Indications and contraindications

 

 

 

Basic healing stay

 

Repeated healing stay

VI/2

Polyneuropathy with paretic manifestations

 

Complex spa care

 

Length of stay 28 days

 

Poor palsies with disability of 0 to 3 degree of muscular test with demonstrable disability according to  electromyography (EMG).

 

Extension possibility

 

Length of stay 28 days

 

Poor palsies with disability of 0 to 3 degree of muscular test with demonstrable disability according to electromyography (EMG).

 

Extension possibility

1 x over 24 months.

 

Contributory spa care

 

Length of stay 21 days

 

Other.

 

Length of stay 21 days   

 

Other.

 

Treatment recommending specialist 

 

 

Neurologist or rehabilitation physician

 

 

 

VI/3

Root syndromes with irritative - vanish root syndrome

 

Complex spa care

 

Length of stay 21 days

 

Directly following hospitalization at the neurological or rehabilitation care unit (up to 3 months after the end of the hospitalization), or in case where improvement is observed after 6 weeks of continuous outpatient rehabilitation care, where the indication for neurosurgery or spondylosurgery has been ruled out.

 

Extension possibility

 

 

 

Contributory spa care

 

 

 

Length of stay 21 days

 

Treatment recommending specialist 

 

 

Neurosurgeon, neurologist, or rehabilitation physician

 

   

VI/6

Conditions after injuries and surgeries of the brain, spinal cord and peripheral nervous system with movement disorders with signs of recurring function

 

Complex spa care

 

Length of stay 28 days

 

Persistent paresis with gradual modification of functions.

 

Extension possibility

Not later than 6 months after the surgery or injury.

 

Length of stay 28 days

 

Within 36 months from the start of the basic stay, if severe to moderate palsy persists and if there is an expectation of the health status improvement.

 

Extension possibility

 

Contributory spa care

 

 

 

Length of stay 21 days   

 

Other.

 

Treatment recommending specialist 

 

 

Neurosurgeon, neurologist, spondylosurgeon, orthopaedist, or rehabilitation physician

 

   

VI/8

Nervosvalová onemocnění primární, sekundární a degenerartivní

 

Complex spa care

 

Length of stay 28 days

 

Extension possibility

 

Length of stay 28 days

 

Extension possibility

1 x per year

 

Treatment recommending specialist 

 

 

Neurologist or rehabilitation physician

 

   

VI/9

Syringomyelia with paretic manifestations

 

Complex spa care

 

Length of stay 21 days

 

Length of stay 21 days

 

1x per 24 month.

 

Contributory spa care

 

 

 

Length of stay 21 days 

 

Treatment recommending specialist 

 

 

Neurologist or rehabilitation physician

   

VI/11

Parkinson's disease (it does not apply to Parkinson's syndrome and secondary extrapyramidal syndrome treated by psychopharmaceuticals)

 

Complex spa care

 

Length of stay 21 days

 

Length of stay 21 days

 

If there is an expectation of improving health and maintaining self-sufficiency.

 

1 x over 24 months.

 

Treatment recommending specialist 

 

Neurologist or rehabilitation physician

   

 

 for 14 days in indicated cases 

The indicative list for healing-rehabilitation spa care is included in Act No. 1/2015 amending Act No. 48/1997 Coll., On public health insurance, and it contains the basic rules for the provision of spa care.

 

 

 

Basic healing stay

 

Repeated healing stay

VII/1

Rheumatoid arthritis in th 1st to 4th stage of rheumatoid arthritis evaluation including juvenile arthritis, continuously treated in outpatient care

 

Complex spa care

 

Length of stay 28 days

 

Treatment from the 2nd stage of the disease with class b disability.

 

Extension possibility

 

Length of stay 28 days

 

Treatment from the 2nd stage of the disease with class b disability.

 

Extension possibility
1 x per year

 

Contributory spa care

 

Length of stay 21 days

 

Disease without prior exacerbation and treatment in case of lower stages of the disease than the 2nd stages with class b functional impairment.

 

Length of stay 21 days   

 

Disease without prior exacerbation and treatment in case of lower stages of the disease than the 2nd stages with class b functional impairment.

