Health care provider payment schemes consist of a complex set of arrangements used to influence provider behavior towards specific health policy objectives. The study aimed at: 1) providing a structured, comparative overview of current payment schemes within the public health system in selected Central and Eastern European (CEE) countries for different health care providers; 2) identifying and comparing major changes in payment schemes since 2010. Methods included: 1) data collection form development; 2) desk research; 3) national experts' consultations; 4) comparative analysis. The results indicate that the nine CEE countries (Bulgaria, Croatia, Czechia, Estonia, Latvia, Lithuania, Hungary, Poland, and Romania) show numerous similarities in provider payment method mix and in the general direction of the recent changes conducted in this field. Output-based payment methods prevail across all countries and types of providers. Primary health care (PHC) providers are characterized by the most diverse payment method mix. PHC and hospital inpatient care have experienced the most frequent changes in their payment schemes within the last 13 years. These focused mostly on modifying existing payment methods (e.g. detailing payment categories), and applying additional methods to pay for specific services or performance (e.g. fee-for-service, bonus payments). The objectives of conducted change were often similar, thus, there is high potential for a shared, cross-country learning.

• MeSH
• dávkové mechanismy * MeSH
• lidé MeSH
• primární zdravotní péče ekonomika   MeSH
• zdravotní politika MeSH
• zdravotnický personál MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH
• Chorvatsko MeSH
• Estonsko MeSH
• Evropa MeSH
• Litva MeSH
• Lotyšsko MeSH
• Maďarsko MeSH
• Polsko MeSH
• Rumunsko MeSH
• východní Evropa MeSH

AIM: This study aimed to evaluate the compliance of dentists in Croatia and the Czech Republic with endodontic recommendations and identify the subjective and objective factors influencing their adherence to them. METHODOLOGY: A total of 1386 dentists from Croatia and the Czech Republic participated in an online survey through a self-administered, author-designed questionnaire. After excluding those who did not perform root canal treatments (RCT), 1376 responses (394 from Croatia and 982 from the Czech Republic) were statistically analysed. RESULTS: The median age of respondents was 40 years, with a higher proportion of females in both countries. Croatian dentists treated fewer patients weekly but performed more RCTs and placed more composite fillings than their Czech counterparts. Czech dentists more frequently employed magnification devices, rubber dam (RD), pre-endodontic build-ups, nickel-titanium (NiTi) instruments, irrigant activation, bioceramic sealers, indirect post-endodontic restoration of lateral teeth, and single-visit treatments. These practices were also more common among endodontists than general dental practitioners and other specialists in both countries. Croatian dentists adhered more consistently to the recommended irrigation protocol. In the Czech group, adherence to recommended procedures, such as magnification, RD usage, and irrigation protocol correlated with younger age, smaller weekly number of patients, and preference for treating patients in the supine position. No such correlations were observed among the Croatian dentists. CONCLUSIONS: Despite notable improvements in recent years, dentists still do not fully comply with the recommended RCT working procedures in Croatia and the Czech Republic.

• MeSH
• dodržování směrnic statistika a číselné údaje   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• terapie kořenového kanálku * statistika a číselné údaje   MeSH
• vzorové postupy ve stomatologii * statistika a číselné údaje   MeSH
• zubní lékaři statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Chorvatsko MeSH

Cílem studie bylo zjistit, jakým způsobem se chorvatští zubní lékaři rozhodují o odesílání svých pacientů k endodontistům a zda se toto rozhodnutí liší v závislosti na demografických proměnných týkajících se praktických zubních lékařů a charakteru jejich stomatologické praxe. Metodika: Byl sestaven dotazník zaměřený na demografické údaje týkající se účastníků studie a jejich praxe, typy prováděných endodontických zákroků a faktory ovlivňující jejich rozhodování o odeslání pacienta k endodontistovi. Dotazník byl rozeslán všem praktickým zubním lékařům s adresou ordinace v chorvatské Rijece. K analýze rozdílů ve zkoumaném vzorku byl použit χ2 test na hladině významnosti p < 0,05. Výsledky: Většina respondentů (39 z 94; 41,5 %) byla ve věku 40 až 49 let. Analýza ukázala, že většina respondentů byly ženy (64 z 94; 68,1 %). Významně více mužů (10 z 30) mělo postgraduální vzdělání ve srovnání se ženami (9 z 64; 33,3 % vs. 14,1 %; p < 0,001). Pokud jde o vliv demografických proměnných, měl významný vliv na rozhodování o odeslání pouze počet zubních lékařů zaměstnaných v ordinaci (χ2 = 7,006; p = 0,030). Respondenti, kteří pracovali ve vlastní zubní ordinaci sami, odesílali pacienty významně častěji než respondenti pracující v ordinacích, kde jsou zaměstnáni tři a více zubních lékařů (72,4 % vs. 20 %; p < 0,05). Závěr: V souvislosti se stárnutím evropské populace rostou náklady na zdravotní péči a je třeba sledovat nadužívání a nevyužívání specializované péče, aby byla pro každého pacienta zajištěna řádná léčba. Studenti a zubní lékaři by měli být podporováni v postgraduálním vzdělávání, které zvyšuje jejich odbornou způsobilost.

