velikost textu

Léková politika - ceny, úhrady a spoluúčast

Upozornění: Informace získané z popisných dat či souborů uložených v Repozitáři závěrečných prací nemohou být použity k výdělečným účelům nebo vydávány za studijní, vědeckou nebo jinou tvůrčí činnost jiné osoby než autora.
Název:
Léková politika - ceny, úhrady a spoluúčast
Název v angličtině:
Drug policy – prices, settlements and participation
Typ:
Disertační práce
Autor:
Mgr. Jana Davidová
Školitel:
prof. RNDr. PhMr. Jan Solich, CSc.
Oponenti:
prof. RNDr. Viliam Foltán, CSc.
Doc.RNDr. Stanislava Hartlová, CSc.
Id práce:
61104
Fakulta:
Farmaceutická fakulta v Hradci Králové (FaF)
Pracoviště:
Katedra sociální a klinické farmacie (16-16220)
Program studia:
Farmacie (P5206)
Obor studia:
Sociální farmacie - lékárenství (DSF)
Přidělovaný titul:
Ph.D.
Datum obhajoby:
11. 7. 2008
Výsledek obhajoby:
Prospěl/a
Jazyk práce:
Čeština
Abstract v angličtině:
Abstrakt ve Value in Health Participation on drug costs in the elderly in the Czech Republic Davidova, J.; Praznovcova, L.; Vlcek, J. In: Value in Health, Vol. 8 Issue 6 Page 615-A242, Supplement to ISPOR 8th Annual European Congress, Florence, Italy. November 2005 OBJECTIVES: Analysis of participation on drug costs in seniors in the Czech Republic in connection with seniors’ social status (e.g. financial, household conditions). METHODS: Quota-sampled questionnaire-based interview with 450 respondents visiting pharmacy; Ratio men:women approximately 1:2; Age 60 years old and elder; 3 regions of the Czech Republic RESULTS: Most of respondents (60 %) live in households with their partners. Respondent’s income was retirement pension in 80 %. Its average level was between 5001 and 7499CZK. Respondents used together 1651 medicines on physician’s prescription in last four weeks. Overall co-payment for medicines was 31944CZK, e.g. 70CZK per patient. Only 27 % of respondents used fully reimbursed products. Respondents used together 273 OTC drugs in value of 12900CZK, e.g. 29CZK per patient. Average respondents spent on medicines 100CZK in last four weeks, e.g. between 2 and 1.3 % of their income. There were respondents, about 10 %, searching for the level of co-payment in several pharmacies and 8 % of respondents, who had to refuse dispensation of medicines due to co-payment. 108 CONCLUSIONS: Our study demonstrates that there are patients who may fail to access medication due to co-payment. The financial participation on health care costs is generally low in the Czech Republic (8.6 % of total health expenditures) but there were differences in co-payment levels in patients ranging from 1 CZK to thousands CZK. In our opinion problem might be the absence of any instrument limiting the highest individual participation for example in 12-month period as in Sweden. In our study co-payments were lower in smaller communities that may be due to better communication between physicians and patients or physicians and pharmacists. 109 8.6 Abstrakt ve sborníku konference ESCP Lisabon 2003 ANALYSIS OF PHARMACOTHERAPY BY THE ELDERLY IN THE CZECH REPUBLIC Authors: Praznovcova L, Davidova J, Vlcek J In: Abstract Book of 4th ESCP Spring Conference on Clinical Pharmacy - Clinical Pharmacy and the Ageing Patient; Lisboa, Portugal 14.-17.5.2003, s.36- 36. Background and Objective: Polypharmacy is typical for ageing population in the Czech Republic. The detail analysis of Rx drugs pharmacotherapy by seniors. Design: The methodology of the research was questionnaire-based survey, anonymous, based on personal interview. Rx drugs used by seniors were divided under ATC classification. Number and sort of drugs in concrete ATC group were evaluated in correlation to sex and age. The statistic evaluation was made by using Microsoft Excel. Setting: Interviews of last year pharmacy students with seniors in pharmacies, used for student’s degree thesis. 