Biomedical subjects
Publications and source records attributed to I Gladkij.
This paper summarizes the results of a comparative study focused on health care system performance in EU countries and candidate states in Central and Eastern Europe.
The European Regional Office of WHO develops in recent years overall activities to promote continuous quality development in member countries. Several innovated targets and indicators of the strategy of the programme Health for All as well as the extensive definition apparatus elaborated by the department for ensuring the quality and evaluation of technologies is also focused on improving the quality of care. In the submitted article the author discusses the basic philosophy of procedures of the systematic development of the quality of care which resulted from the common effort of the European Regional Office of WHO and the Association of National Medical Societies. The European Regional Office in collaboration with some European health institutions and medical societies developed also information systems and models of systematic development of quality of care which are excellent examples of what can be achieved on a horizontal level. This applies in particular to the programmes DIABCARE, WHOCARE, ORATEL and OBSUOUID. In the submitted paper examples are given of the implementation of these programmes as well as the pertinent fundamental references. The author mentions briefly also some forms of implementation in some advanced European countries. In the conclusion the author deals briefly with the essential aspect of quality of health care, i.e. the relationship of effectiveness and economy of health care.
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The health services adopt some methods for quality improvement and quality management from other branches of activities, in particular industry. Health care has naturally its specific features which make it possible to adopt findings in a creative and not merely in mechanical way. The method of quality assurance involves in particular the inspective character of detecting and eliminating different shortcomings, while the method of systematic improvement of the quality and its total management activates in its effort to achieve a high standard of provided services, all workers and the entire organization, integrating medical pretentiousness, effectiveness and efficiency with decentralized responsibility. The total quality management implies a systematic approach and democratic process of quality improvement. The creative approach of workers to the quality of care is based on the comprehensibility and complete acceptance of the objectives of the institution and the obvious and systematic evaluation of all processes and their results. In the submitted paper the author discusses necessary prerequisites and individual steps of implementation of programmes for improving the quality of care, as outlined by experts abroad, and based on the author's findings.
The author defines the term of quality assurance as a cycle of activities to ensure the best possibly attainable standard of provided health care and characterizes its attributes. Within the range of a review he analyzes different constituents of quality assurance, in particular with regard to effectiveness and efficiency of health care. In view of the increasing costs of high standard health care efforts of optimization and utilization review of health care are an essential parallel process of quality assurance. The decisive factor is motivation of doctors and health professionals for both mentioned processes, which at present lacks systemic support in this country. The author gives an account of experience assembled abroad pertaining to suggestions for improvement of the standard and optimization in utilization of health care as well as inevitable steps for introducing a programme for quality assurance in health institutions. In the conclusion the asset of this process is summarized.
Quality is one of the main features of advanced health care. It is a comprehensive concept which comprises specialized technological, interpersonal and economic properties of the structure, process and results of provided care. The tool for improving the quality is assessment of defined realistic targets and systematic monitoring of the quality from all aspects. The prerequisite for quality assessment is a clear definition of quality criteria and definition of the desirable standards of care. Accreditation of health institutions is a suitable method for assessing in a more objective way the quality of health care. Obtaining accreditation should imply that the institution works consistently with defined standards and manifests a systematic effort to improve provided care and services. The optimal position is achieved if accreditation becomes a system of eligible dynamic assessment.
The submitted prognosis of need of personnel to ensure specialist diabetological care in the Czech Republic is based on an analysis of the development of the number of diabetic patients and on analysis of activities which must be provided to diabetics in order to maintain the selected standard of health care. The estimate of the future number of diabetics is assessed by the method of demographic projection for one-year age groups, separately for men and women. The analysis of activities in diabetological care was elaborated from the results of an anonymous survey among diabetologists in the South Moravian region. Reflections on different variants of the standard of provided care respect also the analysis of the hitherto recorded trend in the number of health workers in diabetology and their available time. The estimate of needs is objective and can be applied in specialized diabetological services as well as in a different organization of care of diabetics, e.g. by the general practitioner. The contemporary organization of care of diabetics cannot ensure the required standard of care. The prognosis submits several possible ways how to achieve this standard. The prognosis deals in particular with the number of working hours of doctors but does not omit other categories of health workers.
The submitted prognosis of need of personnel to ensure specialist diabetological care in the Czech Republic is based on an analysis of the development of the number of diabetic patients and an analysis of activities which must be provided to diabetics in order to maintain the selected standard of health care. The estimate of the future number of diabetics is assessed by the method of demographic projection for one-year age groups, separately for men and women. The analysis of activities in diabetological care was elaborated from the results of an anonymous survey among diabetologists in the South Moravian region. Reflections on different variants of the standard of provided care respect also the analysis of the hitherto recorded trend in the number of health workers in diabetology and their available time. The estimate of needs is objective and can be applied in specialized diabetological services as well as in a different organization of care of diabetics, e.g. by the general practitioner. The contemporary organization of care of diabetics cannot ensure the required standard of care. The prognosis submits several possible ways how to achieve this standard. The prognosis deals in particular with the number of working hours of doctors but does not omit other categories of health workers.
The authors draw attention to possibilities of a marked reduction of the injury rate based on a statistical investigation and analysis of the causes and sources of injuries. The injury rate is the second most important cause of impaired health and is the most important cause of loss of the living and working potential in Czechoslovakia. The main cause of injuries is the human factor; therefore injuries are to a considerable extent avertible and can be influenced to a considerable extent. Areas of frequent injuries which have been for a long time the object of perfect records, analysis and social action such as e.g. the injury rate at work or during transport have an unequivocal declining tendency as far as the number of deaths and severe casualties is concerned. The paper reveals hitherto statistically not recorded areas of injuries and risk groups of the population on which investigations and preventive measures against injuries should be focused.
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