engleski

Cancer care in Croatia, comparison with surrounding countries: Can we do better?

Cancer is a major public health problem worldwide. In the European Union (EU), Croatia (HR) and Hungary have the highest standardized cancer mortality rates (each min 330/100, 000 inhabitants, EU average 259.5/100, 000 inhabitants). The five-year survival rates for cancer patients in HR are also lower than the EU average. By analysing all segments of oncology care, we wanted to find out what could be the reason for this. Methods: This paper contains data from all oncology centres in HR (nine non-clinical and five clinical hospital centres), data from the Croatian Bureau of Statistics, the Croatian Institute of Public Health, Eurostat, and the Swedish Institute for Health Economics. Results: In HR, the health care of patients with malignant diseases is carried out in clinical hospital centres (CHC) and general hospitals (GH). 48% of the population live in counties that do not have clinical oncology centres. 30% of them have access to oncology treatment in their counties and 18% do not have oncology treatment in their counties. More people in HR than in any other EU Member State claim that their health needs are not met due to geographical distance (HR 0.6%, EU 0.1%). The presence of risk factors in HR is higher than the EU average, especially smoking and obesity and the response to screening programs for breast cancer, colorectal cancer, and cervical cancer is generally below the EU average. In HR in 2020 there are 130 oncologists (3.1 oncologists/100, 000 inhabitants), which is less than the EU average (Italy 7.1 ; Spain 3.9 ; United Kingdom 3.8 ; Germany 3.5). 106 oncologists (82%) work in clinical centres and 24 oncologists (18%) in non-clinical centres. 62 physicians specialize in oncology (77% for CHC and 23% for GH). The radiation equipment in HR is insufficient: there are 15 linear accelerators out of an optimal 24 (0.4/100, 000 inhabitants) and has a waiting time of w 2.5 months. In 2017, HR spent 6.8% of GDP on health care, less than the EU average (9.8%). Direct costs per capita for cancer treatment are significantly lower than other EU Member States (HR 100 €, EU average 195 €). Conclusions: If we want to improve the outcomes of cancer patients in HR, considerable efforts must be made to improve all segments of cancer care.

cancer care ; Croatia ; European Union ; comparison

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