Background The European Charter of Patients' Rights (ECPR) presents basic patients' rights in health care. We analysed the characteristics of patients' complaints about their rights through the official system and non-governmental organizations in Croatia. Methods The official system for patients 'complaints in Croatia does not have a common protocol but there are different modes for addressing patient complaints. In this cross-sectional study, we analysed the reports about patients' complaints

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... from the regional committees sent to the Ministry of Health and mapped the complaints received by the Croatian Association for the Protection of Patient's Rights (CAPR) to ECPR. Results The official data from the Ministry of Health in 2017 and 2018 included only 289 individual complaints from 10 out of 21 counties. Complaints were most frequently related to secondary and tertiary healthcare institutions and details were not provided. CAPR had 301 complaints about violations of patients 'rights. The most common complaint was the Right of Access to health care (35.3%) followed by the Right to Information (29.9%) and the Right to Safety (21.7%). The fewest complaints were about the Right to Complain (1.9%), Right to Innovation (1.4%), Right to Compensation (1.4%), and Right to Preventive Measures (1.0%). Conclusions Reporting and dealing with patients' complaints about violations of their patients' rights is not effective in systems with parallel but uncoordinated complaints pathways. Mapping patient's complaints to the ECPR is a useful tool to assess the perception of patients' rights and to plan actions to improve the complaints system for effective health care.