Foreigners in the Czech Republic

The health care data shown are not any exhaustive information on the utilization of health care by foreigners and conditions of their health in the CR.

Table 6-1 Health insurance contracts of foreigners: General Health Insurance Company of the CR; 1 January to 31 December 2003

The table concerns foreigners with both long-term and short-term residence in the CR, who effected health insurance with the GHIC CR, namely commercial insurance concluded voluntarily.

In 2003, most foreigners, who signed health insurance contracts with the GHIC CR, came from Ukraine, while in the previous year it applied to Vietnamese. Ukrainians participated in the total number of insured foreigners with 22.9% (5 502 persons), Vietnamese with 21% (5 064 persons) and foreigners from Russia 9.3% (2 238 persons). The health care was utilized most by Vietnamese (29.1% of all foreigners utilizing the health care, i.e. 3 195 persons), Ukrainians (21.9%, 2 397 persons) and Russians (11.3%, 1 236 persons).

Tables 6-2 and 6-3 Utilization of health care by foreigners

Data on the utilization of health care by foreigners are measured through annual report V (MZ) 1-01. It is compiled only by hospitals and regards foreigners that cover health care from health insurance policies concluded in the CR, insurance policies concluded abroad, in cash, or whose health care is reimbursed by state authorities (the Ministry of Health of the CR, Ministry of the Interior of the CR, Ministry of Justice of the CR, district offices, etc.). The figures also include asylum seekers accommodated in asylum establishments of the Ministry of the Interior of the CR, whose health care is paid by the Ministry of the Interior of the CR.

Foreigners, whose health care is paid for out of general health insurance, are not included in the report. The numbers of persons utilizing health care paid for out of health insurance contracts, which are given in Table 6-2, differ from the GHIC CR data listed in Table 6-1 on health insurance contracts of foreigners. This is due to the possibility of drawing on this contractual insurance by foreigners in more hospitals in the reference period and drawing on the health insurance contracts in health establishments other than hospitals.

Tables 6-2 and 6-3 in 2003 newly show data for hospitals for health sector in total. It means that besides hospitals coming under the Ministry of Health of the CR there are shown also hospitals under the Ministry of Defence of the CR, Ministry of Justice of the CR and Železniční nemocnice (Railway hospital), which comes under the České dráhy (Czech Railways) joint-stock company.

In 2003, as in the previous years, Czech hospitals provided health care to 60 870 foreigners. Structure of foreigners most often healed in the Czech Republic did not change much against 2002 as for their nationality; Slovaks ranked first, while in the previous year Ukrainians were first. Health care was provided to 11 324 Slovaks (18.6%), 11 270 Ukrainians (18.5%) and 6 249 Vietnamese (10.3%). As for the EU member countries, it was Germans that sought health care most (9.2%, 5 579 persons). Citizens of the Ukraine and Germany paid for the health care mostly in cash, the health care provided to Slovaks was covered mostly from foreign insurance and the one provided to Vietnamese was paid for from contractual health insurance.

Costs of the health care provided in hospitals were up on the year 2002 by 67 310 thousand CZK. This growth against 2002 was caused by higher number of foreign patients treated (by 18.6%). The costs of the health care provided were highest with Slovaks (18.7%) and Ukrainians (16.2%). Costs of the health care provided to citizens of the EU member states were highest with Germans again (8.5%). In 2003, costs of the health care provided to foreigners from the EU member countries increased by 8.6%. The proportion of health care costs in total costs remained the same when compared to the previous year; it amounted to 71.5%. From the total of CZK 455 339 thousand spent on the health care for foreigners 29.4% were paid from foreign insurance, 24.4% in cash and 10.4% were paid by public bodies. The lowest amount of costs was paid from the contractual insurance (7.3%). 28.5% cases remained unpaid, of which 13% after maturity date.

The same as the last year, health care was provided most frequently to foreign citizens in the Hlavní město Praha Region (38.8% of foreigners who utilized health care) and the Karlovarský Region (8.9%). Last year, the Středočeský Region ranked second among regions. Regarding amounts of the costs, the Hlavní město Praha Region was the leader again (48.9%) followed by the Liberecký Region (8.2%).

Table 6-4 Foreigners treated in hospitals: by cause of hospitalization; 2003

Table 6-4 on foreigners hospitalised in Czech hospitals covers hospitals of all government departments. It gives figures only on foreigners who were not assigned any birth number and who were not insured in the framework of general health insurance (i.e. only foreigners with temporary residence).

The most frequent reasons for hospitalisation of foreigners included injuries and poisoning cases followed health-status-affecting factors, contacts with health services (e.g. checkups and examinations which required hospitalisation, care after injuries, suspicion of a disease, etc.), diseases of the circulatory system, and diseases of the digestive system.

Tables 6-5 and 6-6 Abortions of female foreigners

All types of abortions made in health establishments of the CR shall be reported on the form “Application for Induced Abortion - Report of Abortion and Ectopic Pregnancy”. This report is also filled in for female foreigners granted permanent or long-term residence in the CR. Female foreigners with temporary residence and female tourists are not monitored.

In 2003, 2 660 abortions in female foreigners were reported, which is by 3.3% less than in the previous year (2 751), of which 2 176 (81.8%) were legally induced abortions. Number of vacuum aspirations decreased in comparison to the previous year, namely by 4.1% (1 750 in 2003 and 1 825 in 2002).

From legally induced abortions (LIA) 7.9% were therapeutic abortions. Vacuum aspirations made up 80.4% of all LIA.

The total number of abortions in female foreigners increased since 1995 (from 1 447 in 1995 to 2 660 in 2003), of which the number of LIA increased from 1 245 in 1995 to 2 176 in 2003.

Between 1995 and 2003 the proportion of abortions in female foreigners in the total number of abortions in the Czech Republic much changed, namely from 2% in 1995 to 6.7% in 2003. This rise is not only due to the rising number of foreigners in the CR, but it is also caused for the most part by a large drop in the number of abortions in Czech female citizens. Similarly, the evaluation of the data by region is also influenced by the biggest concentration of foreigners in the Hlavní město Praha Region and the Středočeský Region.

Table 6-7 New notified TB cases in the CR; by the patient’s country of birth

This table gives the number of newly notified cases of tuberculosis (TB) cases in the CR broken down by the country of birth of patients (not necessarily foreigners).

There were 1 162 TB cases newly notified in 2003, by 3.2% down on 2002, of which foreigners accounted for 11%.

The comparison of the data on health care utilisation by foreigners for 2003 and 2002 suggests that the 1 268 more foreigners signed health care insurance policies with the General Health Insurance Company (GHIC). However, the number of foreigners utilising health care on the basis of these policies more than doubled in comparison with the last year (increase by 115.7%).

6 498 more foreigners sought health care in hospitals (the difference results from the total number of 54 372 foreigners treated in hospitals in 2002 for the health sector as a whole). It was reflected also in the total amount of costs for this care, which increased by 67 million CZK when compared to the previous year (in 2002 the total amount of costs for health care provided to foreigners was 388 092 thousand CZK for health sector as a whole).

The same as the previous year, the number of hospitalised foreigners rose. A downward trend was recorded for the number of abortions of female foreigners and newly notified TB cases.

Generally, more foreigners were treated in Czech hospitals than in the previous year and at the same time costs spent on their treatment increased, too. When compared to 2002, in 2003 twice more foreigners drew contractual health insurance effected with the GHIC CR.