Trends in preventive activities for the adult population in family medicine in Croatia: 1995-2012.

A few preventive activities were recorded in Croatian family medicine (FM) from 1995 until 2003, and then in 2004, additional fee-for-service reimbursement for general check-ups for people aged 45 to 65 years was introduced. The aim of this study was to investigate the trends in preventive activities before and after the introduction of those measures by using the Croatian Health Service Yearbooks for 1995-2012 as the main database. Data on the number of preventive, general, and total number of check-ups were collected. The results showed that the total number of check-ups registered in FM was low, suggesting that the additional reimbursement did not bring any improvements. In fact, the trend in the number decreased after 2004. These results are not unexpected because of the ineffectiveness of general check-ups as indicated in the literature. General check-ups should be replaced by targeted preventive interventions with evidence-based effectiveness.

Trends in prescribing in primary care in Croatia, 2000-2012: prescribing volume, costs and regulatory measures.

The rise of pharmaceutical costs is a significant burden to overall health care expenditure. The Croatian Health Insurance Fund (CHIF) in attempts of its containment, use administrative measures directed toward the two greatest generators: pharmaceutical industry, through negotiating prices and periodic revisions of basic and suplemental drug lists, and primary care physicians, through limits in the volume of prescriptions, and annual financial expenditure. The aim of the study was to determine trends in quantity of issued prescriptions and pharmaceutical expanditure from 2000 to 2012. Data were obtained from the CHIF annual reports. Results clearly demonstrate two trends: the increase in quantity of issued prescriptions, together with accompanying rates: number of prescriptions per inhabitants, and per patients, and the increase in total cost of prescriptions until 2004, with their maintenance and slight variations since then. Despite controversies in approach, CHIF succeded in slowing down the costs, primarily by applying measures towards regulation of drug prices.