Ceskoslovenske zdravotnictvi最新文献

The author analyzes indicators of drug consumption at the regional level in the CSSR and the main towns. The analysis covers the period from 1971-1985 and pertains to the following indicators: A. Expenditure on drugs per day of treatment by functional types of health institutions. B. per capita expenditure on drugs and C. expenditure on drugs. From the indicators dynamic time series are elaborated and the analysis is focused on the development in the past. The author presents basic indices, mean coefficients of growth and parameters characterizing the development in a multiple way. Statistical testing of parallelisms between the obtained developmental parameters reveals factors which influence drug consumption in the investigated territories.

In their contribution to training and postgraduate training the authors pay in the first part of their paper attention to postgraduate training of directors of district and factory institutes of national health which is implemented in the form of periodic innovation courses. They use as a basis a survey made in 63 respondents who took part in the above courses. In the questionnaires the set-up and contents of training were evaluated, the view of directors as regards the concept and character of these courses. In the second part the authors submitted information of the contents of further periodic innovation courses for directors--public health medical officers.

The aim of the work was to test the hypothesis that drug consumption, consistent with greater demands on therapeutic and preventive care, increases more in older people, as compared with the average population. The authors investigated drug consumption in old people during five-year periods with two-year intervals (1982, 1984, 1986). It was found that during these periods expenditure on drugs increased by 80.1%, although this population group increased only by 15.1%. For comparison the increase of drug consumption expressed in expenditure in the younger population (0-59 years) was 38.1%.

Improvement of health care of the population calls for marked improvement of the health community system of work in close cooperation with all polyclinical departments and common diagnostic and therapeutic components of the hospital and polyclinic. The first line of contact with the patient under conditions of the rapidly developing process of specialization in the health services, without coordinated consultation with all constituents of the hospital and polyclinic, cannot meet new qualitative tasks in conjunction with the main target of the health services--systematic improvement of physical and mental health of the population. As part of the improvement of the system of health facilities it is necessary to promote the professional and control function of the hospital and polyclinic in the appropriate catchment area with special attention to the implementation of its preventive function.

Efforts to influence favourably the health status of our population lead to ever more detailed analyses of the life style and influence of the family on the habits of the young generation. The authors made two pilot studies. In the first one they focused attention on dietary habits and in the second one on the leisure time, incl. physical activity. The results should be applied not only in health education but also in food production and sale, and by the national committees with respect to supplies, the standard of services, transport etc.

Although in our country considerable financial means are spent on the health services, they do not suffice for the health services to meet their tasks under adequate conditions and to contribute to the favourable health status of the population. Under conditions of the reconstruction of the economic mechanism the authorities accept the necessity to increase the financial means for the health services, they ask, however, for concrete justification of these demands. This involves considerable efforts in conjunction with attempts to express performed work in the health services in relation to their costs. This means that the contents of different tasks have to be defined, to create a uniform classification, define the sources of information, the method of calculation and perform other essential tasks associated with the financial assessment of health activities. Certain provisions in this respect were already made. It is essential to proceed with this work or take over the results of work performed in other countries. Optimation of expenditure on the health services which ought to be the result of this work will be a valuable contribution in relation to social resources justifying the financial demands of the health services, as well as in relation to different health facilities and their staff who will get a better grasp of the medical and economic relations.

The author demands more accurate application of the term social factors, he emphasizes their importance in contemporary tasks of the health services and processes of nation-wide health promotion. He recommends that more attention should be paid to subjective factors, to the participation of man in health care; when investigating subjective factors, new methodological procedure must be sought in social medicine. Some experience assembled in socio-medical experiments is presented.

The author analyzes the basic principles of the programme of Health Promotion in relation to health problems in the CSSR. She discusses urgent task of improvement of the health status and their association with the WHO programme Health for All by the Year 2000. She specifies the role of the department of health and in particular the discipline of public health for fulfilling the programme and the importance of a socio-medical approach to the solution of health problems of the population.

Mass (complete) dispensarization of the population is the highest type of individual care of the population not only in disease but also in health. Extension of dispensary care to the entire population is consistent with the implementation of primary health care (WHO, UNICEF--Alma Ata 1978) and can be achieved by the year 2000 also under our conditions, provided certain organizational, personal and professional prerequisites are met. The latter do not depend only on the health services but have an overall community character.