{"id":55104,"date":"2025-02-21T06:46:00","date_gmt":"2025-02-21T05:46:00","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=55104"},"modified":"2025-02-21T06:46:26","modified_gmt":"2025-02-21T05:46:26","slug":"vnitrni-lekarstvi-je-pateri-ceskeho-zdravotnictvi-ale-pretizenou","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=55104","title":{"rendered":"Vnit\u0159n\u00ed l\u00e9ka\u0159stv\u00ed je p\u00e1te\u0159\u00ed \u010desk\u00e9ho zdravotnictv\u00ed \u2013 ale p\u0159et\u00ed\u017eenou"},"content":{"rendered":"\n

Po 10 letech proto vych\u00e1z\u00ed nov\u00fd N\u00e1rodn\u00ed program komplexn\u00ed intern\u00ed p\u00e9\u010de<\/em><\/p>\n\n\n\n

Praha, 20. 2. 2025 \u2013 Srde\u010dn\u00ed selh\u00e1n\u00ed, cukrovka, vysok\u00fd tlak \u2013 typick\u00e1 trojice nemoc\u00ed, s nimi\u017e se dnes a denn\u011b setk\u00e1vaj\u00ed internist\u00e9 u sv\u00fdch pacient\u016f. Lid\u00ed se dv\u011bma a v\u00edce chronick\u00fdmi chorobami neust\u00e1le p\u0159ib\u00fdv\u00e1. Kapacity 3 000 internist\u016f, kte\u0159\u00ed se o n\u011b staraj\u00ed, jsou t\u00e9m\u011b\u0159 vy\u010derpan\u00e9. L\u00e9ka\u0159i t\u00e9to specializace st\u00e1rnou a mediky se pro obor da\u0159\u00ed nadchnout jen obt\u00ed\u017en\u011b. Interna je n\u00e1ro\u010dn\u00e1 a \u00fahrady od zdravotn\u00edch poji\u0161\u0165oven klesaj\u00ed. Pokud tento obor \u2013 p\u00e1te\u0159 \u010desk\u00e9 medic\u00edny \u2013 tlak nevydr\u017e\u00ed, bude to m\u00edt pro zdravotn\u00ed syst\u00e9m neblah\u00e9 d\u016fsledky. Na to, co je t\u0159eba zm\u011bnit, upozor\u0148uje nov\u00fd N\u00e1rodn\u00ed program komplexn\u00ed intern\u00ed p\u00e9\u010de (NPKIP).<\/strong><\/p>\n\n\n\n

\u201eInterna je p\u00e1te\u0159\u00ed nemocni\u010dn\u00ed p\u00e9\u010de, kterou dopl\u0148uj\u00ed internist\u00e9 ambulantn\u00ed. Obor lze p\u0159irovnat k\u00a0desetiboji, kdy sportovec ovl\u00e1d\u00e1 n\u011bkolik discipl\u00edn. Nesta\u010d\u00ed jen skv\u011ble sk\u00e1kat, mus\u00ed um\u011bt h\u00e1zet i koul\u00ed. Stejn\u011b tak internista pe\u010duje o srdce, pl\u00edce, ledviny, za\u017e\u00edvac\u00ed trakt a dal\u0161\u00ed org\u00e1ny. Jeho role je o to kl\u00ed\u010dov\u011bj\u0161\u00ed, o co rychleji roste po\u010det polymorbidn\u00edch pacient\u016f. Internista je schopen drtivou \u010d\u00e1st p\u00e9\u010de o takto nemocn\u00e9 pokr\u00fdt. Jeho role je nezastupiteln\u00e1<\/em>,\u201c<\/em> \u0159\u00edk\u00e1 prof. MUDr. Richard \u010ce\u0161ka, p\u0159edseda \u010cesk\u00e9 internistick\u00e9 spole\u010dnosti (\u010cIS) \u010cLS JEP.<\/p>\n\n\n\n

