challenges of patients in czech republic and ukraine

A comparative analysis of the Czech Republic and Ukraine

A presentation by East To West Marketing Inc.

Real Patients, Real Patience

Thursday, 9 June, 16

UkraineCzech Republic

Brief Country Stats


603,628 square km

Kyiv

Russia, Belarus, Slovakia, Hungary, Romania, Moldova, Black Sea and Sea of Azov

1991 from USSR

UkraineCzech Republic78,866 square km

Prague

Poland, Germany, Austria, and Slovakia

1990 from Czechoslovakia

Total Area

Capital City

Neighbours

Independence

Brief Country Stats


Brief Country Stats



€126.8 billion/yr

45.6 million

63 male, 74 female

Ukrainian

Hryvnia

€ 1 = UAH 10.6

€218.6 billion/yr

10.5 million

74 male, 80 female

Czech

Czech Koruna

€ 1 = CZK 19

GDP

Population

Life Expectancy

Official Language

Currency

Currency Value

Brief Country Stats



Czech Republic

Healthcare Structure


Ukraine

Healthcare Structure


Quick Healthcare Facts



‣ Public/Private system

‣ Tax supported

‣ Reforms target primary care

‣ Complex insurance, covers dental and contraception in addition to physicians

‣ Free basic coverage, but specialized equipment and other costs extra

‣ 87% of hospital costs paid by patients

‣ No health reforms in 20 years, reforms promised for 2014

‣ Great reliance on hospitals instead of primary providers




‣ April 2012 will bring drug coverage reform

‣ New funding for Western European drugs

‣ Achieved near-universal healthcare. Citizens, workers and visitors covered

‣ Insufficient financing segregates population by income and location

‣ About 1% of population on private health insurance

‣ 80% of medical services consumed by top 20% of earners

‣ 18.5% do not have any access to medical care




Insurance and Co-Payments



‣ 199 hospitals ‣ 176 health institutes (psychiatric

treatment, etc)‣ 51 medical spas

- Full/partial/no coverage for spas, depending on insurance plan

‣ Of all hospitals, 45% are local, 45% are regional

‣ Private insurance provides quality care to those who can afford it

‣ Low private insurance penetration due to:- lack of affordability- lack of trust in the private

system

Insurance and Co-Payments



Czech Republic

Hospital Statistics


Czech Republic

‣ Regional & Central Hospitals: - account for 1,000 beds- serve as centres for teaching/

training- provide full range of services- owned by the Ministry of Health

‣ A few small hospitals are privately owned

‣ Hospitals increasingly run by managers and economists- previously run by senior

physicians

The “Na Homolce” hospital in Prague

Hospital Statistics


Ukraine

Hospital Statistics


‣ 3,258 hospitals (2001)‣ Approximately 466,000 beds (2001) ‣ Lack of patient associations‣ Largest private health fund dedicated

to HIV/AIDS

Ukraine

The “Oleksandrivs’ka” hospital in Kyiv

Hospital Statistics



Current Healthcare Challenges



1,264 cases overall

8.4 cases per 100,000 ppl

5 cases per 100,000 ppl

Health insurance seen as a tax

4% of Czechs experienced bribery over a medical

examination

Average: €1,700 per month Private pays double public

HIV/AIDS

Tuberculosis

Maternal Mortality

Financial

Corruption

Doctor Wages

1% prevalence, highest in Europe



87% of hospital costs covered by patients

Bribery very prevalent

Average: €230 per month



Ukraine



Ukraine

‣ “Chernobyl Disaster” aftermath felt very strongly- Worst nuclear disaster of all

time- Occurred in 1986- Cancer rates in Ukraine 3 times

average- Over 9 million people affected

by the disaster- Newborn defects highest in

the world- Effects will be felt for

thousands of generations



‣ Healthcare is guaranteed by the constitution, but lack of funding results in lack of care for those unable to pay

- “Sink or Swim” system based on income

‣ Extremely low wages limit staff ’s professional development

‣ Lack of university funding result in shortage of qualified new staff

‣ A patient cannot know if:

- the service/procedure they are receiving is properly priced

- cost and necessity information is reliable

- non-performed procedures/non-supplied drugs are billed to their insurer




Getting Treated



‣ PHPs in regional policlinics prescribe drugs, treat acute illnesses, and in some cases provide patient education

