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Fiscal (un)sustainability of the Croatian healthcare system: additional impact of the COVID-19 crisis*
Article | Year: 2021 | Pages: 495 - 515 | Volume: 45 | Issue: 4 Received: June 8, 2021 | Accepted: July 14, 2021 | Published online: December 6, 2021
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FULL ARTICLE
FIGURES & DATA
REFERENCES
CROSSMARK POLICY
METRICS
LICENCING
PDF
Source: OECD/European Union (2020: 44), for Croatia authors’ calculations.
Source: OECD/European Union (2020).
Source: OECD/European Union (2020).
|
|
2015
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2016
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2017
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2018
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2019
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2020
|
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Health insurance contributions
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18,121.28
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18,468.68
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19,135.18
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19,904.22
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22,188.02
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21,042.81
|
|
Budgetary income
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2,400.00
|
2,588.95
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2,629.76
|
3,100.00
|
2,600.00
|
3,769.21
|
|
Income under special Regulations
(mostly supplemental health insurance)
|
1,618.17
|
2,650.80
|
1,867.89
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2,004.79
|
2,291.70
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2,451.01
|
|
Property income
|
14.52
|
14.02
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17.36
|
15.19
|
12.53
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7.76
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Foreign aid - EU projects
|
0.42
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1.45
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0.40
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1.34
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2.87
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0.79
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Income from CES (Croatian Employment Service),
professional training without employment
|
0.62
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0.43
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0.91
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0.48
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0.00
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0.00
|
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Income from services provided
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0.05
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0.37
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0.86
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1.16
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1.30
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1.99
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Income from sale of non - financial assets
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0.75
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0.50
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0.65
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0.72
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1.90
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3.11
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Other income
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0.28
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0.70
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0.34
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0.36
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0.44
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0.25
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Income from financial assets and liabilities
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0.00
|
26.14
|
0.00
|
0.00
|
0.00
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1,077.58
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In total
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22,156.10
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23,752.05
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23,653.35
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25,028.27
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27,098.76
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28,354.51
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Budgetary income
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2015
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2016
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2017
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2018
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2019
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2020
|
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Contributions for the unemployed
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1,305.45
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1,124.94
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937.44
|
778.27
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676.65
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851.10
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Contributions for persons deprived of their liberty
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10.71
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11.05
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11.37
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10.18
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12.48
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10.92
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Additional contributions for pension beneficiaries
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361.00
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363.11
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371.06
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393.59
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408.86
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420.53
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Income from special tax on tobacco
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1,339.93
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1,432.09
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1,399.69
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1,540.41
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1,636.71
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1,278.12*
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Premium for supplemental health insurance policy
at the expense of the state budget
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768.83
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683.55
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624.05
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565.62
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509.33
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464.19
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Funds to cover the costs of healthcare of insured
persons
at the expense of the state budget
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1,060.22
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818.00
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939.11*
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939.11*
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939.11*
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939.11*
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Total amount receivable from the
state budget (estimate)
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4,846.13
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4,432.74
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4,282.72
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4,227.19
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4,183.14
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3,963.97
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Budgetary income (paid)
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2,400.00
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2,588.95
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2,629.76
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3,100.00
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2,600.00
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3.769,21
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Difference
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-2,446.13
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-1,843.79
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-1,652.96
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-1,127.19
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-1,583.14
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-194.76
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Note: CHC – Clinical Hospital Center, CH – Clinical Hospital, GH – General Hospital, SH – Special Hospital. Health resorts, health care centers, and institutes are omitted from this part of the analysis. At the time of this analysis (May 2020), the CHC Sestre Milosrdnice and the Clinic for Children’s Diseases did not make public the data on due liabilities for 2020, so the data for 2019 was used in analysis.
Source: Authors’ work according to the Reports on liabilities of individual hospitals, hospital websites.
Note: CHC – Clinical Hospital Center, CH – Clinical Hospital, GH – General Hospital, SH – Special Hospital. Health resorts, health care centers, and institutes are omitted from this part of the analysis. At the time of this analysis (May 2020), the CHC Sestre Milosrdnice and the Clinic for Children’s Diseases did not make public the data on due liabilities for 2020, so the data for 2019 was used in analysis.
Source: Authors’ work according to the Reports on liabilities of individual hospitals, hospital websites.
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Year
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Financial bailouts
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Amount
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1994
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Financial bailout agreement
with health institutions
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214.84
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1994
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Agreement with wholesalers -
paid obligations for medicines
|
62.13
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1998
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Settlement of due
obligations towards health care institutions - from the budget
|
593.00
|
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1999
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Commitments of hospital
suppliers
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845.37
|
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1999
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Budget transfer for
suppliers
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792.02
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|
1999
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Short-term loan from a bank
|
120.00
|
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1999
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Promissory note issued for
pharmacy debt (debt older than 90 days)
|
244.98
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1999
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Pliva takes over CHIF debt
to pharmacies
|
375.21
|
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2000
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CHIF issues bonds
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1,668.67
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|
2000
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Short-term loan
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115.00
|
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2001
|
Collection of receivables
from CHIF
|
750.37
|
|
2001
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Short-term loan
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108.00
|
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2002
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Loan
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820.00
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2003
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Loan
|
410.00
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2004
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Transfer to hospitals from
the Ministry of Finance (state budget) for suppliers
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533.01
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2005
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Agreement with Zagrebačka
banka on taking over overdue receivables for medicines
|
808.70
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2007
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Sale of shares owned by CHIF
through the Privatization Fund - paid orthopedic devices and aids
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90.00
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2007
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Obligations to suppliers -
CHIF
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1,200.00
|
|
2008
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Liabilities of hospitals to
suppliers of medicines and medical supplies
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500.00
|
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2012
|
Assignment agreement
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465.03
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2013
|
Assignment agreement
|
3,062.06
|
|
2014
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Assignment agreement
|
3,200.00
|
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2017
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Budget transfer to hospitals
to settle debt to wholesalers
|
200.00
|
|
2019
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Extraordinary payment of
CHIF to wholesalers for overdue debt
|
500.00
|
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2020
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Budget transfer to CHIF for
wholesalers debt
|
500.00
|
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2020
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State budget amendment
(additional revenues for CHIF)
|
1,300.00
|
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2021
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Budget transfer to CHIF (600
million for pharmacy debt and 300 million for hospitals)
|
900.00
|
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2021
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Budget transfer to CHIF for
pharmacy debt and hospital debt (installments of 900 million in April, May
and June, plus a state budget amendment of an additional 895 million)
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3,595.00
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Total
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23,973.39
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December, 2021
IV/2021
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