Social ownership of health facilities in Croatia is being replaced with state, county and private ownership. The Croatian Health Insurance Institute was established in 1993 in place of more limited schemes and it determines the available resources for health by setting and collecting insurance contributions. It is also responsible for setting the normative standards fro health care provision. However, the Ministry of Health produces an annual national health plan with defined objectives. 'The Croatian health reforms have been marked by a distinctive approach to privatisation of primary care and some secondary care. The decision was to lease health care facilities at subsidised rates rather than sell them in order to provide stability in difficult economic times. The debts of the previous system have been eliminated and in 1995 a surplus was accumulated to pay for new capital equipment.'9
Despite some apparent improvements in the overall health care system, a group of palliative care innovators in the country have stated:
'The number of beds in hospital is reduced, even for cancer patients, the outpatient services are limited so that you have to wait for months to get some kind of examination in the social/governmental sector. You might go to the private units but their services are too expensive for most patients, and the additional health insurance does not work as yet. The hospital admissions for dying or old patients are difficult and due to limits the ward discharges early.'10
Health care expenditure (US$) per capita, Central and Eastern Europe
Source: WHO Regional Office for European Health for All database and HiTs
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