The aim of the survey was to identify the endodontic referral pattern among a group of Croatian dentists and to explore if the decision to refer a patient to an endodontist varies based on demographic variables of general dental practitioners and the features of their dental practice. Methods: A questionnaire was designed that focused on demographics of the participants and their practice, the pattern of endodontic procedures they perform and the factors influencing their decision to refer. The survey was mailed to all licensed general practicing dentists with a work address in Rijeka, Croatia. Chi-square test was used at a significance level P<0.05 to analyze differences in the study sample. Results: The majority of respondents (39 out of 94; 41.5%) were between 40 and 49 years old. Analysis revealed that the majority of respondents were female (64 out of 94; 68.1%). Significantly more male practitioners (10 out of 30) had postgraduate education compared to female practitioners (9 out of 64; 33.3% vs. 14.1%; P<0.001). Regarding the effect of demographic variables, only the number of dentists employed in a practice had a significant influence on the referral decisions of dentists (χ2=7.006; P=0.030). Respondents who were the only employed dentists referred patients significantly more often than respondents who work in practices where three or more dentists are employed (72.4% vs. 20%; P<0.05). Conclusion: Due to the aging European population, healthcare costs are increasing, and there is a need to monitor the overuse and underuse of specialized care to ensure appropriate treatment for each patient. Students and dentists should be encouraged to pursue postgraduate education, which enhances their professional competence.

• MeSH
• dospělí MeSH
• index potřeby ortodontické léčby * MeSH
• konziliární vyšetření a konzultace MeSH
• lidé středního věku MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• senioři MeSH
• stomatologická péče * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• Geografické názvy
• Chorvatsko MeSH

OBJECTIVES: Childhood obesity is a growing global problem that can be prevented by improving diet quality. Mediterranean diet (MedDiet), historically present in Mediterranean countries, is considered one of the healthiest dietary patterns. This cross-sectional study aimed to determine the MedDiet adherence and anthropometric parameters in 9-year-old children from the central geographic locations of Split-Dalmatia County, Croatia. METHODS: The study analysed data obtained from 158 children aged nine years from central parts of Dalmatia: Split and Hvar. To assess the MedDiet adherence, the parents of the children filled out the Mediterranean Diet Index (KIDMED) questionnaire. Appointed school medicine specialists collected anthropometric data of the children and categorized them into body mass index (BMI) categories according to the Center for Disease Control and Prevention (CDC) criteria. Additionally, we assessed the influence of parents' education degree on children's MedDiet adherence and anthropometric measures. RESULTS: Results showed that more than a quarter of nine-year-olds included in this study were overweight or obese (BMI ≥ 85th percentile for age and sex). One of the main findings was that 72% of children had suboptimal (poor or average) MedDiet adherence. Moreover, children with suboptimal KIDMED results (KI < 8) had significantly higher body weight, waist circumference, hip circumference, and waist-to-height ratio. Also, results showed that mothers' education notably influences children's anthropometry. CONCLUSION: Our study found that childhood obesity is a significant concern among 9-year-olds, with a high prevalence of overweight and obesity. Additionally, our results showed that MedDiet adherence is suboptimal among this age group. These results indicate that children of the Mediterranean are not spared of modern life challenges. This problem should be prioritized in the future to prevent the development of a metabolically compromised adult population.

• MeSH
• antropometrie MeSH
• dítě MeSH
• index tělesné hmotnosti MeSH
• lidé MeSH
• obezita dětí a dospívajících * epidemiologie   prevence a kontrola   MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• strava středomořská * statistika a číselné údaje   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Chorvatsko MeSH