 

Treatment recommending specialist 

 

Rehabilitation physician or rheumatologist

   

VII/2

Ankylosing spondylitis (Bechterew's disease), continuously treated in outpatient care

 

Complex spa care

 

Length of stay 28 days

 

From the 2nd stage of the disease with class b functional impairment, in the continuous care of a rheumatologist or rehabilitation physician.

 

Extension possibility

 

Length of stay 28 days

 

From the 2nd stage of the disease with class b functional impairment, in the continuous care of a rheumatologist or rehabilitation physician.

 

Extension possibility

 

Contributory spa care

 

Length of stay 21 days

 

Other.

 

Length of stay 21 days   

 

Treatment recommending specialist 

 

Rehabilitation physician or rheumatologist

   

VII/3

Other seronegative spondartritis consistently treated in outpatient care (psoriatic arthritis, Reiter's syndrome, enteropathic arthritis, reactive - parainfectious), secondary arthritis, continuously treated in outpatient care

 

Complex spa care

 

Length of stay 28 days

 

Impairment of spine of the 2nd and higher stage according to classification for ankylosing spondylitis. Chronic arthritis of peripheral joints from class II b. functional impairment according to the classification stages for rheumatoid arthritis.

 

Extension possibility

 

Length of stay 28 days

 

Impairment of spine of the 2nd and higher stage according to classification for ankylosing spondylitis. Chronic arthritis of peripheral joints from class II b. functional impairment according to the classification stages for rheumatoid arthritis.

 

Extension possibility
Not earlier than 12 months from the start of the basic stay and then  1x during the calendar year.

 

Contributory spa care

 

Length of stay 21 days

 

Other.

 

Length of stay 21 days   

 

Other.

 

Treatment recommending specialist 

 

Rehabilitation physician or rheumatologist

   

VII/4

Out of joint rheumatism, continuously treated in outpatient care. Diffuse diseases of the connective tissue, continuously treated in outpatient care (systemic lupus erythematosus, scleroderma, polymyositis, dermatomyositis, Sjogren's syndrome and other overlapping syndromes).

 

Complex spa care

 

Length of stay 28 days


In remission.

 

Extension possibility

 

Length of stay 28 days

 

In remission.

 

Extension possibility
1 x over 24 months.
In the exacerbation of the basic disease after the completion of the last comprehensive treatment of the acute phase even before the 24 months elapse.

 

Contributory spa care

 

 

 

Length of stay 21 days   

 

Other.

 

Treatment recommending specialist 

 

Rehabilitation physician or rheumatologist

   

VII/6

Painful syndromes of tendons, mucous sheets of tendons, bursas, muscle ligaments or joints (including diseases caused by the effects of vibration and long-term, excessive overloading as a occupational illness under another legal regulation that provides a list of occupational diseases) 

 

Complex spa care

 

Length of stay 21 days

 

Occupational illness under another legal regulation that provides a list of occupational diseases)

 

Length of stay 21 days

 

Occupational illness under another legal regulation that provides a list of occupational diseases)
 

Within 12 months from the start of the basic stay.

 

Contributory spa care

 

Length of stay 21 days

 

Other.

 

Length of stay 21 days 

 

Other.

 

Treatment recommending specialist 

 

Orthopaedist, traumatologist, rehabilitation physician or occupational physician

   

VII/7

Koxarthrosis, gonarthrosis in the outpatient care of an orthopedist and rehabilitation doctor

 

Complex spa care

 

Length of stay 21 days

 

From III. degree of Kellgren's disease assessment. From II. degree of functional disability B) in case of a painful form with frequent exacerbations and rapid progression or repeated inflammatory irritation..

 

Possibility of extension.

 

Length of stay 21 days

 

From III. degree of Kellgren's disease assessment. From II. degree of functional disability B)in case of a painful form with frequent exacerbations and rapid progression or recurrent inflammatory irritation and it is expected to improve momentum and maintain self-sufficiency. Once per 24 months. Conditions contraindicated for surgery - Once per 24 months

 

Contributory spa care

 

Length of stay 21 days

 

Differs, unless continuous outpatient rehabilitation care is effective.

