Healthcare from a social science perspective: How economics and sociology can help improve healthcare
Read the interview with Jana Votápková from the Institute of Economic Studies and Professor Dino Numerato from the Institute of Sociological Studies on how social sciences can contribute to more effective healthcare.
The interview was created as part of the faculty podcast De Facto, which has been published in a new concept since April 2025 – its individual episodes reflect current events in the world and at the faculty. Once a month, thematic specials are published, in which several experts from the Faculty of Social Sciences of Charles University comment on topics important not only for the faculty, but also for society. In individual episodes, they offer their professional perspective and understandable explanations of topics that resonate in the public space.
Kristýna Springorum (KS): By dedicating yourself to the economics and sociology of health, you have, I assume, come across cooperation with doctors or scientists from natural sciences. Did it involve any pitfalls? And if so, what were they?
Dino Numerato (DN): Interdisciplinary cooperation has always been a challenge for me. I know that today I am here as a sociologist of health and medicine, but among other things I was also involved in collaboration with cardiologists, neurologists, neonatologists, oncologists – as a participant in a project that was framed by health economics and epidemiology. We did not encounter any major pitfalls. First of all, because this collaboration was agreed in advance. We collaborated with clinics to understand the meaning of certain data, to which we had access through various registries.
When any pitfalls did arise, they were more of everyday matters – for example, the use of language or terms. Part of communication was sharing different perspectives, which sometimes came into conflict and created some tension. But it was always great when that tension could be productive and lead to a result. Collaboration is always a challenge and a long-term process, within which it is good to clarify positions, mainly to respect each other and to develop dialogically.
Jana Votápková (JV): Yes, exactly as Dino said – to respect each other. We have also participated in interdisciplinary projects, for example, we now have a geriatric care project where we collaborate with geriatricians – wonderful people. But we all speak a slightly different language. And sometimes it is rather funny to find common ground with each other. But to that respect, you also need to add mutual education – understanding what the other person does, and then it can work very effectively. When we listen and perceive each other, the outcomes are really nice.
KS: What helped you to speak a common language?
JV: Being honest and saying things to each other straight away. Not assuming that the other person knows something, but explaining the matter straight away, or asking if they know about the methodology, or whether we can look at it together.
KS: Professor Numerato, in 2021–2024, you and your colleagues worked on a project within the Horizon Europe programme called VAX-TRUST, focused on the hesitant attitude towards vaccination as a social phenomenon. Could you briefly describe what you found at the national and international level?
DN: The project’s conclusions were quite diverse. We started from a certain assumption and tried to shift the public and professional debate, which often interpreted the hesitant approach to vaccination as a problem of polarization or even cognitive deficit of parents or citizens.
Specifically, we focused on the relationship between pediatricians – or rather health professionals responsible for vaccination – and parents of children. We monitored their interactions and the process of how parents’ trust in health professionals is formed. One of the main conclusions was that it is important to perceive trust as a two-way relationship. It is not just that parents have trust in the health professional, but the health professional must also have trust in the parents. The absence of this mutual trust can contribute to strengthening uncertainty and distrust on the part of parents.
We also focused on the communication strategies that pediatricians and health professionals use in their daily practice. Together with a colleague from Italy, I led a specific work package dedicated to ethnographic research directly in the offices. In total, we conducted about 460 hours of observation in different countries as part of the project. Thanks to this, we understood the everyday dynamics of communication and discovered how important it is for pediatricians to be able to “translate” the professional language, which often causes uncertainty, into an understandable form. This can include visualizations, metaphors, or an approach that shows parents that the healthcare professional is also a parent and can perceive the situation from a similar perspective. Although parents often have some uncertainty, the key is to talk about it openly without it being perceived as a cognitive weakness.
KS: Dr. Votápková, you are now the responsible director for Charles University in a project that is also analyzing the current mechanisms of financing care in Europe within the Horizon Europe program. Could you briefly describe the situation you started from and what problems the healthcare system is facing in our country and throughout Europe?
JV: We are the main coordinators of the package that deals with cross-border healthcare. The idea originated with my colleague Anne Spranger. We met at the European Observatory on Health Systems and Policies – she comes from Saxony, I have been living in the Šluknov region for several years. At one meeting we discovered that healthcare in border areas is a problem not only in the Czech Republic, but also in Germany. This led us to the conclusion that when we have a problem on both sides, there is a potential for comparative advantages. By joining forces and analyzing the situation, we can contribute to better access to healthcare, especially in border areas, which are often neglected by the center.
However, the situation in the European Union is not simple. Although healthcare workers – doctors and nurses – can work freely in any member state, healthcare itself is not so portable. There are only a few options for receiving healthcare abroad. If you are traveling on vacation or for work, you can use the blue European Health Insurance Card. Under certain conditions, this card reimburses you for healthcare from the public system as residents of that state. However, if you are traveling specifically for healthcare, there are only two options: ask your health insurance company in advance or pay the costs yourself and then ask the insurance company for a refund – but only up to the amount of Czech prices. In the case of Germany or Austria, this often means a problem due to different purchasing power parity.
That is why we are trying to compare the prices of hospitalizations between different financing systems. Using an economic model, we are trying to model the most accurate price difference between types of hospitalizations, because it is not possible to simply compare two numbers – how much does an appendectomy cost in the Czech Republic and Germany, or how much does a vaginal birth cost. Clinical complexity and cost are different in both countries.
We hope that this will contribute to the negotiation process of health insurance companies. As part of the project, our colleague, a lawyer, conducted an analysis and proposed a change to the reimbursement decree, which will enter into force on January 1, 2026. From then on, health insurance companies will be able to conclude contracts with foreign providers if it is beneficial to them. At the moment, however, insurance companies do not know the exact interval in which they can negotiate – we have a German price, a Czech price and we need to find out the real difference. This is exactly what we are trying to calculate for hospitalizations. In a follow-up project, we would like to focus on outpatient care as well.
Listen to the full podcast below or on Spotify or Apple podcasts (only in Czech).
