# The impact of Croatia’s 2013 Primary Care Payment Reform: an exploratory case study of a rural family practitioner group practice

## TL;DR

This study examines how a 2013 payment reform in Croatia affected a rural family practice, finding changes in preventive care and hospital referrals.

## Contribution

The study provides early insights into the impact of a primary care payment reform in a rural Croatian setting.

## Key findings

- Preventive check-ups increased after the payment reform.
- Hospital referrals decreased following the new payment model.
- Prescribing increased despite financial disincentives, suggesting complex behavior patterns.

## Abstract

To explore the effect of Croatia’s 2013 Primary Care Payment Reform on patient care.

The performance of one rural family practitioner group practice in Breznica was assessed one year before and one year after implementation. Using an exploratory case study design with quantitative methods, we examined outcome variables linked to the new payment model. Drawing on publicly available activity reports, we conducted linear regression analyses to identify potential associations.

We observed changes in most incentivized outcomes, notably increases in preventive check-ups and decreases in hospital referrals. Some indicators, such as the increase in prescribing despite financial disincentives, remain inconclusive and highlight the need for further investigation.

These findings are preliminary but provide valuable hypotheses for guiding more rigorous, longitudinal, and multi-site studies.