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Title: [Health system research in the Republic of Croatia 1990-2010].
Author: Kovacević J, Sogorić S, Dzakula A.
Journal: Acta Med Croatica; 2010 Dec; 64(5):341-8. PubMed ID: 21692257.
Abstract:
AIM: The aim of this study was to determine the scope and contents of peer-reviewed scientific publications that bring the results of the Health System Research (HSR) in the Republic of Croatia during the 1990-2010 period. The basic guidelines are in line with the research project, Health Services Research into European Policy and Practice (HSREPP). This project is being implemented with the aim of identifying, evaluating and improving the contribution of Health System Research to the development of Health Policy in Europe. This study included scientific publications indexed in the PubMed database and master theses and doctoral dissertations published at Schools of Medicine in Zagreb, Osijek, Rijeka and Split during the 1990-2010 period. In accordance with the project methodology, scientific publications indexed in PubMed (http://www.ncbi.nlm.nih.gov/pubmed) were searched for by the key words "Croatia AND (Health Care System OR Health System OR Healthcare System)". Then, the database of scientific publications indexed in PubMed was narrowed by key words divided into 4 groups according to HSREPP instructions. The search for master theses and doctoral dissertations was carried out by direct inspection of the completed works in the library of Andrija Stampar School of Public Health, School of Medicine, University of Zagreb. Access to master theses and doctoral dissertations at the other three medical schools was done by the Internet. We analyzed the collected summaries of all publications, master theses and doctoral dissertations and excluded all those that did not correspond to our research. RESULTS: Using this method, we found a total of 536 publications indexed in PubMed-in, 70 master theses and 22 doctoral dissertations meeting the study criteria. For further analysis, we separately considered master theses and doctoral dissertations on the one side, and scientific publications indexed in PubMed on the other side. All papers were listed by the year of publication, the author and the means of publication. Upon inclusion of the key words, 277 papers met the required criteria. After abstract analysis, 158 PubMed indexed papers were found to meet all the criteria and addressed the Health System Research in Croatia. There was a significant increase in the number of published papers during the 5-year study period. Upon analysis of the summary contents of master theses and doctoral dissertations, we separated 6 doctoral dissertations and 35 master theses that met the criteria of the research. They were divided into four groups: research of macro-, mezzo- and micro-level of Health System and assessment of Health Care System results. The group investigating the organization and delivery of health services (meso-level) and the group investigating health technology assessment (micro/meso-level) predominated. There were only a small number of high quality researches dealing with HSR in Croatia. Descriptive approach to the analysis predominated. Reform interventions require research, but are not part of the designed strategy. Funding of HSR is an important issue. The research in Croatia is financed by the Croatian Ministry of Science, Education and Sports. In the UK and the USA, HSR is funded by the National Health Services. In all publications, we could not find a systematic research of the Health System; however, we recognized a growing trend in the number of articles dealing with HSR in Croatia over the past 20 years. Comparison of the number of papers on the Health Care System in Croatia indicated a significant lag in comparison to Western Europe, and similarity with the countries of Eastern Europe.

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