1 Abstract The aim of diploma thesis is searching for solution of long-term sustainability for health care financing in Czech Republic with respect to future demographic development of Czech population and with respect to development of other factors influencing income and expenditure of health care system. After introduction there is the second chapter that describes evolution and current state of Czech health care system. The third chapter deals with historical progress of income and expenses on health care in Czech Republic and adds an international comparison. The chapter four identifies main motives for future change of Czech health system financing. The chapter five shows inspiring examples how health care financing works in Netherlands, Switzerland and Germany. The sixth chapter describes basic aspects, advantages and disadvantages of introducing nominal premium to Czech health insurance system. In chapter seven there is a summary of process of introducing nominal premium and results of model of future income from reformed health insurance for year of nominal premium introduction - 2015. The basic outcome of model is fact that nominal premium introduced in amount of 725 CZK per month per person can bring additional finance to health care system in amount of 31 505 bil. CZK in despite of replacing...

京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第18686号 / 社医博第62号 / 新制||社医||8(附属図書館) / 31619 / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 中原 俊隆, 教授 福原 俊一, 教授 古川 壽亮 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

This thesis contains a characteristic of ways, rules and resources of health care financing in various health care systems and their influence on impartiality, responsibility and efficiency. You can find an analysis of sources and expenditures on health in individual OECD countries - their structure, quality and development trend in this thesis too. The goal of the thesis is to approach the questions of responsibility of a patient, impartiality of health care system and its efficiency through financial stimuli.

The main focus of the thesis is the multilayered view of regional hospitals on their contractual relationship with health insurance companies. The thesis draws information from two case studies of regional hospitals in Central Bohemia. These case studies have allowed me to map the whole process of establishing a contractual relationship with health insurance companies from the first contact to the final conclusion of the contract for a particular year. Through mapping the process I have identified a number of problematic areas that are encountered when concluding contracts. Thesis has also concentrated on the establishment and content of the payment regulation which, to a large extent, determines the final form of the contractual relationship. One of the goals of the thesis is the identification of key problems stemming from the parameters of the contractual relationship and payment mechanism. These problems are analyzed on the level of hospitals, individual specialized units, and in relation to the provision of health care to patients.