Analysis of Regional Health Plans as Enactments of National Health Policy
DOI:
https://doi.org/10.4335/17.3.659-677(2019)Keywords:
region, health policy, regional health plan, Czech RepublicAbstract
The article deals with strategic documents created at the regional level in the context of their relevance to the implementation of the national health policy and their relevance to the solution of the inequalities among regions in access to primary care. The aim of this contribution is to map and evaluate the activity of regions in terms of their conceptual activities related to the establishment of regional policy objectives for the 2010-2015 period. The implementation of the national health policy (i.e. the “Health 21” and “Health 2020” programs) is examined in the context of the regional conceptual activities. The obtained results show that the conceptual activities of regions in the area related to health care differ significantly. While some regional development programs devote only a few pages to healthcare issues, other regions create comprehensive concepts of health care. With the measurement of inequalities, we indicate the regions that are underserved with healthcare services, of which only the Ústí nad Labem region shows the plan to dealt with this disadvantage in its strategic health plan.
References
Aristovnisc, A. (2015) Regional Performance Measurement of Healthcare Systems in the EU: A Non-parametric Approach, Lex localis-Journal of Local Self-Government, 13(3), pp. 579 – 593.
Baumbach, A., & Gulis, G. (2014) Impact of financial crisis on selected health outcomes in Europe, The European Journal of Public Health, 24(3), pp. 399-403.
Bergen, A., & While, A. (2005) ‘Implementation deficit’and ‘street‐level bureaucracy’: policy, practice and change in the development of community nursing issues, Health & Social Care in the Community, 13(1), pp. 1-10. doi 10.1016/j.respol.2005.01.018.
Brown, M. C. (1994) Using Gini-style indices to evaluate the spatial patterns of health practitioners: theoretical considerations and an application based on Alberta data, Social science & medicine, 38(9), pp. 1243-1256.
Chang, R. K. R., & Halfon, N. (1997) Geographic distribution of pediatricians in the United States: an analysis of the fifty states and Washington, DC. Pediatrics, 100(2), pp. 172-179. doi: 10.1542/peds.100.2.172.
Chen, R., Zhao, Y., Du, J., Wu, T., Huang, Y., & Guo, A. (2014). Health workforce equity in urban community health service of China, PLoS One, 9(12), e115988, https://doi.org/10.1371/journal.pone.0115988.
Devaux, M. (2015) Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries, The European Journal of Health Economics, 16(1), pp. 21-33, doi: https://doi.org/10.1007/s10198-013-0546-4.
Dlouhý, M. (2005) Health care regulation: Impact on the supply of outpatient services in the Czech republic, Prague economic papers, 14(3), pp. 267-276, doi:10.18267/j.pep.266.
Dlouhý, M. (2018) Measuring geographic inequalities: Dealing with Multiple health resources by Data envelopment analysis, Frontiers in public health, 6, p. 53, https://doi.org/ 10.3389/fpubh.2018.00053.
Doorslaer, E. V., Wagstaff, A., & Rutten, F. (1992) Equity in the finance and delivery of health care: an international perspective (Oxford: Oxford University Press).
Durdisová, J. (2005) Ekonomika zdraví (Prague: Oeconomica)
Dussault, G., & Franceschini, M. C. (2006) Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce, Human resources for health, 4(1), p. 12, https://doi.org/10.1186/1478-4491-4-12.
Exworthy, M., Blane, D., & Marmot, M. (2003) Tackling health inequalities in the United Kingdom: the progress and pitfalls of policy, Health Services Research, 38(6p2), pp. 1905-1922. https://doi.org/10.1111/j.1475-6773.2003.00208.x.
Gravelle, H., & Sutton, M. (1998) Trends in geographical inequalities in provision of general practitioners in England and Wales, The Lancet, 352(9144), 1910, https://doi.org/10.1016/S0140-6736(05)60402-3.
Goddard, M., Gravelle, H., Hole, A., & Marini, G. (2010) Where did all the GPs go? Increasing supply and geographical equity in England and Scotland, Journal of health services research & policy, 15(1), pp. 28-35.
Gusmano, M. K., Weisz, D., Rodwin, V. G., Lang, J., Qian, M., Bocquier, A., Moysan, V. & Verger, P. (2014) Disparities in access to health care in three French regions, Health Policy, 114(1), pp. 31-40, https://doi.org/10.1016/j.healthpol.2013.07.011.
Gwatkin, D. R. (2000) Health inequalities and the health of the poor: What do we know? What can we do?, Bulletin of the world health organization, 78, pp. 3-18.
