Health care reform in Croatia: the consumers' perspective.
OBJECTIVE
Assessment of the Croatian health care system (under the reform) from the perspective of the users of health care services. We analyzed the consumers' satisfaction with health care system, health care expenses and access, and described the consumers' attitudes toward health reform, examining the differences among sociodemographic groups.


METHODS
The study is based on a data set collected in 1994 through the interviews with randomly selected adults in two major cities of Croatia: Zagreb and Split.


RESULTS
A great proportion of respondents were dissatisfied with the current health care services, quality of health care facilities and equipment, and encountered difficulties in access. The elderly, women, and those with lower socioeconomic status were more likely to be dissatisfied and to consider out-of-pocket payments for health services as a problem. A great number of the respondents believed that the reform would either fail or would not achieve significant results. Compared to the younger and higher socio-economic group, the older and lower socioeconomic groups were more likely to evaluate the health care reform negatively.


CONCLUSIONS
Croatian government decided to rationalize the health care system without taking much account of the impact of health reform on the consumers. Revealed dissatisfaction with the health care services might be linked with the expressed doubts in health care reform and concern that changes could worsen the consumers' position as patients.
Mastilica
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Department of Medical Sociology, Andrija Stampar School of Public Health, Zagreb University School of Medicine, 10000 Zagreb, Croatia. mastil@andrija.snz.hr.
Chen
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D000328:Adult; D000368:Aged; D003258:Consumer Behavior; D017523:Croatia; D003695:Delivery of Health Care / Q000458:organization & administration; D005260:Female; D017048:Health Care Costs; D018166:Health Care Reform; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D012959:Socioeconomic Factors