News
Healthcare system efficiency
The Czech healthcare still has a lot of room of improvement in digitalisation. We are lagging behind most developed countries, while new challenges lie ahead, including the use of artificial intelligence. The pressure on financial and human resources is also increased by the ageing population, says Jakub Hlávka, who works not only for Masaryk University but also for SYRI (National Institute for Research on Socioeconomic Impacts of Diseases and Systemic Risks) in a group focusing on the efficiency of healthcare.
He worked for many years in the United States, where he still teaches at the University of Southern California in Los Angeles. He is also the founder of the Initiative for Effective Healthcare, which analyses data on the Czech healthcare system and develops recommendations to make it more efficient. In the past, he has worked on projects for the U.S. Departments of Health and Defense, NASA, and the Centers for Disease Control and Prevention (CDC). He has extensive private and public sector experience in the Czech Republic, USA, Germany and the UK.
You spent a lot of time in the US, where you gained extensive experience in health economics. Where do you think the Czech system needs to improve the most?
There are many areas, but one of the biggest problems is the relatively weak capacity of public institutions to prepare for long-term challenges and to take advantage of the opportunities offered by modern technologies. As a result, we are lagging behind almost all developed countries in the digitisation of healthcare. However, new digital tools, including artificial intelligence, can bring significant benefits to the Czech healthcare system in the future. They can help make a diagnosis and improve the patient’s journey through the healthcare system, without taking responsibility for complex ethical decisions out of human hands. With very few exceptions, they will not be a substitute for human contact. New technologies can help the Czech healthcare system. As we collectively discovered during the Covid-19 pandemic, the system is not as good as we thought. Our life expectancy is 1.5 years shorter than the average in the EU. All the Western countries are ahead of us, and people in the most advanced countries are living four to five years longer. Yet it is obvious that we are not prepared for the ageing of the population.
What needs to be done?
Ageing will increase demands on financial and human resources, and we can only solve the problem by making the system more efficient. The small, cosmetic changes we have made in recent years will no longer be enough. We need to improve the quality of primary care very significantly. This means that GPs need to help coordinate care and primary and secondary prevention, we need to strengthen the role of geriatric care, which can provide a comprehensive approach to the frail elderly, increase the availability of outreach services in long-term care, which is already at the breaking point, and partially streamline acute care to maintain its quality. All developed countries face these challenges, and the Czech Republic will not be able to avoid them if it does not want to see a gradual deterioration in the availability and quality of healthcare for the vast majority of the population. A few weeks ago, together with colleagues from several institutions and companies, I started working on a new project to analyse the state of population ageing in the Czech Republic and its impact on social systems, especially on health and social care spending, the labour market and more. The results of the project, funded by the Technology Agency of the Czech Republic, will be useful for the development of effective policies in the field of health and social care.
At MU, you head a centre for health economics. Could you tell us more about it?
It is the new Health Economics, Policy and Innovation Institute (HEPII), which has three objectives. The first is to coordinate health economics research. We have already secured the MUNI Award in Science and Humanities (MASH) and grants from Horizon Europe (for research in palliative care), the Czech Health Research Council (for Alzheimer’s disease) and the US National Institutes of Health (NIH) for a pilot project on microsimulation related to population ageing. The second objective is to coordinate training within the new Applied Health Economics programme, which we will be teaching from autumn 2025. And the third objective is to contribute to the public debate, including on the changes needed in the Czech health and social care systems.
This year you started working at the SYRI National Institute. What does your research group, which focuses on health system efficiency, do?
We work with existing data on the functioning of the Czech healthcare system and collect new data. We are interested in areas such as chronic diseases, which are the biggest cost drivers in healthcare systems, the ageing of the population, quality and accessibility of care, cost-effectiveness assessment and modern reimbursement models and economic incentives in public health insurance.
One of SYRI’s aims is to provide policy makers with expert evidence to inform their decisions. How does it work in the USA compared to the Czech Republic?
This is a well-established process in the US but is still in its infancy in the Czech Republic. I worked for more than five years at the RAND Corporation, which provides cutting-edge applied research to many American institutions, from the White House to various government departments and agencies. There is nothing like it in this country. It’s hard to build such an institution without certainty of funding. People in the Czech academic and research community are often dependent on short-term, small-scale grants, so they don’t have the opportunity to focus on long-term priorities for the public sector. Czechia has the Institute of Health Information and Statistics (IHIS) and other institutions in the health sector, but they often lack the expertise and capacity to produce more than summary statistics. Research capacity in the Czech Republic is still insufficient to provide recommendations, international comparisons and evaluations of cost-effectiveness and other dimensions of public policies. I hope that the government will invest more in them in the future. An important aspect is, of course, the communication of findings and recommendations, which is still lacking in this country, and the general public is often unaware of what the scientific consensus is.
PHOTO: ECON MUNI archive