Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services.
The burden of tuberculosis on the public health is staggering. Worldwide, annual incidence of new cases is estimated to be about 8 million. Almost 3 million deaths occur yearly. Early case identification and adherence to treatment regimens are the re...
Bourdon, K H; Rae, D S; Locke, B Z; Narrow, W E; Regier, D A;
Published Date:
1992 Nov-Dec
Source:
Public Health Rep. 107(6):663-668
Description:
The National Institute of Mental Health Epidemiologic Catchment Area Survey is a comprehensive, community-based survey of mental disorders and use of services by adults, ages 18 and older. Diagnoses are based on the criteria in the "Diagnostic and St...
Cohen, D A; MacKinnon, D P; Dent, C; Mason, H R; Sullivan, E;
Published Date:
1992 Nov-Dec
Source:
Public Health Rep. 107(6):727-731
Description:
An intervention was developed to promote safer sex and condom use among patients seeking treatment for sexually transmitted disease (STD) at a public health STD clinic in Los Angeles, CA. The intervention consisted of a short group discussion on cond...
Patterns and predictors of the use of prenatal care in Hawaii were examined by census tract, taking into account summary measures of socioeconomic status, environmental conditions, and aggregated indicators of pregnancy-related risk characteristics o...
Numerous studies have shown that the receipt of adequate prenatal care is associated with improvements in pregnancy outcome, particularly a reduction in the risk of low birth weight. Since medical costs for these low birth weight infants are several ...
This article describes the development and field testing of five 1-minute videotaped nutrition public service announcements focusing on the role of nutrition in reducing cancer risks. Topics include dietary fat, vitamin A, vitamin C, cruciferous vege...
Kato, I; Nomura, A M; Stemmermann, G N; Chyou, P H;
Published Date:
1992 Nov-Dec
Source:
Public Health Rep. 107(6):712-717
Description:
Use of vitamin supplements and the association with personal characteristics were investigated among 4,654 American men of Japanese ancestry in Hawaii. A total of 58 percent of the subjects who were ages 68 to 90 took vitamin supplements. Among suppl...
Assaf, A R; Banspach, S W; Lasater, T M; Ramsey, J; Tidwell, R J; Carleton, R A;
Published Date:
1992 Nov-Dec
Source:
Public Health Rep. 107(6):695-700
Description:
Health promotion and intervention projects at State and community levels need computerized data bases to assist in making policy decisions and in operating the projects. Computer data base systems are used in entering, storing, retrieving, and analyz...
Fuller, S M; McDermott, R J; Roetzheim, R G; Marty, P J;
Published Date:
1992 Nov-Dec
Source:
Public Health Rep. 107(6):682-690
Description:
A survey of breast cancer and breast cancer screening beliefs was mailed to a random sample of 1,000 women who contacted a telephone bank in response to a television-promoted, reduced-cost mammography project. Beliefs and demographics of women in the...
The Illinois Department of Public Health, in cooperation with the Centers for Disease Control (CDC), monitors trends in the prevalence of prenatal risk factors that are major predictors of infant mortality and low birth weight (LBW). Analyzed data fr...
Hartgers, C; van Ameijden, E J; van den Hoek, J A; Coutinho, R A;
Published Date:
1992 Nov-Dec
Source:
Public Health Rep. 107(6):675-681
Description:
To enhance the prevention of human immunodeficiency virus infection, factors related to regular participation in the Amsterdam Syringe Exchange and the borrowing of syringes were studied in 131 HIV-seronegative injecting drug users in a 1989-90 surve...
Traditionally, health education for practicing health professionals, as well as members of the public, focuses on the individual and relies on changing personal behavior. However, health care for persons with acquired immunodeficiency syndrome (AIDS)...
Thacker, Stephen B.; Mayberry, Robert M.; Herndon, Joy L.; Warren, Rueben C.;
Published Date:
1992 Nov-Dec
Source:
Public Health Rep. 107(6):718-723
Description:
A survey was conducted to improve the recruitment, training, and retention of epidemiologists in the Epidemic Intelligence Service (EIS) Program of the Centers for Disease Control. The authors compared minority graduates of the program and nonminorit...
Villarino, Margarita E.; Geiter, Lawrence J.; Simone, Patricia M.;
Published Date:
1992 Nov-Dec
Source:
Public Health Rep. 107(6):616-625
Description:
After years of steady decline, there has been an unprecedented resurgence of tuberculosis (TB) in the United States and outbreaks of multidrug-resistant tuberculosis (MDR-TB). The authors assess the nature, epidemiology, and implications of MDR-TB; p...
Roper, William L.; Baker, Edward L.; Dyal William W.; Nicola, Ray W.;
Published Date:
1992 Nov-Dec
Source:
Public Health Rep. 107(6):609-615
Description:
Although the American public health system has made major contributions to life expectancy for residents of this country over the past century, the system now faces more complex health problems that require comprehensive approaches and increased capa...
International Conference on Lyme Borreliosis (5th : May 30-June 2, 1992 : Arlington, VA)
Published Date:
1992 Nov-Dec
Source:
Public Health Rep. 107(6):644-646
Description:
In 1990, the Council of State and Territorial Epidemiologists and the Centers for Disease Control made Lyme disease (LD) nationally notifiable and developed a national case definition. State epidemiologists were surveyed about their State LD surveill...
An important question in interpreting epidemiologic data is why some persons agree to participate in a health survey while others do not. Information about why people agree to interview or answer a questionnaire could help researchers to devise proce...
Health care systems are rapidly shifting attention from providing health care to producing health, profoundly altering how and which services are provided. To free up individual and collective resources for investment in activities with a greater imp...