Prevalence and Determinants of "String-Pulling" Behaviour in the Croatian Healthcare System

Abstract

In spite of frequent allegations about the Croatian healthcare
system being susceptible to various illegitimate practices,
research on this matter has been scarce so far. To start filling
the gap, this paper investigates how often and why
Croatians rely on friends, relatives and acquaintances in
order to achieve an unfair advantage over other users of the
healthcare system. As revealed by the representative survey
of 2000 individuals, which was conducted in 2015, almost
every fifth citizen employed this dishonest strategy during the
12-month period preceding the survey. Although half of the
respondents justified their wrongdoings with extremely long
waiting lists, logistic regression analysis offered a different
conclusion. Explicitly, the study results indicate that citizens
exert this misbehaviour more often by automatism than out
of real need. Due to a strong embeddedness of this
detrimental economic and social practice in Croatian society,
it would be more beneficial if combating endeavours were
focused on providers of illicit help.