Overview

The public benefits package is comprehensive and covers almost the entire population

Population coverage of the mandatory health insurance system is nearly universal, as all residents have the right to health care through the mandatory health insurance scheme. Although the breadth and scope of the scheme are broad, patients must contribute to the costs of many goods and services through co-payments. However, co-payments do not seem to have affected affordability of health services.

The share of public spending is comparatively high and out-of-pocket payments are relatively low

While Croatia spends a smaller amount on health per capita than most other EU Member States, the share of public spending is comparatively high, amounting to 83.2% in 2018. Out-of-pocket (OOP) payments stood at 10.8% of current health expenditure in 2018, which was clearly below the EU average of 15.5%. Out-of-pocket spending on health as a share of final household consumption was 1.3% in 2018, which was the lowest share of all EU countries and well below the EU average of 3.3%.

Life expectancy is below the EU average and several mortality rates are among the highest in the EU

Life expectancy decreased to 77.8 years in 2020, reflecting the COVID-19 pandemic, and was 2.8 years lower than the EU average of 80.6 years. Mortality rates for the most common causes of death are decreasing, especially for circulatory diseases and cancer, but are still above the EU average. 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.

The health reform agenda remains unfinished, but a National Development Strategy 2020-2030 has been adopted

In recent years Croatia has undertaken reforms in a range of areas, but progress in implementation varied, with implementation still at an early stage in the areas of hospital reform, primary care and human resources management and planning. Quality monitoring systems are underdeveloped, but available indicators on quality of care suggest much scope for improvement. The National Development Strategy for 2020–2030 might provide the required framework for accelerating reforms of hospital and primary care and for improving quality of care.