Croatia is ageing quickly: the share of the population aged 65 years and over is expected to grow from 21% in 2019 to 31% in 2050, remaining above the average for OECD countries. As people get older, they will need help with ongoing medical care, everyday activities such as washing and dressing, household activities such as cleaning and cooking, as well as with social activities such as going out for a walk. This help is part of what is commonly termed long-term care (LTC).
Croatia has traditionally placed a strong emphasis on family care, but with changing family characteristics, the long-term care framework needs to adapt. The Croatian legislation states that care to older people belongs to the family sphere first. Many older people who struggle to carry out everyday activities often find informal support in their spouses, children, friends, and neighbours. Unpaid, family care often comes with costs. Families and friends that provide support to dependent older individuals are more likely to experience declines in their physical health and their mental well-being and are more likely to drop out of the labour market or reduce working hours. Income levels of family carers decrease as a result. Furthermore, population ageing coupled with changing social norms and structures (e.g. household composition and female labour market participation) limit the pool of potential family carers available to older people today and in the coming years. Smaller, more geographically dispersed family structures will make this issue more acute as help from children could be more difficult to come by in the coming decades.
This report examines the provision of long-term care in Croatia. It analyses the care needs of the population and current gaps. It points to shortcomings of the system in terms of access to benefits and services, equitability, and affordability. The situation of family carers, their needs and support they receive are also described. The report proposes directions for reform to strengthen the formal component of the long-term care system, with the view that it should be developed to offer affordable alternatives to family care, and to improve direct support to family carers. Such policy options build on analysis of good practices from other EU and OECD countries.
This report brings together previous OECD work carried out in 2019-2021 for the Government of Croatia, with the support of the European Commission. Since the analysis was carried out, the Government of Croatia has also made some commitments to improve the situation. In 2022, the Government of Croatia modified the Social Welfare Act to include a benefit for family carers reflecting the analysis and recommendations outlined in this report. Additionally, the Operational Plan for the Development of Long-Term Care 2023-2027 of the Ministry of Health and the Ministry of Labour, Pension System, Family and Social Policy is currently being developed to improve the co‑ordination of health and social services and investments in the development of non-institutional services are planned to enable older people to improve their quality of life and stay in their own home as long as possible. Finally, Croatia is planning an Ordinance on a unified methodology for assessing needs.