[Medical specialists in Croatia: general overview, possibilities in planning and education in the future]. / Lijecnici specijalisti u Hrvatskoj: opci pregled, mogucnost planiranja i izobrazbe u buducnosti.

The paper describes the dynamics of trends in the number of specialists and the differences that have arisen over a 14-year period among individual specialties. Shown and analysed separately is the basic demographic information (obtained from the National Health Workers Registry) about the specialists working in Croatia in 2000. The data were used to illustrate the two options for planning them: by statistical method for analysing a time sequence and by prediction of specialist needs by anticipated old age retirement. At the end of 2000 there were 7,383 specialists, or 65.8% of the physician total employed in Croatian health service. Of these, 3,664 (49.6%) were females, with the median for females and males being 47 and 50 years, respectively. In relation to 1986, there was a twofold increase or greater in the number of maxillofacial surgeons (basic index 260; average rate of annual increase 7.1%), followed by psychiatrists, epidemiolgists, child surgeons and medical cytologists. The paper uses the Holt two-parameter method of exponential smoothing of the time sequence made up of the number of medical specialists per 100,000 population in 1980-99. Assuming maintained average annual growth of three specialists, this prognostic procedure predicted specialist density of 185/100,000 population for 2009. The feasibility of a more direct planning is illustrated with individual specialist sex and age data at certain age of life. It permits estimating the number of specialists to leave the health system for the most common reason, i.e. old-age retirement. On the set criterion of lady doctors reaching the age of 60 and their male colleagues 65 years, we predicted for each medical speciality the annual number of specialists due to retire for old age by the year 2020. In some specialties, the difference in the number of specialists anticipated to go into old-age retirement in two successive years will reach close to 50% or even slightly higher. In this way, the necessary number of replacement specialists for the retired can be estimated for each medical specialty by taking note of the critical years when, because of great variation in age composition, a larger number of specialists could simultaneously leave their posts. For these critical years, a sufficient number of specialists should be ensured by harmonizing our length of education and training curricula with those in force in the EU countries. The number of specialists and their composition will also be changing, depending on the health system's strategic solution to the need for specialist work in the Family Medicine Service.

[Demographic and educational characteristics of physicians in the health care system in Croatia: overview] ]. / Demografske i izobrazbene znacajke lijecnika zaposlenih u sustavu zdravstva Hrvatske: opci pregled.

The structure of 10,146 physicians working in Croatia's health system in 1990 and that of 11,103 working in 1999 are compared in terms of age, sex and level of training (intern, unspecialized doctor, resident, and specialist). Comparison of the same 5-year groups with reference to 1990 uncovered a reduction in the share of the two youngest 5-year physician groups (ages 25-29 and 30-34 years) in the total physician population working in 1999. Between 1990 and 1999, the average age of working physicians increased from 44.2 to 46.5 years and from 39.2 to 42.4 years in male and female doctors, respectively. In the same period the lady doctors' share of the physician total increased from 50.8 to 55.6%. By the criterion of the number of physicians per 100,000 population in 1980-99, Croatia was below selected group averages of the European countries. From 1991 to 1995 the generally rising trend of the number of physicians was interrupted due to the war in Croatia. Because of unequal numbers of physicians at individual years of age, we emphasized the need for demographic approach both in the planning of physician employment and advanced medical training. This necessity was reinforced by the fact that in 1999, at 35-44 years of age 1,147 (29%) physicians neither possessed a specialty degree nor started on any such course.