Croatia

 Population coverage in Croatia is nearly universal. Dependent family members are covered through the contributions made by working family members, while those who are not economically active as well as vulnerable groups are exempt from contributions and are covered through state budget transfers. 

The Ministry of Health holds the stewardship role in the health system and is the main regulatory body. It is responsible for a number of functions, including health policy development, planning and evaluation, public health programmes, regulatory standards and the training of health professionals. The Croatian Health Insurance Fund (CHIF) is the sole insurer and main purchaser in the mandatory health insurance system. It plays a key role in contracting health services. Complementary health insurance, mainly to cover co-payments for services in the benefit package, is voluntary and purchased individually from either the CHIF (the main provider) or a private insurer: over 60% of the population has this additional insurance. Several health reforms have been initiated in recent years, but implementation has often been incomplete. 

Primary care doctors, such as general practitioners (GPs), paediatricians and gynaecologists, are usually patients’ first point of contact with the health system and act as gatekeepers to specialist and hospital care. Most primary care doctors are self-employed and work in solo practices. Hospital care is delivered through a network of general and specialist hospitals, most of which are owned by the counties. Highly specialised tertiary care is provided by hospitals owned by the central government. Specialised outpatient services, such as consultations provided by secondary care specialists, are mostly delivered in hospital outpatient departments.