Slovakia: health system review

ABSTRACT

This analysis of the Slovak health system reviews recent developmentsin organization and governance, health financing, health-care provision,health reforms and health system performance. The health care systemin Slovakia is based on universal coverage, compulsory health insurance, abasic benefit package and a competitive insurance model with selectivecontracting of health care providers. Containment of health spending becamea major policy goal after the 2008 financial crisis. Health spending stabilizedafter 2010 but remains well below European averages. Some health indicators,such as life expectancy, healthy life years and avoidable deaths are worrisome.Furthermore, weak hospital management, high numbers of unused acutebeds, overprescribing pharmaceuticals, and poor gatekeeping of the systemall lead to over-utilization of services and system inefficiency. This suggestssubstantial room for improvement in delivery of care, especially for primaryand long-term care. Additionally, there is inequity in the distribution of healthproviders, resulting in lengthy travelling distances and waiting times forpatients. Given the ageing workforce, this trend is likely to continue. Currentstrategic documents and reform efforts aim to address the lack of efficiencyand accountability. There has been a strong will to tackle these challenges butthis has often been hindered by a lack of political consensus over issues suchas the role of the state, the appropriate role of market mechanisms and profits,as well as the extent of out-of-pocket payments. Successive governments havetaken different positions on these issues since the establishment of the currenthealth system in 2002, and major reforms remain to be implemented.