Andrija Stampar School of Public Health, University of Zagreb, School of Medicine.
Croatian Health Insurance Fund.
Health Syst Transit. 2021 Nov;23(2):1-146.
This analysis of the Croatian health system reviews developments in its organization and governance, financing, provision of services, health reforms and health system performance. Croatia has a mandatory social health insurance system with nearly universal population coverage and a generous benefits package. Although per capita spending is low when compared to other EU countries, the share of public spending as a proportion of current health expenditure is high and out-of-pocket payments are low. There are sufficient physical and human resources overall, but some more remote areas, such as the islands off the Adriatic coast and rural areas in central and eastern Croatia, face shortages. While the Croatian health system provides a high degree of financial protection, more can be achieved in terms of improving health outcomes. Several mortality rates are among the highest in the EU, including mortality from cancer, preventable causes (including lung cancer, alcohol-related causes and road traffic deaths) and air pollution. Quality monitoring systems are underdeveloped, but available indicators on quality of care suggest much scope for improvement. Another challenge is waiting times, which were already long in the years before 2020 and are bound to have increased as a result of the COVID-19 pandemic.
本报告对克罗地亚卫生系统进行了分析，涉及组织和治理、筹资、服务提供、卫生改革和卫生系统绩效等方面的发展情况。克罗地亚实行强制性社会保险制度，医疗保险几乎覆盖全民，福利优厚。尽管克罗地亚的人均卫生支出低于其他欧盟国家，但公共支出占当前卫生支出的比例较高，自付费用较低。总的来说，克罗地亚的物力和人力资源充足，但一些偏远地区，如亚得里亚海沿岸岛屿和克罗地亚中东部农村地区，面临短缺问题。尽管克罗地亚卫生系统提供了高度的财务保障，但在改善健康结果方面还有很大的提升空间。包括癌症、可预防原因（包括肺癌、与酒精有关的原因和道路交通死亡）和空气污染导致的死亡率在内，几项死亡率在欧盟中属于较高水平。质量监测系统不够发达，但现有的护理质量指标表明有很大的改进空间。另一个挑战是候诊时间，在 2020 年之前，候诊时间已经很长，而由于 COVID-19 大流行，候诊时间势必会进一步延长。
