Foreigners in the Czech Republic
6. Health care for foreigners | Contents |
(Insurance policies of the General Health Insurance Company of the Czech Republic, health care for foreign citizens and falling ill with selected diseases)
The information on foreign citizens disclosed in this chapter is attained from the National Registry of the Hospitalized and National Registry of Abortions, information system of the public health service (TB Registry) and reports on the utilization of health care by foreigners. The reports are processed by the Institute of Health Information and Statistics of the CR (IHIS CR) in the framework of the National Health Information System (NHIS). The data are supplemented by information on insurance contracts of foreigners in the CR from the General Heath Insurance Company of the CR (GHIC CR).
The health care data shown are not any exhaustive information on the utilization of health care by foreigners and conditions of their health in the CR.
Further information can be obtained on the IHIS CR's website: www.uzis.cz.
Methodological notes on the tables
Table 6-1 Health insurance contracts of foreigners: General Health Insurance Company of the CR; 1 January to 31 December 2004
The table concerns foreigners with both long-term and short-term residence in the CR, who effected health insurance with the GHIC CR, namely commercial insurance concluded voluntarily.
From the total number of foreigners having insurance contracts from the GHIC CR, foreigners from the EU 25 made up 11.3%. Most foreigners, who signed health insurance contracts with the GHIC CR, came from Viet Nam, followed by Ukrainians. Vietnamese participated in the total number of insured foreigners with 23.4% (5 706 persons), Ukrainians 22.7% (5 528 persons) and foreigners from Russian Federation 9.5% (2 314 persons). The health care was utilized most by Vietnamese (27.2% of all foreigners utilizing the health care, i.e. 2 807 persons), Ukrainians (24.6%, i.e. 2 537 persons) and Russians (11.7%, i.e. 1 205 persons).
Tables 6-2 and 6-3 Utilization of health care by foreigners
Data on the utilization of health care by foreigners are measured through annual report V (MZ) 1?01. It is compiled only by hospitals and regards foreigners that cover health care from health insurance policies concluded in the CR, insurance policies concluded abroad, in cash, or whose health care is reimbursed by state authorities (the Ministry of Health of the CR, Ministry of the Interior of the CR, Ministry of Justice of the CR, regional offices, etc.). The figures also include asylum seekers accommodated in asylum establishments of the Ministry of the Interior of the CR, whose health care is paid by the Ministry of the Interior of the CR.
Foreigners, whose health care is paid for out of general health insurance, are not included in the report. The numbers of persons utilizing health care paid for out of health insurance contracts, which are given in Table 6-2, differ from the GHIC CR data listed in Table 6-1 on health insurance contracts of foreigners. This is due to the possibility of drawing on this contractual insurance by foreigners in more hospitals in the reference period and drawing on the health insurance contracts in health establishments other than hospitals.
Tables 6-2 and 6-3 show data for hospitals for health sector in total. It means that besides hospitals coming under the Ministry of Health of the CR there are shown also hospitals under the Ministry of Defence of the CR and Ministry of Justice of the CR. In 2004, Czech hospitals provided health care to 55 831 foreigners. Of that, 25 348 of foreigners treated were from the EU 25. In 2003, 60 870 foreigners were treated or cured in the CR, of which 11 010 foreigners were from the EU 15. In 2004, 11 949 foreigners were from the EU 15. Health care was provided most often to citizens of Slovakia (19.8%, i.e. 11 070 persons), the Ukraine (16.0%, i.e. 8 955 persons), Germany (10.9%, i.e. 6 109 persons) and Viet Nam (10.6%, i.e. 5 943 persons). Citizens of the Ukraine and Germany paid for the health care mostly in cash, the health care provided to Slovaks was covered mostly from foreign insurance and the one provided to Vietnamese was paid for from contractual health insurance. From the total number of foreigners treated, most of the patients were in the age group of 20 - 59 years (73.1%).
In 2004, the biggest number of foreigners was treated in the Hlavní město Praha Region (35.6%, i.e 19 892 persons), the Jihomoravský Region (9.2%, i.e. 5 155 persons) and the Karlovarský Region (9%, i.e. 5 008 persons). The smallest number of foreigners treated was in the Vysočina Region (1.2%, i.e. 653 persons), the Zlínský Region (1.3%, i.e. 752 persons) and the Olomoucký Region (2.2%, i.e. 1 220 persons).
In 2004, the costs of the health care provided to foreigners totalled 370 412 thousand CZK. In comparison with 2003 they decreased by 84 927 thousand CZK. This drop was accompanied by a lower number of foreign patients treated in hospitals (-5 039 persons). Of total costs spent on health care provided to foreigners the costs spent on patients from the EU 15 reached 70 810 thousand CZK, which is by 31 478 thousand CZK less than in the previous year. The table 6-3 shows data for the EU in total, i.e. consisting of the current 25 Member States. The costs of the health care provided were highest with Slovaks (26.6%), Ukrainians (13.7%) and Germans (9.3%).
