Preventive Programmes in Family Medicine : Case study Croatia

Abstract

Many of contacts between the physician and the patient enable primary, secondary and tertiary prevention. The majority of preventive programs provided in family medicine are focused on cardiovascular and malignant diseases. In order to improve prevention in family medicine, a concept of pro-active prevention has been developed. Therefore, a patient-oriented approach is recommended in which a phyisician encourages preventive actions and provides preventive procedures during consultations made for different reasons. The program elements to be determined in advance include target group definition; frequency and method of a target group coverage, recording target group response, risk factor(s) measurement and follow up of patients with positive screening results. The preventive programs in family medicine should be developed and implemented on evidence-based guidelines. The paper describes organization of Family Medicine Services in Croatia and Preventive activities in the Family Medicine Services. The Health Care Measure Plan and Programme is included in the Contract between the Croatian Institute for Health Insurance and each GP. GPs in Croatia are obliged to provide all preventive activities but, however, there are no mechanisms for monitoring and evaluation. The contracted GPs realize the biggesr part of income grom capitation fees. In fact, the there is a lack of financial and professional incentives for GPs to provide preventive activities in the routine daily work.