{"id":24460,"date":"2016-02-09T09:51:30","date_gmt":"2016-02-09T08:51:30","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=24460"},"modified":"2016-02-09T09:51:30","modified_gmt":"2016-02-09T08:51:30","slug":"hradi-pojistovna-vysetreni-crp-nebo-si-ho-ma-pacient-sam-platit","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=24460","title":{"rendered":"Hrad\u00ed poji\u0161\u0165ovna vy\u0161et\u0159en\u00ed CRP? Nebo si ho m\u00e1 pacient s\u00e1m platit?"},"content":{"rendered":"<p><strong>OT\u00c1ZKA: Hrad\u00ed poji\u0161\u0165ovna vy\u0161et\u0159en\u00ed CRP, aby se zjistilo, zda je t\u0159eba nasadit antibiotika? Nebo si ho m\u00e1 pacient platit?<\/strong><!--more--><\/p>\n<p>ilustra\u010dn\u00ed foto: stockimages-FreeDigitalPhotos.net<\/p>\n<p><strong>ODPOV\u011a\u010e:<\/strong><\/p>\n<p>Vy\u0161et\u0159en\u00ed CRP poji\u0161\u0165ovna hrad\u00ed a pacient za n\u011bj nic neplat\u00ed, a\u0165 je provedeno p\u0159\u00edmo l\u00e9ka\u0159em v ordinaci, nebo v extern\u00ed laborato\u0159i. Po\u017eadovat po pacientovi platbu by l\u00e9ka\u0159 mohl pouze v p\u0159\u00edpad\u011b, \u017ee k vy\u0161et\u0159en\u00ed CRP neshled\u00e1v\u00e1 \u017e\u00e1dn\u00fd zdravotn\u00ed d\u016fvod, ale pacient na n\u011bm trv\u00e1. Stanoven\u00ed CRP se pou\u017e\u00edv\u00e1 pro rozli\u0161en\u00ed virov\u00e9 a bakteri\u00e1ln\u00ed infekce, a to hlavn\u011b p\u0159ed nasazen\u00edm antibiotick\u00e9 l\u00e9\u010dby, kter\u00e1 by u virov\u00e9ho onemocn\u011bn\u00ed byla zbyte\u010dn\u00e1, ev. pro n\u00e1slednou kontrolu \u00fasp\u011b\u0161nosti t\u00e9to l\u00e9\u010dby.<\/p>\n<p>V sou\u010dasn\u00e9 dob\u011b vyu\u017e\u00edv\u00e1 \u0159ada praktick\u00fdch l\u00e9ka\u0159\u016f, hlavn\u011b d\u011btsk\u00fdch, mo\u017enost prov\u00e1d\u011bt stanoven\u00ed CRP p\u0159\u00edmo ve sv\u00e9 ordinaci, tzv. v re\u017eimu POCT (Point of Care Testing). Poji\u0161\u0165ovna p\u0159\u00edslu\u0161n\u00fd v\u00fdkon hrad\u00ed nad r\u00e1mec kapita\u010dn\u00ed platby praktick\u00fdm l\u00e9ka\u0159\u016fm pro d\u011bti a dorost i v\u0161eobecn\u00fdm praktick\u00fdm l\u00e9ka\u0159\u016fm. Hrad\u00ed ho i u l\u00e9ka\u0159sk\u00e9 slu\u017eby prvn\u00ed pomoci (LSPP).<\/p>\n<p>V\u00fdkon s k\u00f3dem 02230 \u2013 \u201eKvantitativn\u00ed stanoven\u00ed CRP (POCT)\u201c ale m\u016f\u017ee m\u00edt l\u00e9ka\u0159 ve smlouv\u011b s VZP jen p\u0159i spln\u011bn\u00ed stanoven\u00fdch podm\u00ednek. Je v\u0161ak nasmlouv\u00e1n v\u0161em l\u00e9ka\u0159\u016fm, kte\u0159\u00ed maj\u00ed pot\u0159ebn\u00e9 vybaven\u00ed, podm\u00ednky spl\u0148uj\u00ed a o za\u0159azen\u00ed v\u00fdkonu do smlouvy po\u017e\u00e1daj\u00ed. Smyslem tohoto opat\u0159en\u00ed je zajistit pot\u0159ebnou kvalitu dan\u00e9ho vy\u0161et\u0159en\u00ed. Chybn\u00e9 proveden\u00ed v\u00fdkonu nebo jeho \u0161patn\u00e9 vyhodnocen\u00ed m\u016f\u017ee v d\u016fsledku pozd\u011b \u010di naopak zbyte\u010dn\u011b nasazen\u00e9 terapie po\u0161kodit pacienta.