Intern\u00ed odd\u011blen\u00ed jsou s 8 807 l\u016f\u017eky na 291 pracovi\u0161t\u00edch v r\u00e1mci \u010cR nejpo\u010detn\u011bj\u0161\u00ed. Podle \u00dastavu zdravotnick\u00fdch informac\u00ed a statistiky \u010cR se p\u00e9\u010de na intern\u00edch odd\u011blen\u00edch nemocnic v roce 2023 dost\u00e1valo 339 722pacient\u016fm. To je ze v\u0161ech obor\u016f nejv\u00edce. Jak uv\u00e1d\u00ed prim. MUDr. Zden\u011bk Monhart, Ph.D., FEFIM, v\u011bdeck\u00fd sekret\u00e1\u0159 \u010cIS \u010cLS JEP, tento n\u00e1por nebude mo\u017en\u00e9 v budoucnu zvl\u00e1dat, pokud se syst\u00e9m nezm\u011bn\u00ed. \u201eSpektrum nemocn\u00fdch se za posledn\u00edch 30 let z\u00e1sadn\u011b zm\u011bnilo. P<\/em>od\u00edl polymorbidn\u00edch pacient\u016f se pohybuje nad 40 % a st\u00e1le roste. Osob se dv\u011bma a v\u00edce chorobami p\u0159ib\u00fdv\u00e1 p\u0159edev\u0161\u00edm ve v\u011bku nad 65 let. A ty p\u0159edstavuj\u00ed 72,2 % v\u0161ech hospitalizac\u00ed na intern\u00e1ch. Abychom p\u00e9\u010di nad\u00e1le zvl\u00e1dali, pot\u0159ebujeme m\u00edt dostatek l\u00e9ka\u0159\u016f a z\u00e1rove\u0148 sn\u00ed\u017eit pracovn\u00ed z\u00e1t\u011b\u017e, aby n\u00e1m neut\u00edkali k jednooborov\u00fdm specializac\u00edm. V ambulantn\u00ed sf\u00e9\u0159e pot\u0159ebujeme vy\u0161\u0161\u00ed \u00fahrady od poji\u0161\u0165oven. Tam je n\u00e1\u0161 obor \u2013 v ekonomick\u00e9m srovn\u00e1n\u00ed s jin\u00fdmi \u2013 znev\u00fdhodn\u011bn,\u201c<\/em> vysv\u011btluje prim. Monhart.<\/p>\n\n\n\n

Podle p\u0159edsedy sekce ambulantn\u00edch internist\u016f \u010cIS MUDr. Tom\u00e1\u0161e Hauera, by modern\u00ed internista m\u011bl m\u00edt dostatek kompetenc\u00ed a b\u00fdt spr\u00e1vn\u011b ohodnocen, jinak se mlad\u00ed do oboru nepohrnou. \u201ePr\u016fm\u011brn\u00fd v\u011bk l\u00e9ka\u0159\u016f na\u0161\u00ed specializace se pohybuje kolem 64 let,\u201c <\/em>\u0159\u00edk\u00e1 MUDr. Hauer. P\u0159ipom\u00edn\u00e1, \u017ee pro st\u00e1t je v\u00fdrazn\u011b levn\u011bj\u0161\u00ed zaplatit pr\u00e1ci jednoho internisty ne\u017e t\u0159\u00ed specialist\u016f. \u201eNa pacienta se d\u00edv\u00e1me komplexn\u011b. Bereme v \u00favahu v\u0161echny jeho neduhy, v\u011bk, rodinn\u00e9 z\u00e1zem\u00ed. Hl\u00edd\u00e1me po\u010det a skladbu l\u00e9k\u016f, kter\u00e9 u\u017e\u00edv\u00e1. Zva\u017eujeme tak\u00e9, jak\u00e1 vy\u0161et\u0159en\u00ed by m\u011bl podstoupit, a zda pro n\u011bj nejsou zbyte\u010dn\u011b zat\u011b\u017euj\u00edc\u00ed,\u201c<\/em> popisuje MUDr. Hauer.<\/p>\n\n\n\n

