Web-economic-crisis-health-systems-and-health-web

356 Economic crisis, health systems and health in Europe: country experience
User charges
• Introduction of user charges for primary care visits and outpatient prescription
drugs (2011).
Changes to health service planning, purchasing and delivery
Prices of medical goods
• Introduction of pay-back agreements for drugs (2010).
• Introduction of reference pricing (2010).
• VAT on pharmaceuticals and medical devices introduced (5%) (2012).
• Introduction of new rules on wholesale pricing and on recalculating the prices
of medical devices on an annual basis (2012).
Salaries and motivation of health sector workers
• The number of nonmedical workers on temporary contracts reduced (2012).
Payment to providers
• Reduction of the global budget for hospitals by 3.28% compared with
2009 (2010).
• Reviews instituted for hospital budgets to identify potential savings
(2010 onwards).
Overhead costs: restructuring the Ministry of Health and purchasing agencies
• The Croatian Health Insurance Institute and the Croatian Institute for
Health Protection and Safety at Work merged to create a national health
insurance fund (Croatian Institute for Health Insurance) (2011).
Provider infrastructure and capital investment
• No response reported.
Priority setting or protocols to change access to treatments, coordination
of care and patterns of use
• Prescriptions for certain medicines became valid for longer (six months), in
order to lessen the burden on family medicine doctors, reduce unnecessary
visits and decrease administrative costs (2009).
Waiting times
• No response reported.
Health promotion and prevention
• Strong investment in prevention programmes, including cancer screening,
healthy school meals and prevention of cardiovascular diseases.