INTRODUCTION: Previous research has raised concerns about high prevalence of drug-related problems, polypharmacy and inappropriate benzodiazepine prescribing in nursing homes (NHs) and confirmed lack of studies from Central and South-Eastern Europe. The aim of our study was to determine the prevalence and characteristics of polypharmacy, hyperpolypharmacy and inappropriate benzodiazepine prescribing in NH residents in Croatia. METHODS: Data from 226 older NH residents from five Croatian NHs were collected using the InterRAI Long-Term Care Facilities assessment form. The prevalence and determinants of polypharmacy/hyperpolypharmacy and patterns of inappropriate benzodiazepine prescribing were documented. RESULTS: The prevalence of polypharmacy (49.6%) and hyperpolypharmacy (25.7%) among NH residents was high. In our study, 72.1% of NH residents were prescribed at least one psychotropic agent, 36.7% used 2-3 psychotropics and 6.6% used 4+ psychotropics. Among benzodiazepine users (55.8%), 28% of residents were prescribed benzodiazepines in higher than recommended geriatric doses, 75% used them for the long term and 48% were prescribed concomitant interacting medications. The odds of being prescribed polypharmacy/hyperpolypharmacy were significantly higher for older patients with polymorbidity (6+ disorders, proportional odds ratio (POR) = 19.8), type II diabetes (POR = 5.2), ischemic heart disease (POR = 4.6), higher frailty (Clinical Frailty Scale (CFS ≥5); POR = 4.3) and gastrointestinal problems (POR = 4.8). CONCLUSIONS: Our research underscores the persistent challenge of inappropriate medication use and drug-related harms among older NH residents, despite existing evidence and professional campaigns. Effective regulatory and policy interventions, including the implementation of geriatrician and clinical pharmacy services, are essential to address this critical issue and ensure optimal medication management for vulnerable NH populations.

• MeSH
• benzodiazepiny * terapeutické užití   škodlivé účinky   aplikace a dávkování   MeSH
• domovy pro seniory statistika a číselné údaje   MeSH
• lékařská praxe - způsoby provádění statistika a číselné údaje   normy   MeSH
• lidé MeSH
• nevhodné předepisování * statistika a číselné údaje   MeSH
• pečovatelské domovy * statistika a číselné údaje   MeSH
• polypharmacy * MeSH
• prevalence MeSH
• psychotropní léky terapeutické užití   škodlivé účinky   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Chorvatsko MeSH

OBJECTIVE: Cardiovascular diseases are the leading global cause of death. Due to the disparities in cardiovascular risk factors between rural and urban populations, this study aims to assess the differences in the prevalence of risk factors in urban and rural areas of eastern Croatia. METHODS: The cross-sectional study included 280 participants (140 from urban and 140 from rural areas) registered at studied general practice offices. Methods included e-health records, questionnaire, physical examination methods, and blood sampling for laboratory tests. RESULTS: The most common risk factors among participants were elevated total cholesterol (83.6%), elevated LDL cholesterol (81.8%), increased body mass index (75.0%), increased waist-hip ratio (82.9%), increased waist circumference (63.2%), and arterial hypertension (70.1%). The rural participants had a significantly higher prevalence of arterial hypertension (p = 0.023), increased body mass index (p = 0.004), increased waist circumference (p = 0.004), increased waist-hip ratio (p < 0.001), and increased LDL cholesterol (p = 0.029), while the urban participants had a significantly higher prevalence of insufficient physical activity (p < 0.001). CONCLUSIONS: In the examined sample, the prevalence of cardiovascular risk factors is generally high. Participants from rural areas are significantly more susceptible to cardiovascular risk factors than participants from urban areas.

• MeSH
• dospělí MeSH
• index tělesné hmotnosti MeSH
• kardiovaskulární nemoci * epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• městské obyvatelstvo * statistika a číselné údaje   MeSH
• poměr pasu a boků MeSH
• prevalence MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• rizikové faktory kardiovaskulárních chorob MeSH
• rizikové faktory MeSH
• senioři MeSH
• venkovské obyvatelstvo * statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Chorvatsko MeSH

Aim: This study aimed to test an existing theory of the Anxiety about Aging Scale and determine the relationship between ageism and anxiety about aging in nurses in the Republic of Croatia. Design: A cross-sectional study. Methods: The sample consisted of 798 nurses from Republic of Croatia. Participants filled Anxiety about Aging Scale and Kogan's Attitude toward Old People Scale. Results: Regarding the factor structure of the 20 items, chi-square test revealed a statistically significant finding (χ² = 2131.090, df = 164, p > 0.05). Analyses confirmed the four-factor structure (fear of older adults, psychological concern, fear of loss, and physical appearance) and the indicators of adequate reliability and validity. Furthermore, Kogan's Attitude toward Old People Scale significantly correlated with fear of older adults (r = 0.409; p < 0.01); attitudes changed with fear of older adults. Factors such as age, work experience duration (in years), and education individually affected aging anxiety, but not sex, living with older adults, and work department. Conclusion: The Anxiety about Aging Scale Croatian version is a valid and reliable measuring instrument for nurses. Nurses who have expressed greater anxiety about aging have a more negative attitude toward older adults.