Internisty slou\u017e\u00edc\u00ed na urgentn\u00edch p\u0159\u00edjmech, tak\u00e9 tr\u00e1p\u00ed rostouc\u00ed po\u010det lid\u00ed, kte\u0159\u00ed p\u0159ijdou s probl\u00e9mem, jen\u017e by mohl pozd\u011bji vy\u0159e\u0161it praktick\u00fd l\u00e9ka\u0159. \u201eSou\u010dasn\u00e1 v\u00fd\u0161e poplatku za o\u0161et\u0159en\u00ed v nemocnici mimo pracovn\u00ed dobu v hodnot\u011b dvou to\u010den\u00fdch piv bohu\u017eel vede p\u0159ibli\u017en\u011b t\u0159etinu lid\u00ed k tomu, \u017ee jdou do nemocnice s trivi\u00e1ln\u00edmi pot\u00ed\u017eemi. Nutnost o\u0161et\u0159ov\u00e1n\u00ed t\u011bchto pacient\u016f v r\u00e1mci \u00fastavn\u00ed pohotovostn\u00ed slu\u017eby p\u0159isp\u00edv\u00e1 k frustraci mlad\u00fdch l\u00e9ka\u0159\u016f v nemocnic\u00edch nap\u0159\u00ed\u010d v\u0161emi akutn\u00edmi obory. Uv\u00edtali bychom proto zv\u00fd\u0161en\u00ed poplatku za pohotovost,\u201c<\/em> \u0159\u00edk\u00e1 MUDr. Monhart, kter\u00fd je sou\u010dasn\u011b prim\u00e1\u0159em Intern\u00edho odd\u011blen\u00ed i odd\u011blen\u00ed Urgentn\u00edho p\u0159\u00edjmu Nemocnice Znojmo. V t\u00e9to nemocnici se po\u010det akutn\u011b p\u0159ijat\u00fdch k hospitalizaci dlouhodob\u011b z\u00e1sadn\u011b nem\u011bn\u00ed. Zvy\u0161uje se v\u0161ak \u010d\u00edslo ambulantn\u011b o\u0161et\u0159en\u00fdch na urgentn\u00edm p\u0159\u00edjmu. V roce 2005 zde internist\u00e9 o\u0161et\u0159ili p\u0159ibli\u017en\u011b 2 000 akutn\u011b nemocn\u00fdch pacient\u016f, v roce 2024 to bylo ji\u017e 8 000 \u2013 tedy \u010dty\u0159n\u00e1sobn\u011b v\u00edc. \u201eKv\u016fli o\u0161et\u0159en\u00ed vy\u0161\u0161\u00edho po\u010dtu \u010dasto polymorbidn\u00edch pacient\u016f, kter\u00e9 je odborn\u011b i \u010dasov\u011b n\u00e1ro\u010dn\u00e9, z\u00e1t\u011b\u017e l\u00e9ka\u0159\u016f roste,\u201c<\/em> vysv\u011btluje prim. Monhart.<\/p>\n\n\n\n

Do budoucna by internist\u016fm mohla pomoci um\u011bl\u00e1 inteligence. Nap\u0159\u00edklad zrychlit diagnostick\u00fd proces, a poskytnout tak l\u00e9ka\u0159\u016fm v\u00edce \u010dasu na komunikaci s pacientem a jeho rodinou. Pr\u00e1v\u011b edukace je podle internist\u016f cenn\u00fdm n\u00e1strojem u polymorbidn\u00edch pacient\u016f, kter\u00e9 lze nasm\u011brovat ke zm\u011bn\u011b \u017eivotn\u00edho stylu. Pokud takov\u00fd pacient zhubne, p\u0159estane kou\u0159it nebo nadm\u011brn\u011b p\u00edt alkohol, jeho chronick\u00e9 pot\u00ed\u017ee se podle expert\u016f v\u00fdrazn\u011b zlep\u0161\u00ed.<\/p>\n\n\n\n

<\/a> \u201eVnit\u0159n\u00edmu l\u00e9ka\u0159stv\u00ed by ulevilo i zv\u00fd\u0161en\u00ed pravomoc\u00ed vysoko\u0161kolsky vzd\u011blan\u00fdch zdravotn\u00edch sester. Roz\u0161\u00ed\u0159en\u00ed kompetenc\u00ed nel\u00e9ka\u0159sk\u00fdch zdravotnick\u00fdch pracovn\u00edk\u016f je nezbytn\u00e9, ale vy\u017eaduje aktivitu ministerstva zdravotnictv\u00ed,\u201c <\/em>uzav\u00edr\u00e1 prim. Monhart.<\/p>\n\n\n\n

Odhad Sv\u011btov\u00e9 zdravotnick\u00e9 organizace p\u0159edpokl\u00e1d\u00e1 n\u00e1r\u016fst pod\u00edlu populace nad 60 let z 12 % v roce 2015 na 22 % v roce 2050. Po\u010det osob ve v\u011bku 80 let a vy\u0161\u0161\u00edm by se m\u011bl od roku 2020 do roku 2050 dokonce ztrojn\u00e1sobit. <\/p>\n","protected":false},"excerpt":{"rendered":"

Po 10 letech proto vych\u00e1z\u00ed nov\u00fd N\u00e1rodn\u00ed program komplexn\u00ed intern\u00ed p\u00e9\u010de Praha, 20. 2. 2025 \u2013 Srde\u010dn\u00ed selh\u00e1n\u00ed, cukrovka, vysok\u00fd tlak \u2013 typick\u00e1 trojice nemoc\u00ed, […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":15130,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-55104","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/55104","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=55104"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/55104\/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=55104"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=55104"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=55104"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}