Holcík, J., Koupilová, I., & Gerylovová, A. (1997) Assessment of health needs, their geographic distribution and association of health care indicators in Districts within the Czech Republic, Casopis lekaru ceskych, 136(21), pp. 662-665.
Horev, T., Pesis-Katz, I., & Mukamel, D. B. (2004) Trends in geographic disparities in allocation of health care resources in the US, Health policy, 68(2), pp. 223-232, https://doi.org/10.1016/j.healthpol.2003.09.011.
Ježek, J., (2011) Problémy strategického plánování rozvoje měst v České republice. Kritická analýza Areas of concerns regarding strategic planning of urban development in the Czech Republic. Critical analysis, In: Klímová, V. & Žítek, V. (eds.) 14th International Colloquium on Regional Sciences (Brno: Masaryk University), pp. 161 – 168.
Jihomoravský kraj (2013) Program rozvoje Jihomoravského kraje 2014-2017, available at: http://www.krjihomoravsky.cz/Default.aspx?ID=212277&TypeID=2 (May 5, 2018).
Karlovarský kraj (2013) Program rozvoje Jihomoravského kraje pro období 2014 – 2020, available at: http://www.karlovarsky.cz/region/Documents/SEA_PR_KV_2014_2020.pdf (March 01, 2017).
Kotherová, Z. (2014) Two Sided Platforms in the Health Care Markets: The Case of Czech Republic Healthcare Reform, In: Špalková, D. & Matějová, L. (eds.) 18th International Conference on Current Trends in Public Sector Research (Brno: Masaryk University), pp 222-231.
Kraj Vysočina (2013) Program zdraví 21 pro kraj Vysočina The Health 21 Programme for the Vysočina Region. available at: http://www.dobrapraxe.cz/cz/kraj-vysocina-program-zdravi-21-pro-kraj-vysocina (March 01, 2017).
Královéhradecký kraj (2010) Koncepce zdravotnictví Královéhradeckého kraje 2011-2015, available at: http://www.kr-kralovehradecky.cz/assets/rozvoj-kraje/rozvojove-dokumenty/schvalene-koncepce/Koncepce-zdravotnictvi-KHKx.pdf (March 01, 2017).
Lazarova, D. (2018, February 20) Health ministry to subsidize dental practices in remote areas, available at: from http://www.radio.cz/en/section/curraffrs/health-ministry-to-subsidize-dental-practices-in-remote-areas (May 10, 2018).
Liberecký kraj (2010) Zdravotní politika LK 2010, Zdravotní politika LK 2011, Zdravotní politika LK 2012, Zdravotní politika LK 2013, Zdravotní politika LK 2014, 2015, available at: http://zdravotnictvi.kraj-lbc.cz/zdravi-prevence-zdravotni-politika-libereckeho-kraje/zdravotni-politika-lk (March 01, 2017).
Malý, I., Pavlík, M. & Krůtilová, V. (2012) Aktuální problémy tvorby a implementace zdravotní politiky z pohledu regionů The current issues regarding the creation and implementation of health policies from the perspective of regions, In: Malý, I. & Cibáková, V., (2012) Dopady vybraných veřejných politik na regionální rozvoj v České a Slovenské republice. 1st ed. (Brno: Masaryk University) pp. 177-188, https://doi.org/10.5817/CZ.MUNI.M210-5805-2012-177.
Ministry of Health of the Czech Republic (2017). Pro Ministerstvo zdravotnictví podpoří oblasti s omezenou dostupností zubní péče, available at: http://www.mzcr.cz/dokumenty/ministerstvo-zdravotnictvi-podpori-oblasti-s%C2%A0omezenou-dostupnosti-zubni-pece_14988_1.html (February 25, 2018)
Ministry of Health of the Czech Republic (2017) Program na podporu dostupnosti zdravotních služeb praktických lékařů, available at: https://www.mzcr.cz/dokumenty/program-na-podporu-dostupnosti-zdravotnich-sluzeb-praktickych-lekaru_11690_3.html (March 01, 2017).
Ministry of Health of the Czech Republic (2001) Zdraví pro všechny v 21. století Health for All in the 21st Century, available at: http://www.mzcr.cz/dokumenty/zdravi-pro-vsechny-v-stoleti_2461_1101_5.html (March 01, 2017).
