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20 May 2025 | Country Update
The National Plan for the Development of Geriatric Care in Czechia until 2035
2.4. Planning
Planning in the Czech health system involves MZČR playing a major role by establishing general frameworks on scope, conditions and requirements for provision (see Box2.1). Other stakeholders involved are HIFs, teaching and regional hospitals, and regional authorities.
Box2.1
The Strategic Framework for the Development of Health Care in Czechia until 2030 (Zdraví 2030 or Health 2030) is the government’s current main strategic document (MZČR, 2020a). It was adopted in 2019 and later updated in response to the COVID-19 pandemic. The plan promotes seven priority areas: (1) primary care reform; (2) disease prevention, health promotion and protection, and increasing health literacy; (3) implementation of integrated care models, integration of health and social care, and mental health care reform; (4) health workforce stabilization; (5) health sector digitalization; (6) optimization of the reimbursement system; and (7) involvement of science and research in solving priority tasks (MZČR, 2020a). Health 2030’s development was supported by an extensive analytical study prepared by ÚZIS (2019b), based on the data available from the National Healthcare Information Portal (Národní zdravotnický informační portál, NZIP) (see section 2.8.1). The preceding strategy, Health 2020, was last evaluated in 2018 and concluded that “the implementation of the strategy was largely delayed due to insufficient financial coverage of the planned activities” (MZČR, 2018d).
In response to the COVID-19 pandemic, the National Recovery Plan, funded by the European Commission (an expected €7 billion for Czechia, out of which roughly €0.5 billion should go to the health sector), aims for several investments, particularly for research and development (aim 5.1), increasing health system resilience (aim 6.1), and strengthening cancer prevention and care (aim 6.2) between 2021 and 2026 (MPO, 2021).
Regarding financial planning, each HIF is obliged to develop its financial and operating plan (zdravotně pojistný plánů) on an annual basis for the coming year, including an outlook for the subsequent two years ahead. This serves as a business plan, and also contains plans on contracting and purchasing policies, and resource use. The plans are reviewed by MZČR, in collaboration with MFČR. Following governmental approval, plans are submitted for approval to the Chamber of Deputies. This process can be lengthy and plans may not be approved before the actual year starts; when this occurs, HIFs operate as if their plans had been approved (see section 2.7.1). The following year’s plan evaluates compliance with the preceding one and adjusts expectations on revenues and expenditures for the years ahead accordingly.
Regional authorities have recently taken on more planning responsibilities, although they are not legally obliged to. Most of them have created Regional Healthcare Concepts (Koncepce krajského zdravotnictví), addressing relevant issues within their region. These may include personnel and financial stabilization, coordination among providers (public and private) and strengthening certain fields, among others (see, for example, the Healthcare Concept of the Hradec Králové Region for the period 2021–2025).
All hospitals subordinate to MZČR are required to produce financial and investment plans, and submit them to MZČR for regular review. Similarly, regional hospitals report their financial and investment plans to their respective regional authority.
Czechia’s National Plan for the Development of Geriatric Care until 2035 responds to ongoing population ageing. The plan outlines four main strategic goals:
- Creating conditions for healthy ageing and the prevention of disability,
- Ensuring high-quality geriatric care supported by research and education in geriatrics and gerontology,
- Improving the accessibility and systemic organization of specialized geriatric care, and
- Establishing effective integration within the geriatric care system to meet the complex needs of older patients.
The accessibility of specialized geriatric care is to be ensured through four major areas:
- a network of geriatric clinics at all medical faculties,
- the establishment of a basic network of inpatient geriatric care facilities,
- geriatric outpatient clinics, and
- systemic support to guarantee the availability of geriatric health services.
With proper diagnosis and appropriately tailored treatment, patients with frailty, multimorbidity, and sarcopenia can spend more time at home and in community environments to treat conditions appropriately and in a timely manner. This shift can contribute to greater long-term fiscal sustainability and enhance the role of community- and family-based care, while simultaneously supporting the fullest possible return to quality of life and self-sufficiency through adequate follow-up care and rehabilitation. On the other hand, hospitalization in a dedicated geriatric ward has the potential to improve patients’ functional outcomes at discharge, increase the share of patients returning to their home environment, reduce the number discharged to subsequent inpatient facilities, and lower the rate of early rehospitalizations.
The plan furthermore includes detailed sub-goals and is supported by an analytical study conducted by the Institute of Health Information and Statistics (ÚZIS).