Overview

Czech life expectancy increasingly rose from 2000 until the onset of the COVID-19 pandemic and health behaviours remain an area of concern for overall population health

Average life expectancy at birth increased by more than four years between 2000 and 2019 before falling by nearly two years to 77.4 years in 2021. A drop in mortality rates by one quarter mainly facilitated the rise in life expectancy, particularly for diseases of the circulatory system, though they remain the leading cause of mortality and accounted for just over 40% of all deaths in 2019. Dietary risks, alcohol and tobacco consumption also have a strong influence, and it is estimated that nearly half of total mortality in 2019 resulted from behavioural risk factors.

A broad range of benefits are covered by the statutory health insurance system in Czechia, which is stewarded by the Ministry of Health

Health system stewardship is primarily at the national level, with the Ministry of Health having major roles in licensing, administration and regulation. Czechia’s 14 regions also play a major role via their ownership of health facilities and for registering private facilities. The seven health insurance funds contract a network of providers to comply with the care accessibility requirements (time and distance) set by law. The principles of free patient choice, high financial protection and universal (and compulsory) membership with a health insurance fund remain the core of the Czech system, and a generous benefits package results in a marginal role for voluntary health insurance. There is also a large portion of the population exempt from paying SHI contributions due to being classified as “economically inactive” (including students, pensioners and the unemployed).

The health system is largely financed by public sources and private expenditures are low

With 81.5% of current health expenditure coming from public sources in 2019, Czechia has one of the highest levels of public financing in the WHO European Region. Statutory health insurance contributions (including transferred state contributions on behalf of economically inactive people, rising to account for over a quarter of the total during the first year of the pandemic) make up the bulk of this. Private health care expenditure has hovered between 15% and 20% of current health expenditure over the past decade and out-of-pocket payments apply for some pharmaceuticals, above-standard medical procedures and services and dental care.

Ongoing health reforms in Czechia aim to strengthen public health, health financing and care provision

Strengthened tobacco and alcohol policies, mandatory vaccinations for children, new functionalities for eHealth and efforts to modernize health services have become areas of focus in recent years, while the Strategic Framework for the Development of Health Care in Czechia until 2030 is the government’s main strategic document to promote and develop the health system. New financing mechanisms to make the system more sustainable for the future have also been put in place, including reforms to risk adjustment and redistribution among health insurance funds. Finally, the concentration of highly specialized care has led to designated networks to improve safety and quality for specialized treatments.