 

Length of stay 21 days 

 

I - II. st. illness unless systematic ambulatory care is effective, provided long-term pharmacotherapy is reduced or surgical solution is being postponed. Conditions contraindicated for surgery if systematic outpatient care is not effective.

 

Treatment recommending specialist 

 

Ortoped, traumatolog, rehabilitační lékař nebo revmatolog

   

VII/8

Arthrosis in other localizations, arthropathy

 

Complex spa care

 

Length of stay 21 days

 

Painful form with frequent exacerbations.

 

Length of stay 21 days

 

In case of  a painful form with frequent exacerbations and rapid progression, or in a case of a repeated inflammatory irritation; always under the condition of improving momentum and maintaining self-sufficiency. Once per 24 months

 

Contributory spa care

 

 

 

Length of stay 21 days 

 

Differs, if systematic outpatient care is not effective, provided long-term pharmacotherapy is reduced.

 

Treatment recommending specialist 

 

Orthopedist, rehabilitation doctor or rheumatologist

   

VII/9

Chronic vertebrogenic algic syndrome of functional origin in continuous ambulatory rehabilitation care

 

Complex spa care

 

Length of stay 21 days

 

Chronic vertebrogenic algic syndrome of functional origin in direct relation to hospitalization (up to 3 months after hospitalization) or cases of limited improvement after 6 weeks of continuous ambulatory rehabilitation care.

 

 

 

Contributory spa care

 

Length of stay 21 days

 

Other

 

 

 

Treatment recommending specialist 

 

rehabilitation doctor

   

VII/10

Conditions after orthopedic surgery using joint replacement

 

Complex spa care

 

Length of stay 28 days

 

Immediately as soon as the patient  is in medical rehabilitation, no later than 3 months after surgery or, in case of postoperative complications, within 6 months after surgery. 

 

Possibility of extension.

 

 

 

Contributory spa care

 

 

 

Length of stay 21 days 

 

Treatment recommending specialist 

 

 

Neurosurgeon, neurologist, orthopedist, rehabilitation doctor or traumatologist

   

VII/11

Stavy po úrazech pohybového ústrojí a po ortopedických operacích, včetně stavů po operacích meziobratlových plotének a stenóz kanálu páteřního, pokud není soustavná ambulatní nebo lůžková rehabilitační péče efektivní

 

Complex spa care

 

Length of stay 28 days

 

Immediately as soon as the condition permits the medical rehabilitation, but no later than 6 months after the injury or surgery, in the case of post-operative complications within 12 months of the operation..

 

Possibility of extension

 

Length of stay 28 days

 

No later than 24 months after surgery of the intervertebral discs, spinal canal stenosis, or trauma in the event of persistent severe motility disorder and self-sufficiency limitation, improvement in health is anticipated.

 

Contributory spa care

 

 

 

Length of stay 21 days 

 

Differs in case of Operational Treatment Syndrome (FBS).

 

Treatment recommending specialist 

 

Neurosurgeon, neurologist, orthopedist, rehabilitation doctor or traumatologist

   

VII/11

Conditions after injuries of the locomotor system and after orthopedic operations, including conditions after operations of the intervertebral discs and stenoses of the spinal canal, unless systematic ambulatory or inpatient rehabilitation care is effective

 

Complex spa care

 

Length of stay 21 days

 

Within 12 months after surgery.

 

 

 

Contributory spa care

 

 

 

 

 

Treatment recommending specialist 

 

 

Surgeon, internist, orthopedist, or rehabilitation doctor

   

 

 for 14 days in indicated cases 

The indicative list for healing-rehabilitation spa care is included in Act No. 1/2015 amending Act No. 48/1997 Coll., On Public Health Insurance, and it contains the basic rules for the provision of spa care.

 

 

 

Basic healing stay

 

Repeated healing stay

II/1

Symptomatic ischemic heart disease

 

Contributory spa care

 

Length of stay 21 days

 

Length of stay 21 days 

 

Treatment recommending specialist 

 

Internist, cardiologist, general practitioner, or rehabilitation physician

   

II/2

Condition after myocardial infarction

 

Complex spa care

 

Length of stay 28 days

 

Extension possibility
Within 12 months after the onset of myocardial infarction.

