Review article
The challenges of decentralization in the system of health services
Siniša Zrinščak
; Faculty of Law, University of Zagreb, Zagreb, Croatia
Abstract
The potential and the prospects of décentralisation in the formation of the Croatian System of health services has been disciissed in the article. At first place, the Croatian System ofhealth services, which has been formed after 1990, and completed by the adoption of the two pièces of législation, on health protection and the health Insurance in 1993, is described. The emphasis was put on the questions of Organization, administration and finances of the System. In order to answer thè question whetker and in which way thè strategy of decentralization may contribute to solve thè problems of the Croatian health services, a survey of comparative expériences with Organization of the health services is pre- sented in the article, Besides to the description of various wys of financing the Systems, and the six modes of their territorial Organization in Europe, the recent health seivices reforms in Italy, Germany, Sweden and Hungary} have been pre- sented.
They demonstrate that decentralization makes an important trend everywhere, but also that it arises mostly within thè context ofachieving a rationalization of ex- penses as well as an aspect of privatization of thè System. Some instances point to possible risks of privatization.
At the end the attention was devoted to the important, but often neglected rôle of local self-government in a promotion of public health.
Keywords
health services System; decentralization; financing; administration; public health
Hrčak ID:
197752
URI
Publication date:
7.6.2000.
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