Financiranje javnog zdravstva i organizacija stomatološke prakse u RH

master's thesis

• Title (english): Finance and organisation of the public health system in Croatia
• Author: Michael Richter
• Mentor: Paris Simeon (mentor)
• Committee member: Paris Simeon (predsjednik povjerenstva)
• Committee member: Eva Klarić Sever (član povjerenstva)
• Committee member: Valentina Rajić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Endodontics and Restorative Dentistry); Zagreb
• Defense date and country: 2021-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Endodonics and Restorative Dentistry

Abstract

Zdravstveni sustav Republike Hrvatske (RH) većinski se financira doprinosima na plaće radno aktivnog stanovništva kojima raspolaže Hrvatski zavod za zdravstveno osiguranje (HZZO) kao javna ustanova zadužena za ugovaranje i plaćanje zdravstvenih usluga. Zdravstveno osiguranje može biti obavezno i dobrovoljno, koje se pak dijeli na dopunsko, dodatno i privatno. Od osnutka RH, predlagane su brojne reforme koje su trebale unaprijediti zdravstveni sustav, no one nisu
dosljedno provođene. Djelatnost dentalne medicine može se obavljati u ordinacijama zdravstvenih ustanova, ordinacijama privatne prakse, skupnoj praksi te trgovačkim društvima. Postoje dva osnovna izvora prihoda stomatoloških ordinacija: naplata iz proračuna HZZO-a te izravna naplata „iz džepa“. Ordinacije unutar javnozdravstvene mreže usluge iz obveznog zdravstvenog osiguranja mogu naplatiti HZZO-u, dok se ostale moraju naplatiti „iz džepa“. S druge strane, privatnim ordinacijama
izvan javnozdravstvene mreže preostaje naplata „iz džepa“ kao jedini izvor prihoda. Treba nadodati da osobe koje nisu osigurane dopunskim zdravstvenim osiguranjem moraju djelomično sudjelovati u plaćanju troškova dentalnih usluga.
U RH se za zdravstvo, gledajući i iznos po stanovniku i ukupne izdatke kao udio BDP-a, izdvaja značajno manje sredstava u odnosu na europski prosjek. Osim toga, Hrvatska se 2019. godine nalazila na 24. mjestu na popisu Europskog zdravstvenog potrošačkog indeksa (EHCI). S druge strane, Nizozemska se od samog početka bilježenja EHCI-a nalazi među prva tri mjesta.
Glavna je odlika nizozemskog zdravstvenog sustava tržišno natjecanje pod visokim stupnjem kontrole države. Iz ovog rada može se zaključiti da je glavni uzrok financijske neodrživosti i velikih dugova hrvatskog zdravstva nedostatak političke volje za dosljednim provođenjem reformi.

Abstract (english)

The health care system of the Republic of Croatia (CRO) is mostly financed by paying contributions from the salaries of the working population to the Croatian Health Insurance Institute (CHII). Health insurance can be compulsory and voluntary, and voluntary which can be supplementary, additional and private. Since the founding of the Republic of Croatia, numerous
reforms have been proposed that were supposed to improve the health care system, but they have not been consistently implemented. Dental medicine can be practiced in the offices of health institutions, private practice offices, group practice and companies. There are two basic sources of income for dental practices: CHII treasury and self-financing. Practices within the public health network can charge for compulsory health insurance services to the CHII, while other services need to be self-financed. On the other hand, private practices outside the public health network are left with self-financing as the only source of income. It should be added that persons who are not insured with supplementary health insurance must participate in the costs of dental services. In the Republic of Croatia, significantly less funds are spent for health care compared to the European average. In addition, in 2019, Croatia was ranked 24th on the list of the European Health
Consumer Index (EHCI). On the other hand, the Netherlands has been among the top three since the very beginning of the EHCI record. The main feature of the Dutch health system is competition under a high degree of state control.
From this paper, it can be concluded that the main cause of financial unsustainability and large debts of Croatian health care is the lack of political will for consistent implementation of the reforms.

• Keywords: stomatološka praksa upravljanja; stomatološko osiguranje; financiranje zdravstvene zaštite
• Keywords (english): Dental Practice management; Dental Insurance; Helathcare financing
• Language: croatian
• URN:NBN: urn:nbn:hr:127:897939
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-08-30 06:46:41