Spending on healthcare in the Czech Republic has increased by 60% over the past five years, exceeding CZK 456.6 billion last year, according to a report from an analytical commission studying the distribution of finances among insurers and healthcare providers in 2025.
In relative terms, the amount spent on home care and nursing care in residential social care facilities increased the most, rising by more than 130%.
In a year-on-year comparison, total healthcare costs rose by CZK 38.5 billion last year, while revenues increased by CZK 35.2 billion. “Despite high revenue increases, the public health insurance system fell into deficit in 2023,” the analytical commission said in the report.
Insurance companies were tapping into savings from previous years. Last year’s high revenues were driven by wage and salary growth in response to high inflation. In addition, the involvement of a significant number of Ukrainian refugees in the labour market had an impact, the commission said.
In the forthcoming years, however, annual revenue increases are expected to be lower, growing by roughly 7.55% by 2024 and by 4.03% by 2025, according to health insurers’ estimates.
It is also expected that there will be fewer “state insured persons” for whom premiums are paid from the state budget. In 2024, the state paid CZK 2,085 per month for such people, and in 2025 this is forecast to rise to CZK 2,148 per month. However, while in 2022 there were 6.1 million state insured persons due to the arrival of refugees from Ukraine, in 2025 the number is estimated to decrease to 6.045 million.
“In 2024, the impacts of the COVID-19 epidemic are still receding, the war in Ukraine is still going on with all its negative effects, inflation is close to the inflation target, but the central bank remains cautious. The Czech economy is still stagnant, but moderate growth is expected,” the report noted.
Spending in the public health insurance system has increased by an average of almost 10% since 2018. The highest increase of 15.5% was registered between 2019 and 2020, which was influenced by the COVID-19 epidemic. The lowest increase was seen between 2021 and 2022 (a 3.4% increase).
Of the total CZK 456.6 billion spent by insurance companies last year, the most money went to care in hospitals (CZK 230.2 billion), followed by prescription drugs (CZK 44.7 billion), care by outpatient specialists (CZK 40 billion), medicines prescribed in specialised centres (CZK 31.5 billion), and care by general practitioners (CZK 27.2 billion).
Healthcare fields that respond to the ageing population have seen the largest increases in spending since 2018. These include home care and healthcare in residential social care services such as homes for the elderly, where the increase exceeded 130%, and hospice care, where the increase was almost 85%.
The cost of emergency medical services also rose by more than 100%, while the cost of medicines that can only be administered in specialised departments rose by more than 92%. Care provided by general practitioners and outpatient specialists cost over 70% more last year compared to 2018.
