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The problems in prescription and reimbursement of medical preparations for incontinent patients during their stay in sojourn institutions of social services


Authors: D. Malá
Authors‘ workplace: MUDr. Emílie Bartišková, pověřená řízením ;  Všeobecná zdravotní pojišťovna ČR ;  Odbor kontroly a revize zdravotní péče
Published in: Reviz. posud. Lék., 19, 2016, č. 3, s. 114-117
Category:

Overview

The problems in prescription and reimbursement of medical preparations for incontinent policyholders from the resources of public medical insurance presents a topical problems and is going to be so due to the unfavorable demographic curve. Medical insurance companies in the Czech Republic provide annually more that 3 billions Czech crowns for incontinent patients, what represents also 1% of total expenditures. It can be stated in general that the amount, provided for the preparations or remedies, reaches the size of reimbursement used for the therapy of oncological patients. The paper gives information about the reason or direction of the revision and control activities of the General Medical Insurance Company to prescription, provision, handling and reimbursement of the preparations and remedies for incontinent patients. It also in forms about the results of survey in physicians indicating the care in sojourn institutions of social services (PZSS) and the Dispensing and Supplying Institutions of medical preparations or devices. Based on these observations a recommendation was developed for adjustment of the present Methodology – Compensation Catalogue of the General Medical Insurance Company-Medical Insurance Company. The suggested changes are outlined.

Keywords:
medical preparations and remedies – preparations for incontinent patients – indicating physician – sojourn institutions of social services – degree of incontinence – Dispensing and Supplying Institutions of Medical Insurance Companies – napkin panties – absorption pads – control and revision activity


Sources

1. Úhradový katalog VZP – ZP.

2. Zákon č. 48/1997 Sb., o veřejném zdravotním pojištění.

3. Zákon č. 268/2014 Sb., o zdravotnických prostředcích.

Labels
Medical assessment Occupational medicine
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