Abstract
This chapter analyses health care policies in Croatia over the past 25 years and their effects of the health care system. More specifically, through examples of health financing and health system organization, it describes how the policies, or lack thereof, in this second most costly sector of the economy have brought about a gradual, but steady decline in the quality and efficiency of medical care, medical staff exodus, and other consequences. Topics covered in this chapter include financing and organization of the system as the two largest problems, with an interlay of other concurrent and related problems, such as lack of vision and strategy, corruption, and weak institutions, among others. The chapter also analyzes the role of the stakeholders in creating health policies both through their formal and, more significantly, informal relationships and channels of influence, which clarify the reasons behind the failure to craft coordinated policies.
The system does not actually function at all, it works with Brownian motion. Brownian motion is a random movement of small particles in one space. When there is no air blowing, then the particles are doing a strange trajectory and it’s called Brownian motion. Our system has no clear conception because no one has created it.
Former Head of Hospital, 2016.
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Notes
- 1.
Dr. Andrija Štampar was a distinguished Croatian scholar who is credited for pioneering the development of the field of social medicine in Croatia and beyond. In addition to being a scholar and practitioner, as well as the founder of the School of Public Health, he was also actively involved in global health activities. It is noteworthy to mention that he was one of the leading members and the first President of the Assembly of the World Health Organization with various international expert consulting engagements including China, the US, etc.
- 2.
Integrated care, often used as a synonym of comprehensive care and disease management or complete care, in the terminology of the systems theory, brings together inputs, delivery, management and organization of care in order to improve access, quality, user satisfaction and efficiency of the same (Gröne and Garcia-Barbero 2001). Furthermore, Kodner and Spreeuwenberg (2002) create a patient-centered definition of integrated care to mean ‘Integration is a coherent set of methods and models on the funding, administrative, organisational, service delivery and clinical levels designed to create connectivity, alignment and collaboration within and between the cure and care sectors.’
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Radin, D. (2019). Health Policy in Croatia: A Case of Free Falling. In: Petak, Z., Kotarski, K. (eds) Policy-Making at the European Periphery. New Perspectives on South-East Europe. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-73582-5_13
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