BMJ  2005;331:223-226 (23 July), doi:10.1136/bmj.331.7510.223

Education and debate

Croatian healthcare system in transition, from the perspective of users

Miroslav Mastilica, associate professor1, Sanja Kusec, master of science in public health2

1 Department of Medical Sociology, Andrija Stampar School of Public Health, Medical School, University of Zagreb, Rockefellerova 4, HR-10000 Zagreb, Croatia, 2 Department of Educational Technology, Andrija Stampar School of Public Health

Correspondence to: M Mastilica mmastil@snz.hr

Reform of the Croatian healthcare system focused mainly on centralising financing, rationing services, and encouraging the provision of private health services with incentives. Although these changes may have contained costs, they have increased inequality of access to health care and proved highly unpopular with users

The first 150 words of the full text of this article appear below.

Introduction

In Croatia, as in other countries in transition, healthcare reform was a necessary process that went alongside general changes in the political system and economy. New objectives and measures were defined in the early 1990s, adopted by the Croatian parliament, and came into force with the new Health Care Act and Health Insurance Act in 1993.

The principal motive for healthcare reform was dissatisfaction with the existing healthcare system: the government was dissatisfied with the economic inefficiency of the system, doctors were dissatisfied with their income, and people were mainly dissatisfied with access (long waiting times), the behaviour of staff, and regular shortages of drugs.1 2 Consequently, healthcare reform primarily focused on financing, rationing of services, and introduction of private incentives in the provision of services.

Healthcare reform—objectives, measures, problems

Centralisation of financing resulted in the establishment of a central insurance fund in 1990, responsible for implementation of health policies and financing and control of . . . [Full text of this article]

Problems with the reforms

Impact of the reforms from the perspective of users

Conclusion


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