Naslov
Has the era of decentralization in health care ended?

Autori
Džakula, Aleksandar

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
European Journal of Public Health, Volumen 17 ; Suplement 2 / Keskimaki, Ilmo - Helsinki : European Public Health Association, 2007, 174-174

Skup
15th EUPHA Conference

Mjesto i datum
Helsinki, Finska, 11.10.2007. - 13.10.2007

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
decentralization; health care reform

Sažetak
Issue: Decentralisation appears in all transition countries as an important element of health care reforms. Croatia has a broad range of experiences with decentralization dating from socialism, but also during the last fifteen years of transition. Description: We analysed decentralization processes and models performed in Croatia. Furthermore, we analysed general and specific settings for the decentralization. Lessons: During the last fifteen years Croatia experienced huge demographic changes. Together with some general crisis, health care system was faced with specific financial and organizational crises relevant for the decentralization. Additional challenges for the decentralization were professional and management crisis in health care. Although the Government implemented much effort to decentralize the system, it is still highly controlled and regulated by central administration. Among many arguments for such situation such as inappropriate management capability, financial crisis, etc. we also found such as quality assurance, higher efficiency and equity issues. Conclusions: The decentralisation in health care has to be planned to suit the needs of regions and population (bottom-up), and not to follow the uniform model devised by the central government. The processes of decentralisation can have negative effects on the quality of health care, increase prices and emphasise inequity in health. Poorly managed decentralisation can slow down development and block changes.

Izvorni jezik
Engleski

Znanstvena područja
Javno zdravstvo i zdravstvena zaštita

POVEZANOST RADA