1764 respondents (1062 females and 702 males) were asked. Main Outcome Measures: Evaluation of pharmacotherapy by the elderly Results: Results of analysis confirmed the relation between causes of morbidity, mortality and consumption of drugs in related ATC groups. ATC groups C, A, N, M, R and B were the most important groups. The elderly on the first place used drugs of group C. Cardiac drugs (25,39 % of total number), diuretics (17,25%), peripheral vasodilatators (14,52%) were the most used drugs of group C. Drugs of group A occupied the second position, 110 including antidiabetics (A10 - 22,81 %), mineral supplements (A12 - 17,89%) and antacids (A02 - 15,79%). From group N there were the most used: psycholeptics (N05 - 37,40%), analgesics (N02 - 23,75%), psychoanaleptics (N06 - 14,83%). From group M there were used antirheumatics (M01 - 66,01%), antirheumatics for local administration (M02 - 21,34%), antiuratics (M04 - 9,15%). From group R there were used antiastmatics (R03 - 49,34%), drugs for treatment of cold (R05 - 28,62%), antihistaminic (R06 - 18,09%). The special position had group B; anticoagulants, antitrombotics (B01 - 12,04%) were used for the prevention of Coronary Heart Disease. Number of used drugs increased with age; it was approximately 3,52 per senior. This analysis confirmed polypharmacy by the elderly. Conclusions: Pharmacotherapy should be evaluated very intensively. To the most important areas belongs the process of the choice of concrete drug, but also problematic of interactions and side effects. 111 8.7 Abstrakt ve sborníku konference ESCP Praha 2004 The Analysis of Pharmaceutical Care Demand in the Czech Republic Authors: Davidova, J.; Praznovcova, L.; Vlcek, J. Dept. of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University in Prague, Czech Republic In: Risk Management in Pharmacotherapy, 33. European Symposium on Clinical Pharmacy, 20-23 October 2004, Prague, Czech Republic Background and Objectives: Patients’ safety is influenced to a great extent by the relationship between patients and pharmacists. Pharmacists need to know their patients to meet their needs and expectations. In our study we aimed to define characteristics of patients demanding pharmaceutical care in Czech pharmacies. Design: Questionnaire-based survey, quota sampling; Statistics in MS Excel (F Test, T Test, CHI Test); Pilot study for future project; Settings: 400 respondents visiting pharmacy in all age groups, men and women ratio 1:1; Various regions of the Czech Republic; Data collection 2002 – 2003; Main Outcomes: Characteristics of patients demanding pharmaceutical care in Czech pharmacies, preferred sources of information on correct use of medications 112 Results: Respondents defined as demanding pharmaceutical care were respondents: 1. Who answered “sometimes” or “mostly have difficulties with correct use of their medication and rely on their pharmacist’s advice” (58.27 %) 2. Who reported searching information on OTC drugs in pharmacy (40.97 %). Based on this definition 77.35 % of respondents reported demand of pharmaceutical care. Most respondents prefer to visit the same pharmacy (85.75 %). They included mainly women, older people and patients using more drugs and people, who have difficulties with correct use of their medication. No respondent in age group < 21 years reported using Internet and/or newspaper to obtain this kind of information. Internet and/or newspaper as well as pharmacists’ advice were mostly used by respondents in age group 41 – 60 years old and by respondents with university education. Conclusions: Pharmacies still continue to be the most important sources of information on prescribed and/or OTC medication for majority of patients and customers in the Czech Republic. Further study is in process to find out more drug related issues and financial participation on drug costs in elderly patients since these were the most discussed situations in this pilot study.
Dokumenty
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Stáhnout Text práce Mgr. Jana Davidová 1.14 MB
Stáhnout Abstrakt v českém jazyce Mgr. Jana Davidová 513 kB
Stáhnout Abstrakt anglicky Mgr. Jana Davidová 187 kB
Stáhnout Posudek vedoucího prof. RNDr. PhMr. Jan Solich, CSc. 65 kB
Stáhnout Posudek oponenta prof. RNDr. Viliam Foltán, CSc. 250 kB
Stáhnout Posudek oponenta Doc.RNDr. Stanislava Hartlová, CSc. 597 kB