Ambulatory geriatrics in the Czech Republic: A survey of geriatricians’ opinions

Abstract

According to the latest published data, the total of 33 outpatient geriatric facilities were registered in the Czech Republic at the end of 2011 employing (mostly on a part-time basis) 63 physicians. The aim of this paper was to analyze the reasons of this situation. An extensive survey of the opinions of Czech geriatricians performed in spring 2013 addressing all the 230 geriatricians registered in the Czech Medical Association of J. E. Purkyně was focused on the situation in ambulatory geriatric care, the experience with the demand for it, the approach of health insurance companies, and the cooperation with other physicians. The survey has identified that the major obstacle to the development of geriatrics is the persisting artificial separation of medical and social care. Its negative consequence is a breach of the complexity and consistency of care and the cooperation among specialists. A real threat to the development of ambulatory geriatric care is particularly the existing financing system of ambulatory geriatric services and the unofficial “stop state” of health insurance companies that prevent new contractual relationships. Another obstacle is the lack of readily available relevant information, so that the demand for specialist care remains on a low level. The phenomenon of the ageing population is still not perceived as a major challenge by the Czech society, and this situation is also reflected by the level of awareness and interest in these issues.