Overview

Slovenia has made important life expectancy gains - while modifying health behaviours is key to further improving population health outcomes

Life expectancy has increased markedly over the last two decades, and despite a (temporary) drop of one year in 2020 due to high COVID-19 related mortality, it is equal to the EU average of 80.6 years. Circulatory diseases and cancers are the leading causes of death while health-related lifestyles and health behaviour, such as dietary habits, alcohol consumption and smoking rates have a strong influence on the morbidity and mortality of the population. Additionally, gender and other socioeconomic determinants contribute to significant inequalities in population health.

Health spending has increased and a statutory social health insurance (SHI) provides universal coverage for a broad benefits package

Although per capita health spending in Slovenia is lower than the EU average, it has increased steadily, reaching US$ PPP 2283 in 2019. The SHI system, with a single public insurer, provides almost universal coverage for a broad benefits package. In tandem, high levels of co-insurance have resulted in extensive uptake of complementary, voluntary health insurance (VHI). Raising additional funding for health care and diversification of funding sources are long-standing issues of policy debate.

Community-based, person-centred primary health care reinforces integrated care

There is a strong historical link between primary care and public health programming in Slovenia. Primary care is provided mostly by a network of community-based primary health care centres, offering preventive, diagnostic, curative, rehabilitative, palliative and health promotion services close to patients’ homes under one roof by a wide range of health care professionals. Personal primary care physicians act as gatekeepers to secondary-level specialist care. An expansive reform of long-term care services is currently underway.

Accessibility and financial protection are relatively high, with health workforce shortages and long waiting times for secondary-level specialist care being the main challenges

Slovenia has some of the lowest rates of out-of-pocket and catastrophic spending in the EU, due to its near universal SHI coverage and extensive uptake of complementary VHI.

Unmet medical needs due specifically to cost (or travel distance) is negligible with little difference between income groups. Despite significant efforts, however, long waiting times, especially for specialist services, persist and are the driving factor of unmet medical need. Moreover, uneven distribution and low levels of some health care staff exist, particularly primary care physicians and registered nurses working in hospitals. Over the past year in particular, the uptake in digital solutions has been considerable and has helped to maintain access to health care during COVID-19 pandemic.