{"id":46644,"date":"2016-02-08T12:33:53","date_gmt":"2016-02-08T11:33:53","guid":{"rendered":"http:\/\/zakrasnejsivimperk.cz\/?p=46644"},"modified":"2016-02-26T10:38:59","modified_gmt":"2016-02-26T09:38:59","slug":"infoservis-vysetreni-crp-hradi-vseobecna-zdravotni-pojistovna-detem-i-dospelym","status":"publish","type":"post","link":"https:\/\/zakrasnejsivimperk.cz\/?p=46644","title":{"rendered":"ODPOV\u011a\u010e NA OT\u00c1ZKU: Vy\u0161et\u0159en\u00ed CRP V\u0161eobecn\u00e1 zdravotn\u00ed poji\u0161\u0165ovna hrad\u00ed a pacient za n\u011bj nic neplat\u00ed"},"content":{"rendered":"<h6 style=\"text-align: justify;\"><em><strong>Hrad\u00ed V\u0161eobecn\u00e1 zdravotn\u00ed poji\u0161\u0165ovna (VZP) vy\u0161et\u0159en\u00ed CRP, aby se zjistilo, zda je t\u0159eba nasadit antibiotika? Nebo si ho m\u00e1 pacient platit?<\/strong><\/em><\/h6>\n<p style=\"text-align: justify;\">Vy\u0161et\u0159en\u00ed CRP poji\u0161\u0165ovna hrad\u00ed a\u00a0pacient za n\u011bj nic neplat\u00ed, a\u0165 je provedeno p\u0159\u00edmo l\u00e9ka\u0159em v\u00a0ordinaci, nebo v\u00a0extern\u00ed laborato\u0159i. Po\u017eadovat po pacientovi platbu by l\u00e9ka\u0159 mohl pouze v\u00a0p\u0159\u00edpad\u011b, \u017ee k\u00a0vy\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\u00a0bakteri\u00e1ln\u00ed infekce, a\u00a0to hlavn\u011b p\u0159ed nasazen\u00edm antibiotick\u00e9 l\u00e9\u010dby, kter\u00e1 by u\u00a0virov\u00e9ho onemocn\u011bn\u00ed byla zbyte\u010dn\u00e1, ev.\u00a0pro n\u00e1slednou kontrolu \u00fasp\u011b\u0161nosti t\u00e9to l\u00e9\u010dby.<\/p>\n<p style=\"text-align: justify;\">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.\u00a0v\u00a0re\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\u00a0dorost i\u00a0v\u0161eobecn\u00fdm praktick\u00fdm l\u00e9ka\u0159\u016fm. Hrad\u00ed ho i\u00a0u\u00a0l\u00e9ka\u0159sk\u00e9 slu\u017eby prvn\u00ed pomoci (LSPP).<\/p>\n<p style=\"text-align: justify;\">V\u00fdkon s\u00a0k\u00f3dem 02230 \u2013 \u201eKvantitativn\u00ed stanoven\u00ed CRP (POCT)\u201c ale m\u016f\u017ee m\u00edt l\u00e9ka\u0159 ve smlouv\u011b s\u00a0VZP 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\u00a0o\u00a0za\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\u00a0d\u016fsledku pozd\u011b \u010di naopak zbyte\u010dn\u011b nasazen\u00e9 terapie po\u0161kodit pacienta.<\/p>\n<p style=\"text-align: justify;\">L\u00e9ka\u0159 mus\u00ed zdravotn\u00ed poji\u0161\u0165ovn\u011b p\u0159edlo\u017eit doklad o\u00a0absolvov\u00e1n\u00ed certifikovan\u00e9ho \u0161kolen\u00ed o\u00a0t\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\u00a0\u00dastav l\u00e9ka\u0159sk\u00e9 biochemie 1.\u00a0LF\u00a0UK a\u00a0VFN 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\u00a0prov\u00e1d\u011bn\u00ed laboratorn\u00edch vy\u0161et\u0159en\u00ed v\u00a0re\u017eimu POCT a\u00a0zaji\u0161t\u011bna vnit\u0159n\u00ed kontrola kvality v\u010detn\u011b \u0159\u00e1dn\u011b veden\u00e9ho z\u00e1znamu o\u00a0n\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\u00a0syst\u00e9mu mezilaboratorn\u00edch porovn\u00e1vac\u00edch zkou\u0161ek.<\/p>\n<p style=\"text-align: justify;\">V\u00fdkon tedy nen\u00ed nasmlouv\u00e1n automaticky ka\u017ed\u00e9mu praktick\u00e9mu l\u00e9ka\u0159i. I\u00a0l\u00e9ka\u0159, kter\u00fd nem\u00e1 p\u0159\u00edslu\u0161n\u00fd v\u00fdkon uveden\u00fd ve smlouv\u011b s\u00a0poji\u0161\u0165ovnou, v\u0161ak m\u016f\u017ee pacientovi zajistit vy\u0161et\u0159en\u00ed CRP v\u00a0laboratorn\u00edm re\u017eimu, tj.