THE COSTS AND REIMBURSEMENTS FOR LUNG CANCER TREATMENT AMONG SELECTED HEALTH CARE PROVIDERS IN THE CZECH REPUBLIC

The objective of the article is to objectivise and assess the costs for the lung cancer therapy from the payer’s (health insurance company) and the healthcare provider’s (hospital) perspective based on information available from several large hospitals and specialised centres. No comprehensive assessment of costs related to the treatment of lung cancers at all stages has been published in the Czech Republic to-date. The results in this study are calculated based on diagnostic and therapeutic algorithms, i.e. process maps. These, in turn, are derived from the recommended therapeutic procedures issued by the Masaryk Institute of Oncology, the University Hospital in Hradec Králové and the University Hospital in PlzeÀ. In total, the costs and reimbursements were calculated for 32 utilized algorithms, i.e. process maps. The costs for therapeutic processes account for 22 results, while 10 results correspond to diagnostic processes. Both direct and indirect costs were included in individual calculations. The calculations imply that treatment cosi significantly differ depending on the selected diagnostic and therapeutic procedure. It becomes apparent that the setting of the reimbursement system presently generates different stimuli for providers, who may reach both positive and negative balances. This fact, in turn, may have an effect on the economic result leading, in its consequence, to the preference of more suitable alternatives in terms of reimbursement regardless of the optimum procedures for the particular patient. This fact is, to a certain extent, reflected by the reimbursements calculated by means of the DRG system. The given algorithms may potentially be used by health care providers to reach working costs, which will allow accurate calculations for particular hospitals.