title: Slovakia: Health System Review.
abstract: This analysis of the Slovak health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The health care system in Slovakia is based on universal coverage, compulsory health insurance, a basic benefit package and a competitive insurance model with selective contracting of health care providers. Containment of health spending became a major policy goal after the 2008 financial crisis. Health spending stabilized after 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 acute beds, overprescribing pharmaceuticals, and poor gatekeeping of the system all lead to over-utilization of services and system inefficiency. This suggests substantial room for improvement in delivery of care, especially for primary and long-term care. Additionally, there is inequity in the distribution of health providers, resulting in lengthy travelling distances and waiting times for patients. Given the ageing workforce, this trend is likely to continue. Current strategic documents and reform efforts aim to address the lack of efficiency and accountability. There has been a strong will to tackle these challenges but this has often been hindered by a lack of political consensus over issues such as 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 have taken different positions on these issues since the establishment of the current health system in 2002, and major reforms remain to be implemented.
authors.affiliation: Slovak Ministry of Health, Institute for Health Policies.
authors.forename: Martin
authors.initials: M
authors.lastname: Smatana
authors.affiliation: University of Economics, Prague.
authors.forename: Peter
authors.initials: P
authors.lastname: Pazitny
authors.affiliation: University of Economics, Prague.
authors.forename: Daniela
authors.initials: D
authors.lastname: Kandilaki
authors.affiliation: Slovak Ministry of Health.
authors.forename: Michaela
authors.initials: M
authors.lastname: Laktisova
authors.affiliation: Head of WHO Country office of Slovakia.
authors.forename: Darina
authors.initials: D
authors.lastname: Sedlakova
authors.affiliation: The Chief General practitioner of Slovakia.
authors.forename: Monika
authors.initials: M
authors.lastname: Paluskova
authors.affiliation: Berlin University of Technology and European Observatory on Health Systems and Policies.
authors.forename: Ewout
authors.initials: E
authors.lastname: van Ginneken
authors.affiliation: Berlin University of Technology and European Observatory on Health Systems and Policies.
authors.forename: Anne
authors.initials: A
authors.lastname: Spranger
mesh_terms: D003695:Delivery of Health Care / Q000191:economics / Q000331:legislation & jurisprudence* / Q000458:organization & administration*; D005102:Health Expenditures; D006291:Health Policy; D061889:Healthcare Financing; D006801:Humans; D007348:Insurance, Health; D008134:Long-Term Care / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration; D011787:Quality of Health Care; D018154:Slovakia; D019472:Universal Health Insurance