S ukupno 79 bolnica i izvanbolničkih stacionara/rodilišta Hrvatska je 2007. godine bila na 35. mjestu od 44 europske zemlje (1,7 bolnica/100.000 stanovnika; Europa 3,4/100.000). Bez 10 izvanbolničkih stacionara i 6 izvanbolničkih rodilišta Hrvatska je na 41. mjestu (1,4/100.000). Po broju akutnih bolnica, bez izvanbolničkih stacionara/rodilišta, Hrvatska je sa 36 akutnih bolnica na pretposljednjem 43. mjestu (0,8/100.000 stanovnika; Europa 2,6/100.000). Prema ukupnom broju kreveta, Hrvatska je na 23. Mjestu (352/100.000 stanovnika; Europa: 489 kreveta/100.000). Prosječnim brojem kreveta na jednu akutnu bolnicu, Hrvatska je bez izvanbolničkih stacionara/rodilišta (446) na 2. mjestu iza Nizozemske (541). Prema broju akutnih bolnica na 1.000 km2 površine, bez izvanbolničkih stacionara/rodilišta, Hrvatska je na 39. mjestu (0,6/1.000 km2; Europski prosjek bez Rusije: 2,3/1.000 km2). Najviše akutnih bolnica u Hrvatskoj ima Požeško-slavonska županija (2,3/100.000), a najmanje Splitsko-dalmatinska i Ličko-senjska županija (0,2/100.000) ili 7 puta manje od prosjeka Hrvatske, a 13 puta manje od europskog prosjeka. Unatoč dostatnom broju akutnih kreveta, Hrvatska ima nedostatak i neravnomjernu raspodjelu akutnih bolnica. Izrazita nejednakost raspodjele bolnica u Hrvatskoj rješiva je zamjenom postojećih izvanbolničkih stacionara/rodilišta u Dalmaciji, Kvarneru, Istri, Lici te istočnoj Slavoniji samostalnim komunalnim/gradskim bolnicama s dogovorenim specijalističkim sadržajima, što bi znatno poboljšalo dostupnost pravovremene specijalističko-konzilijarne i bolničke zdravstvene zaštite.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. Aim: 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. Method: 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 ards/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). Discussion: 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. Conclusion: 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
