Foreigners in the CR

6. Health Care For Foreigners

Contents

The information on foreign citizens disclosed in this chapter is attained from national health registers (the National Registry of the Hospitalised and the National Registry of Abortions), information system of bodies for public health protection (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 from the General Heath Insurance Company, j.s.c. (GHIC, j.s.c.) on health insurance of foreigners in the Czech Republic.

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: http://www.uzis.cz

Methodological notes on the tables

Table 6-1. Health insurance of foreigners with the General Health Insurance Company, j.s.c. from 1 January to 31 December 2006

The table concerns foreigners with both long-term and short-term residence in the CR, who effected health insurance with the GHIC, j.s.c., namely commercial insurance concluded voluntarily.

The number of insured foreigners increased in 2006 compared to 2005 by 32% and amounted to 40 238 individuals. However, compared to the previous year the number of insured foreigners coming from the EU member states decreased by 10% and their contribution to the total number of insured foreigners who signed health insurance contract made 4.4%. Most foreigners, who signed health insurance contracts with the GHIC, j.s.c., came again, like in previous years, from Viet Nam, followed by Ukrainians. Vietnamese participated in the total number of insured foreigners with 31.1% (12 531 persons), Ukrainians 18.6% (7 474 persons) and foreigners from Russian Federation 14.1% (5 662 persons). The health care was utilized most by Ukrainians (29.7%, i.e. 2 656 persons), Vietnamese (23.4%, i.e. 2 089 persons) and Russians (13.4%, i.e. 1 198 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 public health insurance, are not included in the report.

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 2006, Czech hospitals provided health care to 69 210 foreigners. Of that, 34 513 of foreigners treated were from the member states of the European Union. In comparison with the year 2005, there was an increase in the total number of foreigners, who were provided health care in hospitals, 2 358 persons in total.

Health care was provided most often again, like in the previous years, to citizens of Slovakia (19.7%, i.e. 13 646 persons). Following are foreigners from “other” countries (19.2%, i.e. 13 311 persons, the Ukraine (13.7%, i.e. 9 503 persons), Germany (10.9 %, i.e. 7 526 persons) and Viet Nam (8.9%, i.e. 6 148 persons). Citizens of Slovakia paid for the health care from foreign insurance, citizens from the Ukraine and Germany paid for the health care in cash and the health care 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 (68.8%).

In 2006, according to territorial breakdown, the biggest number of foreigners was treated in hospitals in the Hlavní město Praha Region (43.7%, i.e 30 255 persons), the Jihomoravský Region (11.5%, i.e. 7 937 persons) and the Středočeský Region (7.4%, i.e. 5 510 persons). The smallest number of foreigners treated was in the Vysočina Region (1.3%, i.e. 914 persons), and the Pardubický Region (1.4%, i.e. 967 persons).

Health care provided to foreigners in hospitals of the CR required costs in the total amount of CZK 458 358 thousand. Of the total costs 48.8% made costs on patients from the EU reaching the total amount of CZK 223 490 thousand. The costs of the health care provided were highest with “other” patients (24%) from Slovakia (22.4%), the Ukraine (11.0%), and Germany. (9.1%).

The most often way of payment for health care of foreigners remains even in 2006 payment in cash (33.2%). The proportion of health care costs in total costs amounted to about 86%. For health care provided to foreigners, as at 31 December 2006, the total of CZK 37 555 thousand (i.e. 8.2% of the total amount of costs for health care) remained unpaid after maturity date.

The proportion of costs of health care provided to foreigners in regions in the total amount of costs the Hlavní město Praha Region (CZK 229 302) made 50% of all registered costs. As for the amount of costs of health care the Jihomoravský Region (10.3%, i.e. CZK 46 982) was the second.

Table 6-4. Foreigners treated in hospitals: by cause of hospitalisation; 2006

Table on foreigners hospitalised in Czech hospitals covers hospitals of all government departments.

Compared to the previous years, when only foreigners with temporary residence were registered, from 2006 the table shows foreigners irrespective of length of their stay on the territory of the CR. Dramatic increase in the number of hospitalisations in hospitals compared to 2005 when their number increased by 388% is linked with the change in monitoring of foreigners in the National Register of the Hospitalised where the column “EU nationality” was introduced.

In 2006 the most frequent reasons for hospitalisation of foreigners included pregnancy, childbirth and puerperium and diseases of the circulatory system, diseases of the digestive system, injuries and poisoning cases. The least foreigners were hospitalised, like in the previous years, due to diseases of the blood, blood forming organs and certain disorders involving the immune mechanism.

In 2006, the total number of the hospitalised in Czech hospitals was 2 272 thousand persons. The number of foreigners hospitalised, namely foreigners irrespective of length of their stay in the CR of the total number of the hospitalised was 1.9%.

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 2006, 2 285 abortions in female foreigners were registered, which is an increase in comparison to the previous year (2.1%), of which 1 744 (76%) were legally induced abortions. Number of vacuum aspirations decreased again in comparison to the year 2005 (1 378 in 2006 and 1 427 in 2005).

From legally induced abortions (LIA) 8.9% were therapeutic abortions. Vacuum aspirations made up 79% of all LIA.

The total number of abortions in female foreigners decreased since 1998 (from 2 356 in 1998 to 2 285 in 2006), of which the number of LIA decreased from 2 024 in 1998 to 1 744 in 2006.

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 2006, 37 674 abortions in Czech female citizens were reported; in total, i.e. including female foreigners, 39 959 abortions were reported. It means that the proportion of abortions in female foreigners in the total number of abortions reported in the Czech Republic remains almost the same as in 2005 and was 5.7%.

Table 6-7. Newly 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 973 TB cases newly notified in 2006, i.e. by 9.7% down on 2005, of which foreigners accounted for about 13.4%.

Chapter 6 on the health care of foreigners in the Czech Republic for 2006 is released in the same extent as in 2005. 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 the tables.

The comparison of the data on health care utilisation by foreigners in the Czech Republic for 2006 and 2005 suggests that by 9 773 more foreigners signed health care insurance policies with the General Health Insurance Company, j.s.c.. It was an increase by 32%, which is accompanied by a permanent decrease of the number of foreigners utilising health care on the basis of these policies.

4 % more foreigners sought health care in hospitals in comparison with 2005 when the treatment was provided to 66 852 foreigners. The growth of number of the hospitalised foreigners was linked with a 25% growth of total costs of health cares.

Dramatic growth of hospitalisations of foreigners was due to more detailed registration of foreigners in the Register of the Hospitalised where not only foreigners with temporary residence are monitored but also foreigners irrespective of the length of their stay on the territory of the CR. A downward trend continued in the number of abortions in female foreigners and newly notified TB cases.

Generally, in 2006, more foreigners were treated in Czech hospitals than in the previous year; and costs spent on their treatment increased. At the same time, the number of foreigners, who effected health insurance with the Insurance company of the GHIC,j.s.c., is increasing every year, while the utilization is permanently decreasing (since 2003).