Croatia

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Cancer Centers

University Hospital for Tumors of Zagreb

Healthcare System

Croatia operates under a universal healthcare system, which provides comprehensive health coverage to all its citizens. It is primarily financed through mandatory health insurance contributions, with additional funding from the state budget.

The Croatian healthcare system is managed by the Croatian Health Insurance Fund (CHIF), a public organization responsible for financing healthcare services. The Ministry of Health oversees the healthcare system at the national level and sets policy, while regional management is delegated to the 21 County Health Departments (CHDs).

The population of Croatia receives a wide range of healthcare benefits through the system, including primary care, specialist care, inpatient and outpatient hospital care, dental care, mental health care, rehabilitation services, prescription medications, and emergency medical services. Preventive care, such as vaccinations and screenings, is also covered.

All Croatian citizens and residents are eligible for healthcare benefits, provided they have registered with the CHIF and are up-to-date with their mandatory health insurance contributions. Foreign nationals residing in Croatia may also access the healthcare system if they have the appropriate documentation and insurance coverage.

The National Public Health Information System of the Croatian Institute of Public Health (CIPH) collects data for various registries, including a cancer registry. The Central Health Information System (CEZIH), on the other hand, is managed by CHIF and is used to share standardized health data to support delivery of primary, secondary and tertiary healthcare [1].

Croatia has implemented an electronic health record system (EHR) to improve the efficiency and quality of healthcare services. Healthcare providers are required to use the EHR system to record and share patients' medical information, including diagnoses, treatments, and prescriptions. The CHIF maintains a centralized database of claims data and registries, allowing for effective monitoring of healthcare expenditures, utilization, and quality. This data is used for planning, policy development, and evaluation purposes.

Administrative or Claims Data

Database: Central Health Information System

Sponsor, manager or home institution: Croatian Health Insurance Fund.

Type of information: The content of the complete dataset was not found.

Available type of information: Procedures grouper including tables with all categories of procedures, casemix, admission justification, main diagnosis, as well as different sortings such as frequency by category of hospital, by complexity, etc.

Source of information: Data is acquired from all healthcare providers in Croatia [2].

Data level: Patient level.

Available data level: Hospital level.

Number of records: Unknown.

Date range: Unknown.

Available date range: 2010 onwards.

Data access: Partially publicly available [3].

Contact information: Unknown.

Registries

Database: Croatian National Cancer Registry

Primary purpose: Register new cancer cases and provide data on incidence, prevalence, and survival in Croatia.

Sponsor, manager or home institution: Croatian Institute of Public Health.

Type of information: For patients: sex, date of birth, age at diagnosis, place of residence, vital status, date of death. For tumors: date of cancer diagnosis, cancer diagnosis (ICD-10 and ICD-O-3), basis of diagnosis, morphological diagnosis (ICD-O-3), stage at diagnosis, grade.

Source of Information: Hospital report forms, primary care report forms, pathology and cytology reports, and death certificates. Additional data sources include hospital discharge diagnoses and outpatient visit diagnoses.

Data level: Patient level.

Number of Records: >500,000 cancer incidence diagnoses (since 2001).

Date Range: 1959 onwards [4].

Cancer Areas of Interest: All cancers except non-melanoma skin cancer (C44), including carcinoma in situ and benign and borderline CNS tumors.

Data access: Partially publicly available [5]. Instructions to request data for restricted content [6].

Contact information: Information [7].

Database: Medicinal Products

Primary purpose: List all medicinal products with marketing authorization granted by HALMED and the European Medicines Agency (EMA).

Sponsor, manager, or home institution: Agency for Medicinal Products and Medical Devices (HALMED)

Available information: Medicine name, marketing authorization number, active substance, pharmaceutical form, manufacturer, marketing authorization holder, marketing authorization date, MA period of validity, classification number, registration number, composition, prescription, type of prescription, distribution, advertising to the general public, ATC code and medicinal product marketed in Croatia.

Data access: Partially publicly available [8].

Electronic Health Records

Health Portal: e-Crajani

[9]

Sponsor, manager, or home institution: Ministry of Health of the Republic of Croatia.

Primary Purpose: To provide citizens of the Republic of Croatia access to their medical data from the Central Health Information System, including vaccination and COVID-19 testing records, doctor communications, appointment scheduling, prescription management, and personal information updates.

Number of records: Unknown.

