The Croatian Hospital System: Insight into a Case of Financial Unsustainability

This article shares some unusual insights into the natural and financial operations of the Croatian hospital system. It reveals a puzzling observation: the financial indicators of costs and hospital spending are on the rise, while at the same time, natural indicators, e.g., the number of hospital days and discharged patients, are declining. Physician numbers are increasing while hospital days of treatment are decreasing, and certain drugs consumption has been increasing without a corresponding increase in their patients. These are only some of the examples which are discussed in this publication. Stakeholders in healthcare insist that the hospital system is underfunded, while public finance, which sees financial sustainability through the prism of fiscal restraint, highlights uncontrolled growth of healthcare expenditures as key. Each has an element of truth, but neither is verifiably right or wrong. Due to the absence of a shared understanding of the dimensions of the problem, healthcare, and public finance have created a status quo of hidden deficits and government bailouts. A comprehensive response to this longstanding issue requires open and sincere communication of all public sector functions stakeholders on societal priorities. No matter how much it has been generally accepted so far, healthcare should no longer be a public function whose expenditures are regularly insufficiently planned in the budget, because under the pretext that the lives and health of citizens are at stake, it is irresistibly easy to subsequently cover the lack of financial resources.