 exclude land and constructions (both of service and non-service types), while in 2000 they include both land and non-service constructions.

      Deposits in banks refer to term deposits and receivables from deposits. In 1999, they include means on current accounts and special bank accounts of the funds of health insurance companies. In 2000 and 2001, the deposits in banks exclude means on current accounts and special bank accounts of the funds of health insurance companies as these are classified under financial assets.

      Tangible fixed assets in 1991 and 2001 land and service and non-service constructions are included, the data for 2000 include land and service constructions only.

       Intangible and tangible fixed assets and other components of assets are shown as net.

       There were ten active health insurance companies operating in the Czech Republic at the end of 1999. At the end of 2000 and 2001, they were nine in number

       The figures listed in tables 23-1 to 23-15 are not fully comparable with the years before. Since 2000, the tables show data on the health service in total - i.e. they include data on health establishments under the Ministry of Defence of the CR, Ministry of the Interior of the CR, Ministry of Justice of the CR, and Ministry of Transport and Communications of the CR.

       The data on health establishments are now shown for heath establishments in total and for state-owned health establishments (the previous breakdown was state and non-state health establishments).

       More detailed information on the health service in the Czech Republic is available in the book "Czech Health Statistics Yearbook" (Czech-English version), regional health statistics yearbooks, and specialized publications of the "Health Statistics" the Institute of Health Information and Statistics of the CR (IHIS CR) puts out for the Czech Republic and Czech regions every year. More detailed information on the publications and information released by the NHIS are available on the IHIS CR's website www.uzis.cz.

       Figures on incapacity for work due to disease or injury are released by the CZSO, in accordance with its Catalogue of Publications 2002 (group 3 - LABOUR, SOCIAL STATISTICS, subgroup 33 - Education, Culture, Health), every year in the publication “Pracovní neschopnost pro nemoc a úraz”; from the reference year 2001 on, the data are and will be brought out every six months (i.e. for the 1st half of 2002 in October 2002 and the whole 2002 in April 2003.

       Figures on incapacity for work due to disease or injury are released in the following publication brought out by the CZSO according to the CZSO Catalogue of Publications 2003 (group 3 - LABOUR, SOCIAL STATISTICS, subgroup 33 - Education, Culture, Health):

• “Pracovní neschopnost pro nemoc a úraz za rok 2002”, May 2003.

• “Economic Results of Health Insurance Companies” - quarterly, on the 90th calendar day following the end of quarter
• "Ekonomické výsledky zdravotních pojišťoven za rok 2002" - December 2003.