 

 

 

Treatment recommending specialist 

 

Internist, cardiologist, or rehabilitation physician

   

II/3

Hypertensive disease of 2nd to 3rd degree of hypertensive disease assessment

 

Complex spa care

 

Length of stay 28 days

 

3rd degree hypertension, complicated by ICHS, chronic heart failure, CMP, TIA, chronic renal insufficiency due to vascular nephrosclerosis.
 

Extension possibility

 

 

 

Contributory spa care

 

Length of stay 21 days

 

Other.

 

Length of stay 21 days 

 

Hypertensive disease refractory

 

Treatment recommending specialist 

 

Internist, cardiologist, or rehabilitation physician

   

II/4

Diseases of limb arteries on the basis of II b atherosclerosis or inflammation

 

Complex spa care

 

Length of stay 21 days

 

Diseases of limb arteries on the basis of IIb atherosclerosis.

 

Length of stay 21 days

 

Diseases of limb arteries on the basis of IIb atherosclerosis.
 

Within 18 months of the start of the basic stay, unless invasive treatment is possible. Differs in case that invasive treatment is not possible.

 

Contributory spa care

 

Length of stay 21 days

 

Other.

 

Length of stay 21 days 

 

Other

 

Treatment recommending specialist 

 

Angiologist, internist, or rehabilitation physician

   

II/5

Functional disorders of peripheral blood vessels and conditions after thrombosis, chronic lymphatic oedema

 

Complex spa care

 

Length of stay 21 days

 

Functional disorders of peripheral blood vessels as occupational diseases under another legislation which provides a list of occupational diseases
 

At the earliest, 3 months after the acute stage has disappeared.

 

 

 

Contributory spa care

 

Length of stay 21 days

 

Other.


Functional disorders of peripheral blood vessels and conditions after thrombosis, not sooner than 3 months after the end of the acute stage.

 

Length of stay 21 days 

 

Treatment recommending specialist 

 

Angiologist, internist, cardiologist, physician, or rehabilitation physician

   

II/6

Conditions after cardiac surgeries such as: valve replacement by bioprosthesis or metallic prosthesis, valve reconstructions, atrial septal or chamber defects, surgical myocardial revascularization - coronary artery bypass (CABG), surgeries of congenital heart defects in adults, left ventricular outflow surgery, heart tumour surgery, pericardial surgery, or thoracic aortic surgery

 

Complex spa care

 

Length of stay 28 days

 

Direct transfer from a health care facility of a bed care provider or within 3 months from a surgery.
 

Extension possibility

 

 

 

Contributory spa care

 

Length of stay 21 days

 

Other.

 

Length of stay 21 days 

 

Within 12 months from the start of the basic stay.

 

Treatment recommending specialist 

 

Heart surgeon, cardiologist or rehabilitation physician; medical doctor

   

II/7

Conditions after percutaneous transluminal coronary angioplasty (PTCA)

 

Contributory spa care

 

Length of stay 21 days

 

Within 3 months after percutaneous transluminal coronary angioplasty (PTCA).

 

 

 

Treatment recommending specialist 

 

Heart surgeon, cardiologist or rehabilitation physician; medical doctor

   

II/8

Conditions after reconstruction and revascularization surgeries on the artery system outside the heart and thoracic aorta. Conditions after percutaneous transluminal angioplasty

 

Complex spa care

 

Length of stay 21 days

 

Conditions after reconstruction and revascularization surgeries on the artery system outside the heart within 4 months of surgery.

 

 

 

Contributory spa care

 

Length of stay 21 days

 

Within 4 to 12 months after percutaneous transluminal angioplasty.

 

 

 

Treatment recommending 

 

Angiologist, surgeon, internist, cardiologist, or rehabilitation physician

   

II/9

Conditions after heart transplant

 

Complex spa care

 

Length of stay 28 days

 

Direct transfer from a health care facility of a bed care provider or within 12 months from a surgery.
 

