title: [Does Croatia have hospital surplus?].
abstract: BACKGROUND
  In addition to human resources in health care, hospitals are unavoidable factor in international deliberations of development level of health systems. Besides education of health workers, equipped devices and efficiency of work in hospitals, it is important to compare the number of hospitals, their size, type of hospitals, their distribution and availability to users. These elements are essential to the overall quality and efficiency of health work of an area.
  
  
  OBJECTIVE
  To identify and analyze the hospital by the number, type and size, number and type of beds in them, and the disposition in relation to population and unit area (km2) in Croatia, County of Split-Dalmatia and other European countries in total and by groups of European countries by the gross national product per capita (GDP pc), in 2007. Based on the analysis, to answer the question whether Croatia has a sufficient number of hospitals, particularly in County of Split-Dalmatia and Dalmatia.
  
  
  METHODS
  In this article are used methods of descriptive epidemiology based on available electronic data of the WHO Office for Europe.
  
  
  RESULTS
  Of the 44 European countries, Croatia is in the 35th place with a total of 79 hospitals (1.7 hospitals/100,000 population; Europe 3.4/100,000). Without 10 hospital wards, and 6-of-hospital maternity, Croatian average is 1.4/100,000 which places Croatia in 41st place. By the number of acute hospitals with no out-patient clinic and maternity wards, Croatia is in the penultimate 43rd place with 36 hospitals (0.8/100,000; Europe 2.6/100,000). According to the average number of beds/100,000 population, Croatia is at the 23rd place (Europe: 489 beds/100,000 population; Croatia: 352 beds/100,000). By the size of the hospitals per average number of hospital beds per one acute hospital Croatia has no clinic and outpatient hospitals (446) which puts Croatia in the second place behind the Netherlands (541). According to the number of acute hospitals/1,000 km2 with no out-patient clinic and maternity wards, Croatia is at the 39th place (0.6/1,000 km2; European average without Russia: 2.3/1,000 km2). In Croatia, most hospitals/100,000 population has County of Pozega-Slavonia (3.5/100,000), while the least are in Split-Dalmatia County (0.4/100,000). The most acute hospitals are in County of Pozega-Slavonia (2.3/100,000), and the least in County of Split-Dalmatia (0.2/100,000) or 7 times less than the Croatian average, and 13 times less than the European average. By the number of acute hospitals with no out-patient clinic and maternity wards/1,000 km2 in Croatia, there are most hospitals together, in City of Zagreb and County of Zagreb (3/1000 km2), and the least in County of Lika-Senj and County of Split-Dalmatia (0.2/1,000 km2).
  
  
  CONCLUSIONS
  Croatia is getting behind by the number of hospitals, compared to Europe, especially concerning acute hospitals. Given the density and area unit in the Southern Croatia there is a striking lack of acute hospitals, causing a disparity in the availability of hospital and specialist health care. To make hospital and specialist health care available to the 170,000 inhabitants of Dalmatia, who are more than an hour away from the hospital, it is necessary to replace outpatient-clinics and maternity hospitals with the general hospitals.
  
  
  CONCLUSIONS
  Given the fact that Croatia is at the top of Europe by the size of the hospitals by the number of beds for acute patients, and there is the sufficient number of beds to population, but also a lack of spatial coverage of acute hospitals and therefore poor availability of hospital and specialist care for the advisory large population of south and east of the state and Istria. Croatia should achieve further necessary hospital facilities by planning and building small municipal/town/local hospitals for acute patients with the necessary agreed facilities at the headquarters of the former health centers where already exists specialist diagnostic and therapeutic activities of secondary level health care.
authors.affiliation: Teaching Institute for Public Health of the Split-Dalmatia County, Split, Croatia. ankica.smoljanovic@st.t-com.hr
authors.forename: Ankica
authors.initials: A
authors.lastname: Smoljanović
authors.forename: Mladen
authors.initials: M
authors.lastname: Smoljanović
authors.forename: Marijana
authors.initials: M
authors.lastname: Mlikotić
mesh_terms: D017523:Croatia; D005060:Europe; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006761:Hospitals / Q000600:supply & distribution*; D006801:Humans