Data source: Data inserted by healthcare providers.

Date range: Unknown.

Contact information: Information [10].

Clinical Practices Guidelines

Compilation: Croatian Medical Association Publications

Sponsor, manager or home institution: Croatian Medical Association.

Primary purpose: Offer free access to clinical guidelines and other publications about cancer and other subjects.

Type of information: Clinical guidelines for diagnosis, treatment and/or follow-up of multiple cancer types such as breast, cervical, ovarian, abdominal, lung, prostate, kidney, bladder, testicular, among others.

Access to information: Query for cancer-related publications [11].

Guideline: Guidelines for the treatment of cancer pain in adults

Sponsor, manager or home institution: Croatian Medical Association.

Primary purpose: Offer guidelines on how to treat adults with cancer in pain.

Type of information: Information on anamnesis and assessment of pain, pain scales, drug effects on pain, palliative care, among other information.

Access to information: List of guidelines [12].

Guideline: Clinical guidelines for the oncoplastic treatment of breast cancer

Sponsor, manager or home institution: Croatian Medical Association.

Primary purpose: Offer guidelines for oncoplastic breast cancer treatment.

Type of information: Offer epidemiology data, explanations on preventative examinations, invasive diagnostic methods, describe the psychological element of the treatment, and how the treatment itself should be conducted.

Access to information: List of guidelines [13].

HDGO Guidelines

Sponsor, manager or home institution: Hrvatskog Društva za Ginekologiju i Opstetriciju.

Primary purpose: To improve the quality of healthcare for gynecological cancer patients by standardizing, unifying, and optimizing diagnostics, treatment, and follow-up procedures.

Type of information: Diagnosis, treatments and follow-up of gynecological cancers.

Access to information: List of guidelines [14].

Latest Policymaking Initiatives

Policy: National Cancer Control Plan 2020-2030

Sponsor, manager or home institution: Ministry of Health; all other organizations participating in the plan.

Primary purpose: Improve cancer care at all levels, including primary, secondary and tertiary prevention, diagnosis, treatment, palliative care, research, education, and data recording.

Type of information: Detailed plans for all goals above, including objectives, resources, stakeholders, economic evaluations and key references.

Data level: National level.

Access to information: Contact information [15]. English version [16].

Report: Breast Cancer Screenings and Diagnoses

Sponsor, manager or home institution: Nacionalni Program Ranog Otkrivanja Raka Dojke.

Primary purpose: To recommend and implement a mammographic screening program for women aged 50 to 69 years to reduce breast cancer morbidity and mortality while ensuring quality and accessibility of services.

Type of information: Breast cancer incidence and mortality; Incidance rate; General data on screening program implementation, quality control, and early detection and diagnosis of breast cancer.

Data level: National level.

Access to information: Access Information [17].

Report: EU Country Cancer Profile 2023

Sponsor, manager or home institution: OECD and European Commission.

Primary purpose: To provide reliable data on cancer prevention and care, identifying trends, disparities, and inequalities among EU Member States and regions to guide interventions under Europe's Beating Cancer Plan.

Type of information: National cancer burden; Cancer incidence and mortality; Risk factors for cancer; Early detection programs (screenings); Cancer care performance, The impact of COVID-19 on cancer care.

Data level: National level.

Access to information: Access Information [18].

Cancer-related Patient Associations and Resources

Screening: National Breast Cancer Early Detection Program

Primary Purpose: To reduce mortality from breast cancer by 15-25%, to detect breast cancer in the initial stage in the highest possible percentage, and to improve the quality of life of breast cancer patients.

Data level: National level.

Contact information: Information [19].

Resource: ESMO Patient Guides

Sponsor, manager or home institution: European Society for Medical Oncology (ESMO)

Primary purpose: Provide patients, their relatives and caregivers guides to better understand complex medical information about different types of cancer.

Available guides: Cancer Treatment During the COVID-19 Pandemic; Side Effects Associated with Immunotherapy and Their Management; Personalized Medicine in Oncology; Life with Cancer; Breast Cancer; Ovarian Cancer; Cervical Cancer.

Type of information: Laymen-directed descriptions of specific cancers, their causes, diagnoses, treatment, screening, and side effects, among other relevant information for patients, their relatives and caregivers.

Access to information: Patient Guides [20].

Quality of Life and Palliative Care Research

List of Articles: Quality of Life [21] and Palliative Care [22].