Croatian healthcare system in transition, from the perspective of users

Health care funding reforms in Croatia: A case of mistaken priorities

“…Another consideration might be the high expectations the population holds of the health care system. Prior to the transition to market economy, the health care system (although lacking in financial resources) was characterised by a high level of equity and services virtually free at the point of use [14]. Citizens' dissatisfaction with market elements and cost containment measures gradually introduced into the system has resulted in considerable pressures towards politicians and the state government that have hampered the introduction of "unpopular" but necessary reforms.…”

“…While these have partly been covered by loans and government subsidies, they have been accompanied by a process of substantial and systematic reduction of rights to free health care services and introducing increasing co-payments to virtually all services provided and rationing [14]. Combined with other health care reforms it has lead to a lower standard of health care, which is particularly noticeable in preventive services.…”

“…Over the past ten years the government has attempted to stimulate cost containment through various measures aimed at providers including rationing of services, limitation of services provided, penalties for excessive prescribing or referrals, a limited list of approved drugs, reductions in health budgets; but with only limited success and acceptance from providers and the public [14,50]. Thus, pressured by constant health care deficits, the impression is that the government has kept the weight of its focus on the demand side of the market reducing the public part of expenditure and increasing copayments in order to address excessive demand for unnecessary health care services and to collect additional revenue.…”

Improving comprehension of informed consent

“…Patients' expectations cover also the wish for more information, in understandable language, about the medicines prescribed and the risks involved in the treatments [7]. In the hospital setting, recent accreditation and quality requirements are defined from patient's rights perspective as well, indicating 'the need to deliver culturally and linguistically appropriate services, recognizing that the delivery of these services is more than simply a patient's right, but is, in fact, a key factor in the safety and quality of patient care' [8].…”

Zdravstvena politika Hrvatske. U vrtlogu reformi i suvremenih društvenih izazova

“…Drugo, privatna potrošnja uključuje djelomično (odnosno samo u mjeri u kojoj građani u anketi zaista i prijavljuju takva izdvajanja) i različite oblike neformalnog plaćanja. Istraživanja koja fokusiraju taj dio troškova relativno su rijetka, no studija iz 1994. godine kazuje da je 14% ispitanih trošilo za darove za medicinsko osoblje, a 8% je izravno dodatno plaćalo za medicinske usluge (Mastilica, Božikov, 1999.;Mastilica, Kušec, 2005.). Struktura troškova prikazana u grafi konu 2. govori da je najveći udio troškova bolničke zaštite, a potom slijede troškovi lijekova na recept, specijalističko-konzilijarne zdravstvene zaštite te primarne zaštite i stomatologije.…”