Extension possibility

 

Length of stay 28 days

 

Within 12 months from the start of the basic stay.

Extension possibility

 

Treatment recommending specialist 

 

Heart surgeon, cardiologist or rehabilitation physician; medical doctor 

   

 

 for 14 days in indicated cases 

The indicative list for healing-rehabilitation spa care is included in Act No. 1/2015 amending Act No. 48/1997 Coll., On public health insurance, and it contains the basic rules for the provision of spa care.

 

 

 

Basic healing stay

 

Repeated healing stay

IV/1

Diabetes mellitus

 

Complex spa care

 

Length of stay 21 days

 

Conditions with complications (microangiopathy and macroangiopathy, neuropathy).

 

 

 

Contributory spa care

 

Length of stay 21 days

 

Other.

 

Length of stay 21 days   

 

Conditions with complications (microangiopathy and macroangiopathy, neuropathy).

 

Treatment recommending specialist 

 

Diabetologist and endocrinologist or rehabilitation physician

   

 

 for 14 days in indicated cases 

The indicative list for healing-rehabilitation spa care is included in Act No. 1/2015 amending Act No. 48/1997 Coll., On Public Health Insurance, and it contains the basic rules for the provision of spa care.

  • Infectious diseases transmitted from person to person and bacillus carrying If any disease indicated for spa rehabilitation care is associated with TBC of the respiratory tract or other form of TBC, spa treatment rehabilitation care may be suggested and authorized only after proper termination of the treatment with antituberculotics and with the approval of a pneumologist.
  • All illnesses in the acute stage and conditions that can reasonably be expected to destabilize the state of health.
  • Clinical signs of circulatory failure, it does not apply to group II indications, malignant arrhythmias and sustained hypertension above 120 mm Hg of diastolic pressure.
  • Conditions after deep thrombosis within 3 months after the disease has ceased, conditions after surface thrombophlebitis up to 6 weeks after the disease has ceased.
  • Repeated profuse bleeding of any aetiology in the last 12 months, treatment is possible after positive statement of the hematologist.
  • Cachexia of various aetiology that prevents intensive rehabilitation (BMI less than 16.5). It does not concern indication groups IX and XXIX - anorexia.
  • Malignant tumors during and after the treatment with clinically detectable signs of disease activity. The cases with no provable signs of progression or where progression of malignant disease is slow and long-term, and the nature of the cancer is not an obstacle to the indicated spa therapeutic rehabilitation care of other concurrent illness are not contraindicated. Long-term hormonal anticancer therapy is not contraindication. Oncological malignanct disease within 2 years after the end of the treatment is a contraindication to the use of a natural healing spring - natural mineral water with radon.
  • Uncompensated epilepsy. In the insured person with epilepsy, treatment can be provided based on the positive statement of the neurologist who has the insured person with epilepsy in dispensary care. For indication groups VI and XXVI, epilepsy is not contraindicated.
    • Active attacks or phases of psychoses and mental disorders with asocial symptoms, reduced communication, or inability to adhere to the treatment and internal order of the healthcare facility of the spa therapeutic rehabilitation care provider, transient states of confusion, dementia. Reduced communication is not a contraindication for indication group VI in the case of CNS involvement, and for Indication Groups IX, XXVI and XXIX if it is part of the clinical picture of the disease in question, if psychological condition allows spa health rehabilitation care.
  • Alcohol addiction and addiction to addictive substances. This does not apply to spa treatment rehabilitation care, which immediately follows hospitalization after surgery, when this spa treatment rehabilitation care is an integral part of postoperative care.
  • Nicotine addiction in insured persons with group II, III / 1, III / 2, IV, V. indications Does not apply to spa treatment rehabilitation care which immediately follows hospitalization for the disease, and this spa treatment rehabilitation care is an integral part of postoperative care.
  • 2nd and 3rd degree of urine incontinency and stool incontinency. It does not apply to the disease indication groups VI, VIII/3, XXVI, XXVIII/1, XXVIII/2, XXVIII/6. Anus praeternaturalis (stomia) is not a contraindication to treatment, it only limits the performance of treatment procedures.
  • Pregnancy.