<\/p>\n<p>L\u00e9ka\u0159 mus\u00ed zdravotn\u00ed poji\u0161\u0165ovn\u011b p\u0159edlo\u017eit doklad o absolvov\u00e1n\u00ed certifikovan\u00e9ho \u0161kolen\u00ed o t\u00e9to metod\u011b, po\u0159\u00e1dan\u00e9ho na akreditovan\u00e9m pracovi\u0161ti. T\u00edm je Institut postgradu\u00e1ln\u00edho vzd\u011bl\u00e1v\u00e1n\u00ed ve zdravotnictv\u00ed (IPVZ Praha) a \u00dastav l\u00e9ka\u0159sk\u00e9 biochemie 1. LF UK a VFN Praha. P\u0159i prov\u00e1d\u011bn\u00ed v\u00fdkonu pak mus\u00ed b\u00fdt respektov\u00e1no Doporu\u010den\u00ed odborn\u00fdch spole\u010dnost\u00ed o prov\u00e1d\u011bn\u00ed laboratorn\u00edch vy\u0161et\u0159en\u00ed v re\u017eimu POCT a zaji\u0161t\u011bna vnit\u0159n\u00ed kontrola kvality v\u010detn\u011b \u0159\u00e1dn\u011b veden\u00e9ho z\u00e1znamu o n\u00ed. D\u00e1le je povinn\u00e9 ka\u017edoro\u010dn\u00ed extern\u00ed hodnocen\u00ed kvality v\u00fdsledk\u016f m\u011b\u0159en\u00ed formou \u00fa\u010dasti v syst\u00e9mu mezilaboratorn\u00edch porovn\u00e1vac\u00edch zkou\u0161ek.<\/p>\n<p>V\u00fdkon tedy nen\u00ed nasmlouv\u00e1n automaticky ka\u017ed\u00e9mu praktick\u00e9mu l\u00e9ka\u0159i. I l\u00e9ka\u0159, kter\u00fd nem\u00e1 p\u0159\u00edslu\u0161n\u00fd v\u00fdkon uveden\u00fd ve smlouv\u011b s poji\u0161\u0165ovnou, v\u0161ak m\u016f\u017ee pacientovi zajistit vy\u0161et\u0159en\u00ed CRP v laboratorn\u00edm re\u017eimu, tj. odesl\u00e1n\u00edm vzorku krve do laborato\u0159e. Ani za takto proveden\u00e9 vy\u0161et\u0159en\u00ed CRP pacient neplat\u00ed. Stejn\u00fd postup pou\u017e\u00edvaj\u00ed v p\u0159\u00edpad\u011b pot\u0159eby i l\u00e9ka\u0159i ostatn\u00edch odbornost\u00ed.<\/p>\n<p>Na variantu, \u017ee praktick\u00fd l\u00e9ka\u0159 provede vy\u0161et\u0159en\u00ed CRP p\u0159\u00edmo v ordinaci jako &#8222;nadstandard&#8220; a chce ho zaplatit, by pacient p\u0159istoupit nem\u011bl. Takov\u00fd po\u017eadavek by mohl znamenat, \u017ee l\u00e9ka\u0159 toto vy\u0161et\u0159en\u00ed nem\u00e1 ve smlouv\u011b s poji\u0161\u0165ovnou, a pak zde chyb\u00ed garance kvality, zaru\u010den\u00e1 spln\u011bn\u00edm podm\u00ednek pro nasmlouv\u00e1n\u00ed dan\u00e9ho v\u00fdkonu.<\/p>\n<p>Mgr. Old\u0159ich Tich\u00fd vedouc\u00ed tiskov\u00e9ho odd\u011blen\u00ed a tiskov\u00fd mluv\u010d\u00ed <\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>OT\u00c1ZKA: Hrad\u00ed poji\u0161\u0165ovna vy\u0161et\u0159en\u00ed CRP, aby se zjistilo, zda je t\u0159eba nasadit antibiotika? Nebo si ho m\u00e1 pacient platit?<\/p>\n<\/div>","protected":false},"author":1,"featured_media":15130,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-24460","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nezarazene"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/24460","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24460"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/24460\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/15130"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24460"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24460"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24460"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}