- All paperwork done by hand

‣ Prescriptions not needed for pharmaceutical drugs

‣ Outpatient care provided by primary care physicians or specialists

‣ Specialist visits allowed without GP referrals

‣ Physicians cannot refuse treatment for essential or urgent care

‣ Publicly billed care must be registered with a primary care physician

Getting Treated



Ukraine

Patients and the Internet

Czech Republic


‣ Prague Declaration created to comply with EU’s goal of adopting information technology in healthcare

‣ E-Health documentation to replace paperwork

‣ Electronic prescriptions to replace paper for drugs

‣ Consolidation of ministry information in e-databases

‣ Technology is hoped to improve:

- public awareness of the health service system

- enable active involvement of the patient

- to improve the quality, and ability of education

UkraineInternet market

penetration too low and expensive for

realistic IT modernization

Patients and the Internet

Czech Republic


Trivia Question 1


The capital of Czech Republic is situated by a river. Which one?

Trivia Question 1


Answer 1


The Vltava River

Answer 1


Trivia Question 2


What was Czech Republic called 25 years ago?

Trivia Question 2


Answer 2


Czechoslovakia

Answer 2


Trivia Question 3


The capital of Ukraine is situated by a river.Which one?

Trivia Question 3


Answer 3


The Dnieper River

Answer 3


Trivia Question 4


If you plan to run a study in Ukraine,which languages can you use?

Trivia Question 4


Answer 4


Ukrainian, Russian

Answer 4


Trivia Question 5


Trivia Question 5

All of the former Soviet block countries and most of the East European countries used a system that was providing more in-patient care, with a higher emphasis on building the empire of hospital beds. A typical hospitalization period in both CR and UKR was 14-21 days. As opposed to the Bissmark Healthcare System, what is this one called?


Answer 5


Answer 5

The Semashko Model

Nikolay Semashko was a Russian Commissar of Public Health from 1918 to 1930, and a friend of Lenin.

He was one of the organizers of the healthcare: centralized, integrated, hierarchically organized, and wholly financed from general government revenues.

This system was used in all republics of the former Soviet Union, and in all countries of East European socialist block.


Trivia Question 6


Which of the two countries — Czech Republic or Ukraine — changed from Latin alphabet to Cyrillic for a brief period of time, and then settled back to Latin?

Trivia Question 6


Answer 6


Czech Republic

Answer 6


Trivia Question 7


Which country is a more popular medical tourism destination for patients from Western Europe, Czech Republic or Ukraine?

Trivia Question 7


Answer 7


Czech Republic

Answer 7


Researcher’s Notes



Kyiv

3 facilities in Kyiv

Kharkiv, Dnipropetrovsk, Odessa, Donetsk, Lviv

Prague

2 facilities in Prague

Brno, Ostrava, Liberec,Plzen, Kladno

Best facilitiesare located in

Focus VisionWeb Streaming

Available

Best Cities forDoing Research




Sample‣ Low role of GPs in prescribing‣ High role of pharmacists: can change prescription or sell any other drug ‣ Low role of nurses: mostly in charge of cleaning services

or organizing records‣ Technical engineers are Lab directors are suspicious about market

research studies and rarely participate

Recruitment‣ When interviewing specialists, do not tell them who else is participating

or they may quit if they know that SOMEONE they do not like TAKES PART in your research



Researcher’s Notes (continued)


Methodologies that work‣ CL,TDI, F2F, On-line questionnaires self completion,

ethnography research‣ with physicians, pharmacists and patients

Methodologies that are difficult‣ Diary studies/chart info collection (personal connections with physicians)‣ Interviews with KOLs and MOH officials, Payor - TDI preferred‣ Web-assisted telephone interviews ‣ Creative studies are not understood very well ‣ Physicians would be reluctant to play role games‣ Mixing of senior and younger physicians is not always recommended

Researcher’s Notes (continued)


EAST TO WEST MARKETING INC.

580, 101–1001 West Broadway Vancouver, BC V6H 4E4, Canada

T +1 604 461 6651F +1 604 461 6650

[email protected]


mailto:[email protected]

mailto:[email protected]

http://www.east-to-west.net

http://www.east-to-west.net