Ministry of Health of the Czech Republic (2009) Zdraví 2020 – Národní strategie ochrany a podpory zdraví a prevence nemocí Health 2020 – the national strategy of health protection and promotion and disease prevention, available at: http://www.mzcr.cz/verejne/dokumenty/zdravi-2020-narodni-strategie-ochrany-a-podpory-zdravi-a-prevence-nemoci_8690_3016_5.html (February 15, 2017)
Mobaraki, H., Hassani, A., Kashkalani, T., Khalilnejad, R. & Chimeh, E. E. (2013) Equality in distribution of human resources: the case of Iran’s Ministry of Health and Medical Education, Iranian Journal of Public Health, 42(Supple1), p. 161.
Moravskoslezský kraj (2012) Programové prohlášení Rady Moravskoslezského kraje pro období 2013–2016, available at: http://www.msk.cz/ (March 01, 2017).
Murray, C. J. & Frenk, J. (2000) A framework for assessing the performance of health systems, Bulletin of the world Health Organization, 78, pp. 717-731.
Nemec, J., Pavlík, M., Malý, I. & Kotherová, Z. (2015) Health policy in the Czech Republic: General character and selected interesting aspects, Central European Journal of Public Policy, 9(1), pp. 102-113.
Radvan, M. (2018) Challenges of the Implementation of the European Charter of Local Self-Government in Czech Legislation, Lex Localis-Journal of Local Self-Government, 16 (4), pp. 579 – 593.
Olomoucký kraj (2014) Program rozvoje Jihomoravského kraje pro období 2015 - 2020, available at: https://www.kr-olomoucky.cz/ (March 01, 2017).
Pardubický kraj (2010) Koncepce zdravotnictví Pardubického kraje, available at: https://www.pardubickykraj.cz/koncepce-oz/60892/strednedoba-koncepce-zdravotnictvi-pardubickeho-kraje (March 01, 2017).
Pavlík, M. (2010) Zdravotní politika z pohledu vlády (Brno: Masaryk University).
Plzeňský kraj (2013) Program rozvoje Jihomoravského kraje 2014+, available at: http://www.plzensky-kraj.cz/cs/clanek/program-rozvoje-plzenskeho-kraje-2014-schvalen (March 01, 2017).
Rokosová, M., Háva, P., Schreyoegg, J., Busse, R. & World Health Organization (2005) Health care systems in transition: Czech Republic (Copenhagen: WHO Regional Office for Europe).
Scott, C. (2001) Public and private roles in health care systems (Vol. 39) (Buckingham: Open University Press).
Smith, G. D., Dorling, D., Mitchell, R., & Shaw, M. (2002). Health inequalities in Britain: continuing increases up to the end of the 20th century, Journal of Epidemiology & Community Health, 56(6), pp. 434-435.
Středočeský kraj (2013) Program rozvoje územního obvodu středočeského kraje 2014-2020, available at: https://www.kr-stredocesky.cz/web/regionalni-rozvoj/dokumenty/program-rozvoje-kraje ((March 01, 2017).)
Sundquist, J. (2001) Migration, equality and access to health care services, Epidemiol Community Health, 55, pp. 691–692.
The Official Website of the South Bohemian Region (2014) Koncepce zdravotnictví Jihočeského kraje na období 2015 – 2020, available at: http://www.krajjihocesky.cz/2093/koncepce_zdravotnictvi_jihoceskeho_kraje_na_obdobi_2015_8211_2020.htm (March 01, 2017).)
Ústecký kraj (2014) Strategie podpory zdraví a rozvoje zdravotních služeb v Ústeckém kraji na období 2015-2020, available at: http://www.kr-ustecky.cz/VismoOnline_ActionScripts/File.ashx?id_org=450018&id_dokumenty=1684879 (March 01, 2017).
Ústecký kraj (2014) Strategie podpory zdraví a rozvoje zdravotních služeb v Ústeckém kraji na období 2015-2020 at: http://www.krustecky.cz/VismoOnline_ActionScripts/File.ashx?id_org=450018&id_dokumenty=1684879 (March 3, 2018).
Wilkinson, D. (2000) Inequitable distribution of general practitioners in Australia: analysis by state and territory using census data, Australian Journal of Rural Health, 8(2), pp. 87-93, https://doi.org/10.1046/j.1440-1584.2000.00255.x.
World Health Organization (2015) Tracking universal health coverage: first global monitoring report (Geneve: World Health Organization).
Zlínský kraj (2012) Integrovaná koncepce zdravotnictví. The integrated plan of health care, available at: https://www.kr-zlinsky.cz/integrovana-koncepce-zdravotnictvi-cl-2723.html (April 12, 2017).
