Objectives Population ageing and the prevalence of multimorbidity represent major challenges for healthcare systems. People who need long-term care have complex conditions requiring both health and social services. Informal caregivers are emerging as an important part of the long-term care ecosystem. This paper aims to explore the position and capacities of informal caregivers in Croatia. Design Health and social care legislative documents were analysed using a structured set of keywords. In addition, focus groups were conducted with informal caregivers who cared for a family member. The qualitative method of thematic analysis was used. Setting and participants Two focus groups were conducted with 15 caregivers (13 women and 2 men). Geographically, participants came from all four NUTS2 Croatian regions. All participants cared for a close family member. The length of care provision ranged from 3 to 35 years. Focus groups were conducted using the Zoom platform. Results The analysis of the documents indicates the fragmentation of national policy into health and social policy. Long-term care as a term is recognised only in health policy. However, some components related to long-term care are part of social policy. Caregivers are recognised in social policy, although not in healthcare. In focus groups, three main themes were identified as follows: (1) position and role of the caregivers in the system and society; (2) types of care based on the recipient’s need and (3) support for the caregivers. Conclusion The research showed that the process of exercising certain rights and services for caregivers is not sufficiently clear and feasible in practice. There is a lack of a clearly defined role of caregivers and relationships towards professional care providers in the system. The key to improving long-term care is connecting community services, including health and social services, both formal and informal, with the process of providing care.

Background: The increasing complexity of patient care demands coordinated and integrated approaches involving multiple health and social care professionals. Social capital among professionals plays a critical role in facilitating effective collaboration and continuity of care for complex patients. Objectives: This pilot study aimed to develop and test an instrument based on the position generator method to measure perceived, potential, and activated social capital for patients within professional networks involved in complex patient care in Croatia. Methods: The instrument enabled differentiation between the existence of professional connections and their actual mobilization for patient benefit. This multidimensional approach, including activation levels for patient needs, marks a key improvement over earlier measures. Results: Results indicated that while professionals possess broad networks, the activation of these networks for patient care remains limited. Accumulated work experience is positively associated with greater activation of social capital, whereas formal changes in the work environment showed no significant impact. Conclusions: Despite sample limitations restricting generalizability, the instrument demonstrated sensitivity and applicability for mapping professional networks in healthcare settings. This study lays the groundwork for further research with larger samples to validate the instrument and support the development of coordinated care systems leveraging social capital for improved outcomes in complex patient care.

Objectives Preschool children with complex needs require a multidimensional care model. In such a model, paediatricians are one of the key stakeholders. This study examines Croatian paediatricians’ experiences and perceptions of their role in the care process. It explores their view of the other stakeholders, practices and determinants that influence their role and overall quality of care. Design A desk review was performed as the first part of the research. It included a search of electronic bibliographic databases using a structured set of keywords and an analysis of selected strategic, policy and legislative documents, registers, guidelines and reports related to the research topic. This part of the research helped form the research protocol for the two focus groups that followed. Participants 12 primary, secondary and tertiary care paediatricians participated in the focus groups, following the criteria: specialist paediatric experience longer than 5 years, active work status in the healthcare system at the primary, secondary or tertiary level, personal experience of working with preschool children with complex needs. Results The first part of the research identified structural shortcomings, ambiguity in defining systematic approaches to care processes, quality challenges and a lack of multidimensional evaluation in the care system. Focus groups provided insight into the everyday dynamics of those challenges from the paediatricians’ point of view. Six themes emerged from the analysis of the focus groups: (1) profile and needs of preschool children with complex needs; (2) parents in the process of care from the paediatrician’s perception; (3) the role of paediatricians in the process of caring for a preschool child with complex needs; (4) the absolute and relative scarcity of public resources; (5) the need for systematic solutions; (6) the importance of personal engagement. Conclusions Integration, coordination and continuity of care for preschool children with complex needs cannot be achieved by merely focusing on providing enough human and infrastructural resources. Without clear insight into the interrelation of structural inputs and stakeholders’ specific standpoints, we risk further fragmentation and a decrease in the quality of care.