• MeSH
• diskriminace na základě věku klasifikace   psychologie   MeSH
• lidé MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• škála projevu úzkosti MeSH
• stárnutí * psychologie   MeSH
• úzkost klasifikace   psychologie   MeSH
• zdravotní sestry * psychologie   MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Chorvatsko MeSH

Our study aimed to assess the prevalence of fall risk-increasing drugs (FRIDs) in a sample of community-residing older patients in Croatia and its association with negative health outcomes. An observational, cross-sectional study was conducted on older patients (65+) visiting community pharmacies in three regionally different study sites in Croatia. Data were collected using a questionnaire developed for that purpose and included components of comprehensive geriatric assessment. Prevalence of FRIDs was identified using the "Screening Tool of Older Persons Prescriptions in older adults with high fall risk" (STOPPFall). In the sample of 407 participants (median age 73 (IQR 69-70) years; 63.9 % females), 79.1 % used at least one FRID. The most common drug classes were diuretics, benzodiazepines, and opioids (in 51.1 %, 38.1 %, and 17.2 % participants, respectively). More FRIDs were prescribed to the oldest old patients (85+) and participants from poorer regions of Croatia (Slavonia) (p < 0.05). Exposition to FRIDs was identified as the significant risk factor associated with falls (OR = 1.24 (1.04-1.50); p = 0.020) and higher health-care utilization (OR = 1.29 (1.10-1.51); p = 0.001). Our study highlights the need for rationalization of FRID use. To reduce the unnecessary exposure to FRIDs in older adults, health-care professionals must consider high individualization of medication schemes regarding selection, dosing, and combinations of only necessary FRIDs.

• MeSH
• diskriminace na základě věku * MeSH
• geriatrické hodnocení metody   MeSH
• kohortové studie MeSH
• lidé MeSH
• polypharmacy MeSH
• prevalence MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• rizikové faktory MeSH
• samostatný způsob života * MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• úrazy pádem * statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Geografické názvy
• Chorvatsko MeSH

We report a case of double aneuploidy in a preterm male newborn with karyotype 48,XXY,+18 whose mother was of advanced age and infected with the SARS-CoV-2 virus during the early stages of her pregnancy. The clinical features observed in the newborn included intrauterine growth retardation, dysmorphic facial features, overlapping fingers on both hands, respiratory distress syndrome, ventricular septal defect, patent ductus arteriosus, persistent pulmonary hypertension, and bilateral clubfoot, a phenotype that mainly correlates with Edwards syndrome (trisomy 18). To our knowledge, this is the first reported case of double aneuploidy in Croatia. This paper provides a detailed description of the clinical presentation and treatment strategies used, with the aim of providing valuable data for future recognition and management of similar cases. Furthermore, we discuss the mechanisms of nondisjunction that might account for this rare form of aneuploidy.

• MeSH
• aneuploidie MeSH
• COVID-19 * komplikace   MeSH
• lidé MeSH
• SARS-CoV-2 MeSH
• syndrom trizomie 18 komplikace   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Geografické názvy
• Chorvatsko MeSH

Although defining normative values of cardiorespiratory fitness have been the topic of many Western societies, little evidence has been provided for less developed countries like Croatia. Since cardiorespiratory fitness rapidly declines in Croatian children and adolescents, the newly established normative values would help health-related professionals and physical education teachers to detect 'talented' groups and direct them towards sport and 'risky' groups for planning special interventions. Therefore, the main purpose of the study was to determine normative reference values of cardiorespiratory fitness. A total of 1,612 children and adolescents aged 7-14 years (mean±SD; age 9.7±2.4 years; stature 151.0±17.6 cm; body mass 45.1±19.1 kg; 52.5% girls) participated in this cross-sectional study. Cardiorespiratory fitness was assessed by the Maximal multistage 20-m shuttle run test and the performance was expressed as the number of stages. Maximal oxygen uptake (VO2max) was estimated by equations. Smoothed percentile curves were calculated. Boys outperformed girls in the maximal number of levels achieved after the 20-m shuttle run test and in the VO2max values at each age category. In boys, a gradually higher level of performance between ages 11 and 14 was observed, while in girls the values started to rise after the age of 8. Our study provides one of the first sex- and age-specific normative values for cardiorespiratory fitness assessed by the 20-m shuttle run test in Croatian children and adolescents.

• MeSH
• dítě MeSH
• kardiorespirační zdatnost * MeSH
• lidé MeSH
• mladiství MeSH
• průřezové studie MeSH
• referenční hodnoty MeSH
• rizikové faktory MeSH
• tělesná výkonnost MeSH
• zátěžový test MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Chorvatsko MeSH