The most often way of payment for health care foreigners used in 2004 was payment from foreign insurance (30.4%). The proportion of health care costs in total costs when compared to the previous year increased; it amounted to 80.2%. From the total of CZK 370 412 thousand spent on the health care for foreigners 30,4% were paid from foreign insurance, 24.7% in cash and 10.5% were paid by public bodies. The lowest amount of costs was paid from the contractual insurance (14.6%). 19.8% cases remained unpaid, of which 8.8% after maturity date.
Regarding health care provided to foreigners in regions (as for the amount of costs) - the Hlavní město Praha Region (40.9%) was on the first position and the Jihomoravský Region (10.3%) was the second.
To get oriented regarding the number of foreigners drawing health care in Czech hospitals: the Directorate of the Alien and Border Police Service of the Police Headquarters of the CR registered as at 31 December 2004 the total of 254 294 foreigners residing permanently or for a long time in the CR, which is about 2.5% of the entire population of the CR.
Table 6-4 Foreigners treated in hospitals: by cause of hospitalization; 2004
Table 6-4 on foreigners hospitalised in Czech hospitals covers hospitals of all government departments. It gives figures only on foreigners who were not assigned any birth number and who were not insured in the framework of general health insurance (i.e. only foreigners with temporary residence).
The most frequent reasons for hospitalisation of foreigners, the same as in the previous years, included injuries and poisoning cases. Following were diseases of the circulatory system, diseases of the digestive system and health-status-affecting factors, contacts with health services (e.g. checkups and examinations which required hospitalisation, care after injuries, suspicion of a disease, etc.). While in 2003 the health-status-affecting factors and contacts with health services were the second most often reasons for hospitalisation, in 2004 they were the fourth. The least foreigners were hospitalised due to diseases of the blood, blood-forming organs and certain disorders involving the immune mechanism.
The total number of the hospitalized in Czech hospitals was 2 336 thousand persons (preliminary data). Foreigners hospitalized out of the total number of the hospitalized were only 0.3% due to the fact that they are only foreigners with temporary residence.
Tables 6-5 and 6-6 Abortions of female foreigners
All types of abortions made in health establishments of the CR shall be reported on the form "Application for Induced Abortion - Report of Abortion and Ectopic Pregnancy". This report is also filled in for female foreigners granted permanent or long-term residence in the CR. Female foreigners with temporary residence and female tourists are not monitored.
In 2004, 2 254 abortions in female foreigners were reported, which is by 15.3% less than in the previous year (2 660), of which 1 789 (79.4%) were legally induced abortions. Number of vacuum aspirations decreased again in comparison to the previous year, namely by 16.6% (1 460 in 2004 and 1 750 in 2003).
From legally induced abortions (LIA) 6.6% were therapeutic abortions. Vacuum aspirations made up 81.6% of all LIA.
The total number of abortions in female foreigners increased since 1995 (from 1 447 in 1995 to 2 254 in 2004), of which the number of LIA increased from 1 245 in 1995 to 1 789 in 2004.
The evaluation of the data by region is influenced by the biggest concentration of foreigners in the Hlavní město Praha Region and the Středočeský Region, in which there is the biggest proportion of abortions within the entire CR..
In 2004, 39 070 abortions in Czech female citizens were reported; in total, i.e. including female foreigners, 41 324 abortions were reported. It means that the proportion of abortions in female foreigners in the total number of abortions reported in the Czech Republic was 5.5%.
Table 6-7 New notified TB cases in the CR; by the patient's country of birth
This table gives the number of newly notified cases of tuberculosis (TB) cases in the CR broken down by the country of birth of patients (not necessarily foreigners).
There were 1 057 TB cases newly notified in 2004, i.e. by 9.0% down on 2003, of which foreigners accounted for 14.1%.
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In 2004, the Czech Republic became a member of the European Union (the EU). At the same time, the EU enlarged from 15 to 25 EU Member States.
The data on the health care of foreigners in the Czech Republic for 2004 are released in the same extent as in 2003. A change occurred in the table 6-1, in which the EU countries are now shown separately. In tables 6-2 and 6-3, the number of Member States was extended to 25. The data are provided for health sector as a whole. Until and including 2002, only data for the Ministry of Health of the CR were provided in these tables.
The comparison of the data on health care utilisation by foreigners for 2004 and 2003 suggests that only by 343 more foreigners signed health care insurance policies with the General Health Insurance Company of the CR (GHIC CR). However, the number of foreigners utilising health care on the basis of these policies decreased by 5.8% in comparison with the last year.
5 039 less foreigners sought health care in hospitals in comparison with 2003. It was reflected also in the total amount of costs for this care, which decreased by 85 million CZK when compared to the previous year.
The same as the previous year, the number of hospitalised foreigners by cause of hospitalisation increased. A downward trend continued in the number of abortions in female foreigners and newly notified TB cases.
Generally, in 2004, fewer foreigners were treated in Czech hospitals than in the previous year and costs spent on their treatment decreased, too. In 2004, almost the same number of foreigners as in the previous year drew contractual health insurance effected with the GHIC CR.