Comparing cost-sharing practices for pharmaceuticals and health care services among four central European countries

The paper reviews the existing cost-sharing practices in four Central European countries namely the Czech Republic, Hungary, Poland and Slovakia focusing on patient co-payments for pharmaceuticals and services covered by the social health insurance. The aim is to examine the role of cost-sharing arrangements and to evaluate them in terms of efficiency, equity and public acceptance to support policy making on patient payments in Central Europe. Our results suggest that the share of out-of-pocket payments in total health care expenditure is relatively high (24–27%) in the countries examined. The main driver of these payments is the expenditure on pharmaceuticals and medical devices, which share exceeds 70% of the household expenditure on health care. The four countries use similar cost-sharing techniques for pharmaceuticals, however there are differences concerning the measure of exemption mechanisms for vulnerable social groups. Patient payment policies for health care services covered by the social health insurance are also converging. All the four countries apply co-payments for dental care, some hotel services or in the case of free choice of physician. Also the countries (except for Poland) tried to extend co-payments for physician services and hospital care. However, their introduction met strong political opposition and unpopularity among public.

Graled (Grapevine leaf digitalization) Software for the Detection and Graphic Reconstruction of Ampelometric Differences Between Vitis Leaves

Raster graphic ampelometric software was not exclusively developed for the estimation of leaf area, but also for the characterization of grapevine (Viti vinifera L.) leaves. The software was written in C-Hprogramming language, using the C-1-1- Builder 2007 for Windows 95-XP and Linux operation systems. It handles desktop-scanned images. On the image analysed with the GRA.LE.D., the user has to determine 11 points. These points are then connected and the distances between them calculated. The GRA.LE.D. software supports standard ampelometric measurements such as leaf area, angles between the veins and lengths of the veins. These measurements are recorded by the software and exported into plain ASCII text files for single or multiple samples. Twenty-two biometric data points of each leaf are identified by the GRA.LE.D. It presents the opportunity to statistically analyse experimental data, allows comparison of cultivars and enables graphic reconstruction of leaves using the Microsoft Excel Chart Wizard. The GRA. LE.D. was thoroughly calibrated and compared to other widely used instruments and methods such as photo-gravimetry, LiCor L0100, WinDIAS2.0 and ImageTool. By comparison, the GRA.LE.D. presented the most accurate measurements of leaf area, but the LiCor L0100 and the WinDIAS2.0 were faster, while the photo-gravimetric method proved to be the most time-consuming. The WinDIAS2.0 instrument was the least reliable. The GRA.LE.D. is uncomplicated, user-friendly, accurate, consistent, reliable and has wide practical application.