Raspodjela reumatologa u Hrvatskoj – izazovi centralizacije i heterogenosti reumatološke struke

Scientific paper - Original scientific paper

• Title (english): Distribution of rheumatologists in Croatia – challenges of centralization and heterogeneity of the rheumatology workforce
• Author: Zrinka Biloglav
• Author: Ivan Padjen
• Author: Petar Medaković
• Author: Domagoj Andrić
• Author: Dominic Vidović
• Author: Mario Trošelj
• Author: Branimir Anić
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Author's institution: University of Zagreb; School of Medicine; (Department of Medical Statistics, Epidemiology and Medical Informatics)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Epidemiology

Abstract (croatian)

Cilj: Analizirati demografska obilježja i distribuciju reumatologa u Hrvatskoj po vrstama specijalizacija i županijama te izračunati stopu na broj stanovnika na državnoj i županijskoj razini. Materijal i metode: Ovo presječno istraživanje temeljeno je na podatcima dobivenima od Hrvatskoga zavoda za javno zdravstvo o djelatnim reumatolozima zaključno do rujna 2022. godine. Analizirana je raspodjela reumatologa po dobi, spolu, vrsti specijalizacije, vrsti ustanove (akademska vs. neakademska) i lokaciji (županija). Stopa je izračunata na 100.000 stanovnika opće populacije. Rezultati: Od ukupno 77 reumatologa, 54% je fizijatara, 34% internista i 12% reumatologa s internističkim „deblom“. Žene čine 70% svih reumatologa. Prosječna dob je 50 godina, pri čemu je gotovo trećina (32,5%, N=25) starija od 55 godina. Gotovo dvije trećine (63,64%, N=49) radi u županijama s medicinskim fakultetima. Gotovo 90% internista i reumatologa radi u županijama s medicinskim fakultetima, a više od 50% u tercijarnim bolnicama. Reumatolozi rade u 15/21 županije (71%) i stopa na 100.000 stanovnika iznosi 1,99. Omjer najviše i najniže stope između županija iznosi 7 (Primorsko-goranska vs. Sisačko-moslavačka). Zaključci: Reumatologija je heterogena struka obilježena visokim udjelom žena i različitim profilima specijalističke izobrazbe. Stopa reumatologa na 100.000 stanovnika slična je europskom prosjeku, međutim razlike između pojedinih županija i regija jasno su izražene s tendencijom ka centralizaciji. Procjena dostupnosti reumatološke skrbi u hrvatskom zdravstvenom sustavu ograničena je zbog nedostatne informatizacije zdravstvenog sustava i izostanka mogućnosti usporedbe određenih kvantitativnih pokazatelja zdravstvene skrbi.

Abstract (english)

Aim: We aimed to analyze demographic features and the distribution of rheumatologists in Croatia and estimated the rate of rheumatologists at national and county levels. Material and Methods: This cross-sectional study was based on the data on practicing rheumatologists obtained from the Croatian Institute of Public Health until September 2022. We analyzed the distribution of rheumatologists according to age, sex, specialist training profile, type of institution (academic vs. non-academic) and location (county). We estimated the rate of rheumatologists per 100,000 general population. Results: A total of 77 rheumatologists were identified, including physiatrists (54%), internists (34%) and rheumatologists with an internal medicine „common trunk“ (12%). Females were predominant, comprising 70% of all rheumatologists. The mean age was 50 years, with almost a third (32.5%, N=25) exceeding the age of 55. Nearly two thirds (63.64%, N=49) worked in counties with medical schools (approaching 90% among internists and rheumatologists) and over 50% in tertiary hospitals. Rheumatologists worked in 15/21 (71%) counties, while the estimated rate was 1.99 per 100,000 population. The highest to lowest inter-county ratio was 7 (Primorsko-Goranska vs. Sisak-Moslavina). Conclusions: Rheumatology is a heterogeneous field characterized by a high proportion of females and differences in the profile of specialist training. The rate per 100,000 population is in line with the European mean, however, differences between counties and regions are pronounced with a clear tendency towards centralization. Estimation of the supply of rheumatology services in the Croatian health system is limited due to lacking informatization of the healthcare system and a lack of possibility to compare well-defined quantitative health service indicators.

• Keywords (croatian): reumatolozi – dostupnost i distribucija, statistički podatci; reumatologija – edukacija, statistički podatci; specijalizacija – statistički podatci; liječnice – statistički podatci; ljudski resursi u zdravstvu – statistički podatci; dobna raspodjela; spolna raspodjela; Hrvatska
• Keywords (english): rheumatologists – statistics and numerical data, supply and distribution; rheumatology – education, statistics and numerical data; specialization – statistics and numerical data; physicians, women – statistics and numerical data; health workforce – statistics and numerical data; age distribution; sex distribution; Croatia
• Language: croatian
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Liječnički vjesnik
• Numbering: vol. 146, no. 5-6, pp. 219-230
• p-ISSN: 0024-3477
• e-ISSN: 1849-2177
• DOI: https://doi.org/10.26800/LV-146-5-6-7
• URN:NBN: urn:nbn:hr:105:691199
• Publication: 2024
• Document URL: https://hrcak.srce.hr/319963
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-12-17 09:20:15