My Experience with the Czech Health Care System [Archives:2007/1074/Reportage]

Dr. Khaled Yehya Baker
For Yemen Times
Recently I returned home from the Czech Republic where I spent 17 years studying, practicing and teaching medicine. In 1996, I completed my study of medicine at one of the oldest medical schools in Europe. It is 659 years old! After graduating, I worked at a major teaching hospital where I received my master's and doctoral degrees. I then became a consultant in urology, a teacher of surgery at Charles University and finally a chief doctor at a clinic in the teaching hospital's kidney transplant center.

The Czech Republic is a small yet developed and beautiful country in the middle of Europe with 10 million inhabitants. Prague is the capital and features many fantastic historical sights. Annually, about 8 million tourists visit Prague to enjoy sight-seeing as well as to interact with the country's friendly and hardworking citizens.

In the Czech Republic, the context in which health care is being delivered has changed dramatically over recent years. The introduction of major health and political reform, characterized by expansion of the market economy, privatization of government services, and democratization and decentralization, have created a turbulent and uncertain environment for the development and management of the country's health services. Issues of efficiency, cost-containment, consumer choice and accountability are at the forefront.

The Czech Republic is one of the healthiest of the central and eastern European countries and one of few where the process of transition led to a substantial reduction of mortality rates. Infant mortality is a low 5.2 per 1,000 live births while life expectancy stands at 71.1 years for men and 78.1 years for women.

The main features of the changing health system include introduction of free choice of a general practitioner, direct access to health specialists and their respective departments, and the emergence of a private health sector. Patients are allowed to register with a new general practitioner every six months without restrictive reasoning (in addition to the necessity of re-registering when relocating) and there are virtually no restrictions on access to specialists. This is still considered by many to be one of the most valued “liberties” achieved during the transition, but it is also acknowledged as an important issue in terms of cost and quality of care.

Primary health care is organized at the district level. The district health office is responsible for ensuring that their area offers accessible primary health care services.

The full range of primary health care services currently provided in the Czech Republic includes general medical care, maternal and child health, gynecology, dentistry/stomatology, home care (home attendants), 24-hour emergency cover and a number of preventive services such as immunization and screenings. There is also open access to some specialists, including psychiatrists, venereologists and dermatologists. There are no restrictions on patients' choice of primary health care physician.

As soon as a person receives their health insurance card, they are eligible for free visits to the doctor. This is unlike some countries where a patient must pay out-of-pocket and later be reimbursed by the state. In the Czech Republic doctors' fees and lab work are free, and prescriptions are mostly covered, though there may be a very small fee to be paid by the patient. Overall, the care is of great value.

Generally, a person may approach any doctor and request to be their patient. Additionally, one can ask colleagues at work who they recommend, or simply visit the local medical complex located in each district.

All information about a patient's health history and current condition (blood tests, x-rays, etc.) are entered into a database which is accessible to the medical staff via the internet by entering a patient's name and specific password. It is a great advantage that a doctor can check a patient's information online at anytime.

The administrative staff, in my experience, was helpful. Czech doctors have the time and patience for a question-and-answer session with each patient. I find this to be crucial because when you have a condition, it is important to know as much about it as possible.

The health care system in the Czech Republic is very decent and is comparable to those in western countries. Many countries can learn a lot from the Czech health care system. Modern medical equipment and a high level of scientific knowledge made working in the country ideal. Additionally, interacting with such hardworking professionals enabled me to learn a lot about medicine.

Dr. Khaled Yehya Baker is a visiting physician in Yemen at Azal Hospital in Sana'a. He is chief of the kidney plantation section at Charles University Educational Hospital in Czech Republic.
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