HEALTH STATUS AND HEALTH NEEDS ASSESSMENT – STATE OF THE ART OF THE PUBLIC HEALTH PRACTICE IN CROATIA

Opisana je postojeća javnozdravstvena praksa vezana uz funkciju procjene zdravlja i zdravstvenih potreba stanovništva u Republici Hrvatskoj. U našem sustavu zdravstvene zaštite ta se javnozdravstvena funkcija obnosi korištenjem rutinske zdravstvene i demografske statistike te epidemiološkim istraživanjima. Akademski, koriste se i rezultati drugih tipova javnozdravstvenih istraživanja, ali oni u pravilu imaju slabi utjecaj na praksu procjene zdravstvenih potreba stanovništva. Suvremeno javno zdravstvo uvodi novosti u praksu ocjenjivanja zdravstvenih potreba. Prvo, revidira se rutinska zdravstvena statistika kako bi je se moglo koristiti i za aktualne procjene zdravstvenih potreba. Drugo, uvodi se kvalitativna paradigma u javnozdravstvena istraživanja za rutinske potrebe procjena zdravlja stanovništva ili podskupina u populaciji. Treće, uvedene su zdravstvene ankete koje osim pružanja informacija o ponašanju vezanom uz zdravlje imaju za cilj intervencijom unaprijediti kvalitetu u sustavu zaštite zdravljaPublic health practice performance is measured through its three core functions, i.e. assessment, policy development and assurance. We describe the existing health status and health care needs assessment practices in the Republic of Croatia. Health care needs assessment in Croatia includes mortality and morbidity information available through vital records but does not include community input (opinion and attitude) and participation. Health needs are not analyzed in order to determine the causes of health problems. Analysis of health needs of the population groups at highest risk also does not exist. Resources assessment is not part of the process, so we do not know how adequate the existing health resources are. In the Croatian health care system practice, the assessment function is limited through the almost exclusive use of the routine health and demographic statistics. Academic public health has introduced other kinds of more participative, subgroups oriented, qualitative methodologies but in daily routine, these methods are hardly used. Since health needs assessment is one of the core public health functions, in the future its practice has to be reoriented from pure monitoring towards identifying and solving community health problems. Partnership with community has to be a cornerstone for more efficient health needs assessment practice. In the light of previous statement, we present and discuss new trends in the assessment practice in Croatia, i.e. revision of routine health data collection, ways of performing intervention aimed health surveys, naturalistic approach in health needs assessment, and health needs research of population groups at highest risk