Mislav Gjurić, M.D., Ph.D., Professor, Univ. Erlangen-Nürnberg, Poliklinika Sinteza
Five Stars Croatia Issue 4 — April 01, 2009.

The institutionally established history of Croatian medicine dates back to the foundation of the Zagreb School of Medicine in 1917, and was the product of realization of national interests, spurred by the enthusiasm of its founding fathers, who transferred their experience gained at internationally established centers of medical education abroad.

At that time, certain areas of expertise in Croatian medicine such as pathology, microbiology, dermatology, otorhinolaryngology, neuropsychiatry and pediatrics gained international recognition. Today the highlights of Croatian medicine, comparable with the highest standards in European practice, are the areas of translational research, which combines basic and clinical sciences (regenerative medicine and neuroscience), differentiated ultrasound diagnostics, transplantation medicine and reproductive medicine.

As a consequence of the transformation of the healthcare system in Croatia in the last decade, an increasing consolidation of private initiative is gaining momentum as an alternative to the state-owned system of healthcare. Private institutions which cater for specific health demands are concentrated predominantly in the City of Zagreb, as well as in other regional centers, such as Rijeka, Split and Osijek. They are emerging as newly-fledged centers of healthcare delivery which are confirming their efficacy in solving a wide spectrum of health-related problems, ranging from elective healthcare services and managing acute healthcare problems of the population, to management of the needs of chronic patients.

Thus, the Croatian market of private medical services is dominated by medical specialties such as plastic and esthetic surgery, cardiology, gastroenterology, gynecology, pediatrics, neurology, psychiatry, otorhinolaryngology, dermatology, ophthalmology, orthopedics and physical medicine, and, since quite recently, endoscopic surgery and varicose vein treatment. Simultaneously, there has been a growing tendency to recognize certain methods of complementary medicine such as traditional Chinese medicine and acupuncture, mesotherapy, which, although outside the established system of health management, have given excellent results as supportive options in the treatment of a whole spectrum of diseases.

Today’s sector of private medical care in Croatia can be defined through the parallel existence of two types of entrepreneurial activities. On the one hand, there is a number of private insurance companies which offer a certain spectrum of healthcare services and which have established their reputation in the area of health prevention (individual and systematic medical check-ups, diagnostic services and laboratory tests). Whereas on the other hand, private entrepreneurs, sometimes board certified with international medical licenses as well as with clinical affiliations to renowned centers of medical excellence abroad, are focused primarily on delivery of healthcare in specialized areas such as otorhinolaryngology, ophthalmology, gynecology, orthopedics, cardiology, urology, pediatrics, radiology, etc. Due to the highest level of medical expertise delivered, some of these institutions have grown into real centers of excellence which, regarding personnel and equipment, have become comparable to corresponding institutions offering specialized healthcare in Europe and abroad. Such institutions rely increasingly on day-care surgery procedures, allowing a fast reintegration of patients to their daily routine.

Regarding the present state of development of private medical services, it is obvious that the market liberalization has not yet been fully accomplished; that can be expected by introducing such insurance coverage which will guarantee the insurees to obtain the full freedom of selection of healthcare providers within the whole territory of the Republic of Croatia, which will be governed solely by the excellence and reputation gained in the delivery of healthcare services. Such a strong development of that segment of health services, which is gradually increasing its market visibility, could demonstrate, along with the expected increased market liberalization, its significant business potential, which will directly positively influence the labor market by increasing the number of vacancies in the private health sector. Potentially, it will also influence the area of health education by starting the trend of restoring the attractiveness of the medical profession, resulting in an increase of the admission quotas for prospective students at medical schools in Croatia.