Types of healthcare delivery services

Outpatient Care

Outpatient Care is provided in a medical treatment facility (hospital, clinic, etc.) for a condition or course of treatment, which does not require admission to a hospital (in other words, for a treatment which would require an overnight stay). Outpatient care can be provided by primary care physicians and various types of medical specialists.

A person seeking medical care (a patient or sick person) usually first sees what is often referred to as a “primary care physician” – this person is also often referred to as a “general practitioner”, “family doctor”, “pediatrician”, etc. and he/she could be a dentist, gynecologist, etc.  For care from a primary care physician, it is usually necessary for the person seeking care to have previously registered (been enrolled) with that physician.

A doctor may refuse to accept a patient for treatment in any of the following situations:

  • If the doctor already has a full roster of registered persons – such that the doctor would not have the ability to properly care for their existing registered persons if additional persons were registered.
  • If the doctor’s office is located too far away from the to-be-registered person’s place of residence – i.e. the doctor would be too far away from the person’s home should a home visit be necessary.
  • If the patient is not insured by a health insurance company with which the provider of medical services has a contract; this does not apply to persons with insurance who are insured in another Member State of the European Union, a state that is part of the European Economic Area or the Swiss Confederation, or persons from a country with which the Czech Republic has entered into a social security agreement, which includes within its scope a substantive right to healthcare.

Should a primary care physician refuse to register (or accept) an individual as a patient, the refused person is entitled to have the refusal provided to them in writing. In the case of an emergency (i.e. an accident or sudden acute illness), no doctor can refuse to see a patient; however, once the emergency has been dealt with, the attending doctor can transfer the patient into the care of a primary care physician with whom the person is (or should otherwise have been) registered.

Individuals always have the right to visit a specialist without first seeing their primary care physician. They do not need what is often referred to as a “referral”.

The following types of outpatient care are provided:

a)    Primary Outpatient Care. This includes visits (usually to a doctor’s office) for the following types of care: preventive, diagnostic, therapeutic and assessment. It also includes the coordination of the continuity of healthcare services being provided by other providers (specialists, medical facilities). Primary outpatient care also includes any necessary home visits to a patient.

b)    Specialized Outpatient Care. This is care that requires the services of a medical specialist (for example, an internist, surgeon, cardiologist, etc.).

c)    Stationary Care. This care is provided to patients whose medical condition requires repeated daily outpatient type treatments.

Inpatient Care

If, and as required by the nature of an illness, a primary care doctor or outpatient specialist can ‘recommend’ that a patient receive treatment in a hospital (a medical facility of the inpatient care provider), or the doctor can ‘directly arrange’ for the patient’s admission to a hospital. There are the following types of inpatient health care facilities: acute standard, acute intensive, follow-up and long-term.

The Health Services Act defines “inpatient care” as healthcare, which cannot be provided on an outpatient basis and which requires the patient to be hospitalized in order to provide the patient with the necessary course or type of treatment. Inpatient care must be provided in a medical facility of a healthcare provider with 24-hour operating hours.

In the Czech Republic there are four types of inpatient care:

a)    Acute Standard Inpatient Care. This is intended for any of the following:

  • Patients with a sudden illness or the sudden deterioration of a chronic condition, which seriously threatens their health, but does not lead directly to a failure of vital bodily functions.
  • The performance of a medical procedure that cannot be done on the outpatient basis.
  • To give an early start to some type of medical rehabilitation program.

b)    Acute Intensive Inpatient Care. This level of care is provided to patients in situations in which there is a sudden bodily malfunction or a sudden threat to basic bodily functions or situations in which such a malfunction can be reasonably expected to occur.

c)    Follow-Up Inpatient Care. This level of care is provided to the following:

  • Patients who were given a baseline diagnosis and whose health condition has been stabilized.
  • Patients who are dealing with a sudden illness or a sudden worsening of a chronic condition.
  • Patients whose medical condition requires follow-up care or some type of therapeutic rehabilitative care.
  • Patients who are partially or totally dependent on some type of care for the support of vital bodily functions.

d)    Long-Term Inpatient Care. This level of care is provided to patients whose medical condition cannot be significantly improved by medical treatment or intervention. It is also provided to patients requiring the ongoing provision of some type of nursing care to prevent their condition from worsening. This level of care is also provided to patients with some type of impaired basic bodily function.

Medical Rescue Service and Emergency Service

The Medical Rescue Service is a healthcare service, which is contacted using the below-listed emergency phone number. It is primarily designed to provide pre-hospitalization emergency care to an individual with a severe health impairment or to someone facing a life-threatening situation. It is used in the case of a sudden severe illness or injury, when the patient cannot be expected to get to the hospital by themselves. This service is also used in the event of an accident, when someone needs to receive immediate care. It is also used when someone needs to be taken to a hospital (a medical facility for the providing of inpatient care) for emergency medical care in order to prevent the further deterioration or a health condition or when there is a threat to someone’s life.

The following phone numbers are to be used in an emergency situation:

155           A nationwide emergency number in the Czech Republic to receive aid in the case of a medical emergency. (Medical Rescue Service)

112           The pan-European (common) emergency number to call for help in the event of a situation involving large numbers of injured persons – this number is used to activate a response from the integrated rescue services system (this includes the Police of the Czech Republic, the providers of emergency medical services, fire brigades and fire protection units).

An Emergency Service (paid for by the health insurance provider) is also available for use by those with a less severe sudden illness (including injury, a dental problem outside of normal business hours and in the absence of an attending physician). Based on the arrangements made in different local areas and with different medical facilities, doctors either cover for one other (in their own offices) or the care is provided in special offices of the emergency medical services or dental emergency services.

These emergency services are usually provided by inpatient medical care service providers (i.e. hospitals).

More information can be obtained from the Department of Health or from the offices of the local Regional Authorities on the manner in which emergency medical services are dispatched and provided.

Occupation / Work Related Medical Services

These healthcare services are preventive in nature and their purpose is to assess the influence of work, the working environment and working conditions on the health of individuals. These occupation-related medical services include preventative examinations and health condition assessments, which are used to evaluate the fitness of an individual to perform the tasks required of them by their respective job. Also included here are consultations on occupational health and safety issues, occupationally-related diseases and work-related illnesses. As part of these occupational medical services, the employer pays for employee training in first aid and the regular supervision of workplaces and working conditions.

Dispensary Care

This type of care is given to patients with chronic or long-term illnesses or with a condition in which there is an ongoing deterioration in an individual’s health. Through the active and long-term monitoring of the condition of such patients, it is possible to get a timely diagnosis of when there is the need for additional therapeutic intervention.

Spa Therapeutic / Rehabilitative Care

Spa treatment can be included as part of therapeutic and rehabilitative care. It is prescribed by the patient’s attending physician with a review by a supervising physician. The prescription for this type of care is submitted by an individual’s regular doctor or by the attending physician while the patient is still hospitalized.

Providing of Medicines and Medical Devices

In the Czech Republic there is an extensive network of pharmaceutical dispensing facilities (pharmacies), which are used for the distribution of medicinal products (drugs) and medical devices, both on the basis of a doctor-provided prescription and without it (i.e. an over-the-counter sale).

Medical prescriptions have the following types of validity:

  • 1 day (from the issue date if issued by an emergency room)
  • 5 days (for antibiotics and antimicrobial chemotherapeutics)
  • 14 days (for other types of prescriptions – unless otherwise specifically noted with a different validity period by the person issuing the prescription)

Preventative Care

A primary care physician performs preventive examinations and gives vaccinations against infectious diseases.
 

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Published: 11.12.2012

Last change: 24.06.2014, 14:39