Organization and functioning of primary care for women in Croatia: in relation to the health care reforms introduced between 1995 and 2012.

The main aim of this study was to investigate trends in the organization and functioning of the HC service. The Croatian Health Service Yearbooks, from 1995 to 2012, served as the basis for the data. The results showed that the HC reforms aimed at the organization and functioning of primary care for women somehow compromised their accessibility. A general lack of around 100 gynecologists, the huge number of women on the lists, from 4, 350 to 8,061 women, and excessively heavy daily consultations, between 23.8 and 28.4, were all observed. The location of the majority of gynecological practices in the big cities also makes the service inaccessible to women from the rural areas. A flow of service away from the public to the private providers was also observed. Since, the results of this study can be viewed only in terms of trends and more detailed research will be needed in future.

Preventive health care for women in Croatia: ongoing trends from 1995 to 2012.

The privatization of gynecological services and the introduction of additional reimbursements to capitation fees are ongoing mini reforms in Croatia. In order to evaluate the outcomes of this, study was performed with the main aim of determining trends in preventive activities carried out in public and private gynecological practices from 1995 to 2012. The Croatian Health Service Yearbooks served as the basis for data collection. Data were collected on the number of general check-ups, the number of targeted check-ups, and the number of follow-up check-ups. The results indicate a trend of continuous decline in the number of general and follow-up check-ups, as well as breast examinations and Pap smears, in public gynecological practices even after the introduction of contractual obligations and additional reimbursements and fee-for-service payments. One important note is that many resources were invested in general checks-up interventions, which proved to be ineffective, while fewer resources were invested in the more effective Pap smear interventions.

Trends in family planning and contraception carried out in primary health care in Croatia: 1995-2012: study based on routinely collected data.

The lack of objective findings provided the reason to undertake this study with the main aim of exploring the trends in family planning and contraception carried out in primary health care in Croatia. Based on the Croatian health statistical yearbooks from 1995 to 2012, data were collected on the number and structure of visits and the number and type of prescribed contraceptives by public and private gynecological practices, and visits to family practices and school medicine services. The results showed that only a small number of fertile women received primary care for family planning issues, trends that are evident through the entire follow-up period. A trend of "migration" from the public to the private sector is also observed. Family doctors and school medicine are almost entirely excluded from the provision of family planning despite the magnitude of the family planning problem resulting in a waste of human and material resources.