Croatian health care has the most favourable ratio of investment and supply in terms of the number of beds, doctors, and CT and MRI devices, but it has the worst health outcomes among 21 European countries, according to a new study by experts from the Faculty of Economics of the University of Zagreb.

The Review of Social Policy journal analysed three aspects of the efficiency of the Croatian healthcare system and published the results in its latest new issue.

The first aspect is the overall efficiency of healthcare expenditure in Croatia, which is at the lowest level among the observed countries of the European Union. The journal explains that this is the result of the relationship between healthcare expenditures and life expectancy at birth.

In 2019, Croats had an average of 57.4 years of a healthy life, which is significantly shorter than the EU average of 64.6 years, and even 1.6 years shorter than the data for 2010 in Croatia.

At the same time, life expectancy in Croatia in 2020 was 77.8 years, three years less than the EU average.

Another aspect is the cost-effectiveness of Croatian healthcare. It compares healthcare expenditures with the number of beds in hospitals, CT and MRI devices, and the number of doctors per 100,000 inhabitants.

It turned out that Croatia is maximally efficient in this, therefore, it has 100 percent efficiency, while the average of the selected EU countries in 2018 was 87 percent.

However, in the third aspect, when analysing the relationship between the number of beds, CT and MRI devices and the number of doctors with health outcomes, the efficiency of the Croatian health system drops to 48 percent.

Reduce acute inpatient capacity in hospitals, strengthen outpatient clinics

This is the lowest efficiency among the selected EU countries, whose average was 88 percent in 2018.

Croatia could achieve significantly more favourable health outcomes, that is, achieve the same outcomes with less engagement of intermediate resources, the journal estimates.

The number of available beds in hospitals in Croatia is above the EU average, which affects the increase in expenditures, and at the same time does not contribute to better health outcomes.

Reducing acute inpatient capacities in hospitals while simultaneously strengthening outpatient clinics would contribute to the rationalisation of costs and the financial sustainability of the health system without jeopardizing health outcomes, according to the journal.

They add that health outcomes are also influenced by factors beyond the direct control of the health system. For example, smoking and alcohol consumption are key determinants of healthcare effectiveness.

Croatia allocates only three percent of total health expenditures to health promotion and disease prevention measures, which is insufficient.

The decline in the number of the population and their unfavourable age structure in the future will be a source of pressure to reduce revenues in healthcare and increase expenditures, the journal says.