[Viralhepatitis. Croatian Consensus Statement 2013]. / Virusni hepatitis. Hrvatska konsenzus konferencija 2013.

Croatian Consensus Conferences on Viral Hepatitis took place in 2005 and 2009. Considering the numerous novel concepts on the epidemiology, diagnosis and management of viral hepatitis (chronic hepatitis C genotype 1 in particular) that have emerged in the past four years, a new Croatian Consensus Conference on Viral Hepatitis was held in Zagreb on February 28, 2013. The abridged text of the Croatian Consensus Conference on Viral Hepatitis 2013 presents the new concepts on the epidemiology of viral hepatitis, serologic and molecular diagnosis of viral hepatitis, determination of the IL-28 gene promoter polymorphism, fibrosis grading, algorithm for patient diagnostic follow up, treatment of chronic hepatitis C (genotypes 1-6) and hepatitis B, treatment of special populations (children, dialysis patients, transplanted patients, individuals with HIV/HCV co-infection), and therapy side effects.

Challenges for health care development in Croatia.

The main aim of the research done in this paper was to establish key challenges and perspectives for health care development in the Republic of Croatia in the next two decades. Empirical research was conducted in the form of semi-structured interviews involving 49 subjects, representatives of health care professionals from both, public and private sectors, health insurance companies, pharmaceutical companies, drug wholesalers, and non-governmental organisations (patient associations). The results have shown that key challenges and problems of Croatian health care can be divided into three groups: functioning of health care systems, health care personnel, and external factors. Research has shown that key challenges related to the functioning of health care are inefficiency, financial unviability, inadequate infrastructure, and the lack of system transparency. Poor governance is another limiting factor. With regard to health care personnel, they face the problems of low salaries, which then lead to migration challenges and a potential shortage of health care personnel. The following external factors are deemed to be among the most significant challenges: ageing population, bad living habits, and an increase in the number of chronic diseases. However, problems caused by the global financial crisis and consequential macroeconomic situation must not be neglected. Guidelines for responding to challenges identified in this research are the backbone for developing a strategy for health care development in the Republic of Croatia. Long-term vision, strategy, policies, and a regulatory framework are all necessary preconditions for an efficient health care system and more quality health services.

Implications of the accession of the Republic of Croatia to the European Union for Croatian health care system.

The Republic of Croatia's accession to the European Union (EU) will affect all segments of economy and society, including the health care system. The aim of this paper is to establish the potential effects of joining the EU on Croatian health care, as well as to assess its readiness to enter this regional economic integration. The paper identifies potential areas of impact of EU accession on Croatian health care and analyzes the results of the conducted empirical research. In this research, a method of in-depth interviews was applied on a sample of 49 subjects; health professionals from public and private sectors, health insurance companies, pharmaceutical companies, drug wholesalers, and non-governmental organisations (patient associations). Once Croatia joins the EU, it will face: new rules and priorities in line with the current European health strategy; the possibilities of drawing funds from European cohesion funds; labour migrations; new guidelines on patient safety and mobility. From the aspect of harmonising national regulations with EU regulations in the area of health care, Croatian system can be assessed as ready to enter the EU. Croatia's accession to the EU can result in a better information flow, growth of competitiveness of Croatian health care system, enhanced quality, inflow of EU funds, development of health tourism, but also in increased migration of health care professionals, and potential increase in the cost of health care services. Functioning within the EU framework might result in adaptation to the EU standards, but it could also result in the concentration of staff and institutions in larger cities.

[Assessment of hepatic injury in patients with chronic viral hepatitis]. / Procjena ostecenja jetrenog parenhima u bolesnika s kronicnim virusnim hepatitisom.

The management and prognosis of chronic viral hepatitis greatly depend on the extent and progression of liver fibrosis. Although liver biopsy is still considered as the gold standard to evaluate hepatic fibrosis, it is an invasive procedure with rare but potentially severe complications. It is also prone to sampling errors. These limitations have stimulated the search for new noninvasive approaches. A number of noninvasive techniques such as indirect or direct markers and measurement of liver stiffness using transient elastography have been proposed for the assessment of hepatic fibrosis. The performance of simple tests derived from routine laboratory parameters appears to be similar to that of more complex and expensive fibrosis panels. Transient elastography seems to be more accurate than blood tests for diagnosing cirrhosis. The goal of disease specific, accurate and sensitive markers of fibrosis is worth the effort. The true success in such an attempt can be characterized as hopeful; however, these noninvasive methods can be anticipated to become an important tool in clinical practice.