Geographical and Temporal Distribution of Radiologists, Computed Tomography and Magnetic Resonance Scanners in Croatia

Abstract

The aim of the study was to analyse the temporal and geographic distribution of radiologists, computed tomography and magnetic resonance scanners in Croatia. In this observational study we estimated radiologists’ number per 100,000 population for 1997, 2006, and 2017 and compared private and public CT and MR scanners between 2011 and 2018. We analyzed the availability of radiologists and scanners, and the relationship between the radiological workforce and economic strength among counties. The workforce increased significantly from 1997 to 2017 and was associated with economic strength categories in 2017. In 2018, there were more CT scanners in the public sector, while MR scanners were distributed evenly. In 2011, there was similar distribution of CT and MR between sectors, while in 2018 there were significantly more public CT scanners. Counties with a medical school had significantly more radiologists and MR scanners. The high-to-low ratios per CT and MR were 11 and 8.2, suggesting inequality of health care. Croatia significantly increased its radiological workforce; however, cross-county inequality remained. Counties with higher economic strength and medical schools have better availability of radiologists and equipment. To ensure the sustainable activity of the health care system, a precise estimate of supply and demand of radiology services is needed.

Regional Differences in Standardized Mortality Rate Trends for Peripheral Artery Disease from 2011 to 2020 in the Republic of Croatia

“…Usprkos manjku podataka, razlike između ishoda liječenja na razini institucija u kliničkoj su praksi razvidne i treba pretpostaviti da veći medicinski i akademski centri imaju bolju kvalitetu liječenja. 38 Isto tako, pri analizi dostupnosti endovaskularnih i kirurških intervencija svakako treba istaknuti nekoliko centara visokog volumena u Gradu Zagrebu, što može utjecati na rezultate istraživanja ponajprije u smislu boljeg registriranja PAB-a kao uzroka smrti. Takva centralizacija ljudskih i tehnoloških potencijala nije ekskluzivno obilježje pripisivo liječenju PAB-a, već je takav trend zamijećen i kod drugih specijalnosti.…”

“…Takva centralizacija ljudskih i tehnoloških potencijala nije ekskluzivno obilježje pripisivo liječenju PAB-a, već je takav trend zamijećen i kod drugih specijalnosti. 38 Republika Hrvatska izrazito je opterećena čimbenicima rizika povezanima sa životnim stilom, koji su uzrok više od polovine smrti. 10 Među čimbenicima rizika koji najviše utječu na mortalitet od PAB-a po učinku se ističu povišena razina glukoze u krvi natašte, arterijska hipertenzija (AH), pušenje i prehrana bogata solju.…”

“…Despite the lack of data, the differences in treatment outcomes in clinical practice are clear, and it can be assumed that larger medical and academic centers provide higher quality treatment. 38 Additionally, when analyzing the availability of endovascular and surgical interventions, the presence of several high-volume centers in the City of Zagreb should certainly be emphasized, as they may have influenced the study results, primarily in the sense of better registration of PAD as the cause of death. Such centralization of human and technological potential is not a characteristic exclusive to the treatment of PAD, and such trends have been observed for other specialties as well.…”

“…Such centralization of human and technological potential is not a characteristic exclusive to the treatment of PAD, and such trends have been observed for other specialties as well. 38 The Republic of Croatia is severely burdened by lifestylerelated risk factors, which are the cause of more than half of deaths. 10 Among risk factors that have the highest influence on mortality from PAD, elevated fasting blood glucose values, arterial hypertension (AH), smoking, and a diet rich in salt stand out as those with the greatest effect.…”

Analysis of Mortality from Peripheral Artery Disease from 2011 to 2020 by Region in the Republic of Croatia

“…Previous studies indicate the existence of regional differences in the availability of medical services, such as differences in waiting times for diagnostic examination using computed tomography (CT) and magnetic resonance (MR) imaging, but also differences in mortality from acute and recurrent myocardial infarction. [53][54][55][56] Additionally, the mortality from PAD, as with acute coronary syndrome, is ascribable to the natural course of the disease, but can also be caused by medical, endovascular, or surgical interventions, which necessitates differentiating and recording spontaneous unwanted outcomes as opposed to unwanted outcomes associated with medical interventions. 57,58 The present study had certain advantages and disadvantages, the latter being the study limitations and the possibility of systemic errors.…”