Ceskoslovenske zdravotnictvi最新文献

Expenditure on health services on a world-wide scale have an ever increasing trend. The trends in advanced countries where nowadays the expenditure on health services is cca 10% of the national gross product is to restrict a further rise and to make maximum use of available resources. In Czechoslovakia the position is different, as expenditure on health services is roughly half as compared with advanced countries. Provisions thus will be specific and funds from other sources than the stage budget will be increased and there will be efforts to achieve a maximum effectiveness as regards the use of available resources. At the same time it will be, however, necessary to make an effort to increase the total volume of financial resources for the health services. The importance of these efforts ensues from the present health status of the population.

The author summarizes basic indicators from which conclusions can be drawn on the health status of the population of the Czech Republic in the eighties up to 1988. She emphasizes the mortality life expectancy at birth, abortion rate, work incapacity on account of illness and injury, morbidity from diabetes and tuberculosis, the trend of newly detected malignant tumours and causes of invalidity. The assessed data are supplemented by figures and maps.

The authors evaluate the method applied in an extensive investigation of the general morbidity of the Czech population implemented in 1986, based on treated morbidity, not combined with the method of actual medicinal examinations. The population sample was selected by one-stage selection, randomization was made by birth data (seventh day in odd month). In the investigation participated all health community and factory doctors, as well as paediatricians and adolescent medical officers in the Czech Republic. Morbidity was assessed retrospectively from the documentation of health community doctors. The investigation confirmed the hypothesis that this method can be used under local conditions for periodic examinations of the general morbidity of the population.

The purpose of the submitted paper is to attempt to detect fundamental social factors which shaped the health status of the Czechoslovak population during the period since the Second World War. First attention is paid to the development of the health status. Subsequently the author characterizes briefly the basic spheres which influence health, i.e. the lifestyle, living and working environment and the activities of the health services. In the conclusion the author presents a characteristic of the socio-economic structure of Czechoslovak society as regards social relations. The author emphasizes the need of rapid transition to a truly democratic set-up of society and the implementation of fundamental economic reforms as the prerequisite for gradual improvement of the health status of the Czechoslovak population. Part of the contemplated social changes and at the same time an essential prerequisite of success is the implementation of the strategy of restoration and promotion of national health.

The environment of mentally retarded children suffers from fluctuations of staff in institutes for social care. The reasons are subjective and in the organization of work. As compared with other countries, there are differences in the categories of workers of these institutions as well as in their numbers and training. The concept of care of mentally retarded children has not been fully elaborated in this country so far. This has adverse repercussions on the working results in social care institutes and on the health status of mentally retarded children.

The investigation made by questionnaire was focused not only on the number of smokers but also on attitudes and knowledge of third year students of the Faculty of General Medicine, Charles University, towards smoking. At the same time a partial view of the lifestyle and subjective evaluation of the health status was obtained. The data were compared also with the results of other surveys published in the literature.

The author submits the results of a five-year investigation of ambulatory treatment of children in selected areas of the CSR. The original idea was to assess the morbidity of children in oecologically threatened areas. However, during the first two years it was revealed that the results do not meet the expectations of hygienists. The baseline material was the "Daily working record of the community paediatrician". The sample comprised 3% of the child population aged 0-14 years from all Czech regions except the South Bohemian one.

The author draws attention to some problems of the contemporary health services which must be resolved in the near future. They comprise in particular the better use of the existing number of available beds and ambulatory diagnostic services. Among reasons for inadequate numbers of doctors the author mentions in particular superfluous consulting, examinations in conjunction with assessment of the work capacity, and administrative work done by many doctors. The author also mentions training of doctors, in particular for general practice. Among the causes of the low attractiveness of this discipline he mentions among others that examinations by the GP are, without any sound reason, not considered specialized examinations. Demands for a family doctor imply the patients' call for a more human approach. In the subsequent part the author pays attention to complaints and asks for the creation of a social climate in favour of new life as well as adequate terminal care of moribund patients. Finally he talks about a reform of our health services which will seek ways stimulating initiative, moral and material interest.