Admissions have declined significantly since 2009 (although they are still above EU averages). Furthermore, patients suffering from asthma or chronic obstructive pulmonary disease have relatively low avoidable admission rates to hospitals. Renewed medical guidelines are in preparation and have the potential to improve primary care effectiveness. Further, the Czech Republic requires only minimal reporting of outcomes on quality of care across the different providers. This means that health insurance funds cannot use quality data for purchasing and that patients are exercising their free choice without access to important information. There have also been some more recent advances with projects in the area of quality and safety assurance, such as the adverse event reporting system and the introduction of sectoral safety targets for all health care providers.