\u00a0odesl\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\u00a0p\u0159\u00edpad\u011b pot\u0159eby i\u00a0l\u00e9ka\u0159i ostatn\u00edch odbornost\u00ed.<\/p>\n<p style=\"text-align: justify;\">Na variantu, \u017ee praktick\u00fd l\u00e9ka\u0159 provede vy\u0161et\u0159en\u00ed CRP p\u0159\u00edmo v\u00a0ordinaci jako &#8220;nadstandard&#8221; a\u00a0chce 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\u00a0poji\u0161\u0165ovnou, a\u00a0pak zde chyb\u00ed garance kvality, zaru\u010den\u00e1 spln\u011bn\u00edm podm\u00ednek pro nasmlouv\u00e1n\u00ed dan\u00e9ho v\u00fdkonu.<\/p>\n<p><strong>Old\u0159ich TICH\u00dd,\u00a0vedouc\u00ed tiskov\u00e9ho odd\u011blen\u00ed a tiskov\u00fd mluv\u010d\u00ed VZP<\/strong><\/p>\n<p>&nbsp;<\/p>\n<h6>Co je to CRP<\/h6>\n<p style=\"text-align: justify;\">C- reaktivn\u00ed protein (CRP) je b\u00edlkovinou akutn\u00edho z\u00e1n\u011btu, a tedy vysoce citliv\u00fd parametr z\u00e1n\u011btu. Je sou\u010d\u00e1st\u00ed\u00a0 reakce akutn\u00ed f\u00e1ze imunitn\u00edho obrann\u00e9ho syst\u00e9mu. Jeho hladina v krvi se zvy\u0161uje u v\u0161ech druh\u016f bakteri\u00e1ln\u00edch z\u00e1n\u011btliv\u00fdch proces\u016f, a to ji\u017e za 6-12 hodin od za\u010d\u00e1tku z\u00e1n\u011btu. Vy\u0161et\u0159en\u00ed CRP je proto pova\u017eov\u00e1no za nej\u010dast\u011bji ordinovan\u00e9 vy\u0161et\u0159en\u00ed ve vysp\u011bl\u00fdch zem\u00edch z\u00e1padn\u00edho sv\u011bta, a to od \u00farovn\u011b praktick\u00e9ho l\u00e9ka\u0159e a\u017e po vysoce specializovan\u00e1 pracovi\u0161t\u011b.<\/p>\n<p>Hladina CRP v krvi z\u00e1vis\u00ed na stupni z\u00e1n\u011btu je ve srovn\u00e1n\u00ed s jin\u00fdmi klinicky vyu\u017e\u00edvan\u00fdmi zn\u00e1mkami z\u00e1n\u011btu, jako jsou sedimentace nebo hladina b\u00edl\u00fdch krvinek, daleko pru\u017en\u011bj\u0161\u00ed.<\/p>\n<p>Pou\u017e\u00edv\u00e1 se k rozli\u0161en\u00ed bakteri\u00e1ln\u00ed a virov\u00e9 infekce.<br \/>\nJeho v\u00fd\u0161e souvis\u00ed s m\u00edrou posti\u017een\u00ed tk\u00e1n\u00ed z\u00e1n\u011btem.<br \/>\nPom\u00e1h\u00e1 rozhodnout o p\u0159\u00edpadn\u00e9m nasazen\u00ed antibiotik.<br \/>\nSlou\u017e\u00ed k hodnocen\u00ed efektivity l\u00e9\u010dby antibiotiky.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Hrad\u00ed V\u0161eobecn\u00e1 <\/p>\n","protected":false},"author":2,"featured_media":46647,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19],"tags":[],"jetpack_featured_media_url":"https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2016\/02\/08\/vzp-3.jpg","_links":{"self":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/46644"}],"collection":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=46644"}],"version-history":[{"count":13,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/46644\/revisions"}],"predecessor-version":[{"id":46660,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/46644\/revisions\/46660"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/media\/46647"}],"wp:attachment":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=46644"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=46644"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=46644"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}