Economy & Business ISSN 1314-7242, Volume 12, 2018 Journal of International Scientific Publications www.scientific-publications.net Page 203 COMPARATIVE ANALYSES OF THE HEALTHCARE SYSTEMS IN AUSTRIA, ESTONIA, CROATIA, SLOVAKIA AND BULGARIA Angel Atanasov Georgiev, Doroteya Shtereva-Tzouni, Tihomira Zlatanova Faculty of Public Health, Medical University – Sofia, Bulgaria Abstract The development of the healthcare system in Bulgaria, Croatia (former member of Yugoslavia), Estonia (former member of Soviet Union) and Slovakia (former member of Czechoslovakia) is important as an example of former socialist countries, with centrally planned economy which was transformed into market economy. The aim of this article is to compare healthcare systems in Austria, Estonia, Croatia, Slovakia and Bulgaria as well as the risk factors, effectiveness of the systems, health expenditure, source of revenue and financial flows, out of pocket payments, voluntary health insurance, payment mechanisms, financial protection and equity in financing, equity of access to healthcare, transparency and plans for future development. The conclusion is that despite some improvements over the last three decades, health outcomes in these Eastern European countries remain unsatisfactory in comparison with Austria and the other leading EU countries. Unhealthy lifestyles persist in these countries and there are large disparities between different socioeconomic groups. In Austria health system is complex, with shared responsibilities between different levels of government and self-governing bodies. Austria performs well in ensuring access to healthcare, it reports the lowest levels of unmet needs for medical care across the EU and, despite relatively high out-of pocket payments, provides comprehensive financial protection for vulnerable groups. Keywords: Austria, Bulgaria, Croatia, Estonia, Slovakia, healthcare system, comparative research, health expenditure INTRODUCTION The health status of people in European union has improved significant since 1990, due to a range of factors, including reductions in infant mortality, rising living standards, improved lifestyles, better education, as well as advances in healthcare and medicine. Life expectancy at birth in Austria was 81,3 years in 2015, (EU average 80,6 years) in comparison with Estonia (78 years), Croatia (77,5 years), Slovakia (76,7 years) and Bulgaria (74,7 years) [1], and despite improvements in the health status, population ageing and unhealthy lifestyles pose important challenges to these five European countries. The aim of this article is to compare healthcare systems in Austria, Estonia, Croatia, Slovakia and Bulgaria as well as the risk factors, effectiveness of the systems, health expenditure, source of revenue and financial flows, out of pocket payments, voluntary health insurance, payment mechanisms, financial protection and equity in financing, equity of access to healthcare, transparency and plans for future development. BACKGROUND European health policy follows the principle of ensuring equal access to high-quality care for all, irrespective of income, age and gender. Despite some improvements over the last three decades, health outcomes in Eastern European countries Bulgaria, Croatia, Slovakia and Estonia remains unsatisfactory in comparison with Austria and the other leading EU countries. Although women in these five countries may live longer than men, it is not necessarily the case that they enjoy better health. The gender gap was considerably smaller in terms of healthy life years than it