Health System in Slovakia

Abstract

The HiT profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services, and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis.

Executive summary

1. Introduction

• 1.1 Geography and sociodemography
• 1.2 Economic context
• 1.3 Political context
• 1.4 Health status

2. Organization and governance

• 2.1 Overview of the health system
• 2.2 Historical background
• 2.3 Organization
• 2.4 Decentralization and centralization
• 2.5 Planning
• 2.6 Intersectorality
• 2.7 Health information management
• 2.8 Regulation
• 2.9 Patient empowerment

3. Financing

• 3.1 Health expenditure
• 3.2 Sources of revenue and financial flows
• 3.3 Overview of the statutory financing system
• 3.4 Out-of-pocket payments
• 3.5 Voluntary Health Insurance (VHI)
• 3.6 Other financing
• 3.7 Payment mechanisms

4. Physical and human resources

• 4.1 Physical resources
• 4.2 Human resources

5. Provision of services

• 5.1 Public health
• 5.2 Patient pathways
• 5.3 Ambulatory care
• 5.4 Inpatient care
• 5.5 Emergency care
• 5.6 Pharmaceutical care
• 5.7 Rehabilitation/intermediate care
• 5.8 Long-term care
• 5.9 Palliative care
• 5.10 Mental health care
• 5.11 Dental care
• 5.12 Complementary and alternative medicine
• 5.13 Health care for specific populations

6. Principal health reforms

• 6.1 Main reforms since the 1990s
• 6.2 Reform period, 2002–2006
• 6.3 Key elements of the health reform, 2002–2006
• 6.4 Future reforms

7. Assessment of the health system

• 7.1 Stated objectives of the health care system
• 7.2 Equity
• 7.3 Efficiency of resource allocation
• 7.4 Technical efficiency
• 7.5 Contribution of the health system to health improvement

8. Conclusions

The Slovak health system is a system in progress. Major health reform in the period 2002–2006 replaced all relevant health care related legislation and meant a new approach based on individual responsibility and managed competition. The health insurance funds became profit-making companies, hard budgetary constraints were introduced, and a new regulatory and institutional framework was created. The model sought to create an environment in which societal goals are met through incentives for market players. The future of this system largely depends on political will. Opposing political views may lead to different decisions regarding market mechanisms and state control. The government that entered into power in 2010 pledged to move forward with the market reform agenda.