Authors: L. Nováková 1; V. Šikola 2; Š. Tichý 3; L. Šenolt 1,3; K. Bubová 1,3 Authors‘ workplace: Revmatologický ústav Praha 1; Ústav veřejného zdravotnictví a medicínského práva 1. LF UK, Praha 2; Revmatologická klinika 1. LF UK, Praha 3 Published in: Čes. Revmatol., 33, 2025, No. 3, p. 119-126. Category: Original article
The aim of this study was to assess the capacity and accessibility of rheumatology care in the Czech Republic and to describe organizational characteristics, including regional disparities. Methodologically, this study was a cross-sectional data analysis conducted between January 1 and December 31, 2024, using data from the registry of the Czech Rheumatological Society, health insurance funds, the Institute of Health Information and Statistics, and a questionnaire survey.
The analysis evaluated the number of rheumatologists and full-time equivalents (FTEs; clinical and academic), the structure of care providers (outpatient and inpatient services), and operational parameters including access to physiotherapy, appointment systems, and waiting times. As of December 31, 2024, 337 rheumatologists were registered in the Czech Rheumatological Society (214 certified female specialists and 78 certified male specialists; 34 female and 11 male physicians in training). Health insurance funds had contracted a total of 221.47 FTEs.
Comparison of data obtained from healthcare facilities that completed the questionnaire (62.3%) with data provided by insurance funds revealed a substantial discrepancy in FTE numbers (222.05 vs. 167.34), with the largest differences observed in large inpatient institutions. On average, there were 2.03 FTEs per 100,000 inhabitants nationwide. The lowest densities were observed in the Central Bohemian, Pardubice, and Hradec Králové regions and the Vysočina Region (≤ 1 FTE per 100,000 inhabitants).
A total of 149 outpatient clinics and 58 inpatient facilities were identified, with 85 rheumatology beds concentrated in three hospitals. Overall, 129 facilities completed the questionnaire (92 outpatient and 37 inpatient institutions). One-third of outpatient clinics (33.7%) and 40.3% of all facilities shared medical staff, at least partially, with another healthcare institution.
The mean number of nurses per outpatient clinic was 1.6 and 2.0 nurses per facility overall. Direct access to physiotherapy was reported by 25.6% of all facilities. Prioritized scheduling for acute cases was implemented by 53.9% of all providers. The average waiting time for non-urgent outpatient appointments was 73 days, compared to 9.5 days for urgent referrals, with similar findings across all facility types.
In conclusion, while the number of rheumatologists in the Czech Republic approximates the European average, rheumatology care is compromised by a low number of contracted FTEs and marked regional inequalities. A shortage of younger rheumatologists may soon pose a significant threat to care accessibility. Key priorities include stabilization and expansion of clinical FTEs, strengthening interdisciplinary collaboration, and increasing the attractiveness of the specialty to improve physician recruitment and retention.
Outpatient clinics – patient – rheumatology care – full-time equivalents
1. Tribune CZ. Dobře léčení revmatologičtí pacienti chodí do prá-ce. [online] Tribune.cz, 2024. Dostupné na: https://www.tribune. cz/zdravotnictví/dobre-leceni-pacienti-chodi-do-prace/ (citováno 10. 9. 2025).
2. Muñoz Laguna J, Puhan MA, Rodríguez Artalejo F, de Pauw R, Wyper GMA, Devleesschauwer B, Santos JV, Hincapié CA. Certainty of the Global Burden of Disease 2019 Modelled Prevalence Estimates for Musculoskeletal Conditions: A Meta-Epidemiological Study. Int J Public Health 2023; 68 : 1605763. doi:10.3389/ ijph.2023.1605763. PMID: 37325175; PMCID: PMC10266422. 3. van Nies JA, Krabben A, Schoones JW, Huizinga TW, Kloppenburg M, van der Helm-van Mil AH. What is the evidence for the presence of a therapeutic window of opportunity in rheumatoid arthritis? A systematic literature review. Ann Rheum Dis. 2014; 73(5): 861–870. doi:10.1136/annrheumdis-2012-203130 [Epub 2013 Apr 9]. PMID: 23572339.
4. Benavent D, Capelusnik D, Ramiro S, Navarro-Compán V. Looking through the window of opportunity in axial spondyloarthritis? Joint Bone Spine 2023; 90(6): 105603. doi:10.1016/j. jbspin.2023.105603 [Epub 2023 Jun 22]. PMID:37355203 5. 2015 Workforce Study of Rheumatology Specialists in the United States [White Paper]. Available from: https://assets.contentstack.io/ v3/assets/bltee37abb6b278ab2c/bltb4276e6740a51375/ 632a340a27a8dd5d8cd3ddc0/rheumatology-workforce-study-2015.pdf: American College of Rheumatology Academy for Academic Leadership 2016.
6. Moltó A, et al. OP0025 Inequity in access to care for rheuma-tic and musculoskeletal diseases is a reality in Europe: first data from the EULAR Rheumafacts project. Annals of the Rheumatic Diseases 2025; 84 : 22–23.
7. AoAM C. Physician specialty data report. Association of American Medical Colleges Washington, DC 2020.
8. Battafarano DF, Ditmyer M, Bolster MB, Fitzgerald JD, Deal C, Bass AR, Molina R, Erickson AR, Hausmann JS, Klein-Gitelman M, Imundo LF, Smith BJ, Jones K, Greene K, Monrad SU. 2015 American College of Rheumatology Workforce Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015–2030. Arthritis Care Res (Hoboken) 2018; 70(4): 617–626. doi:10.1002/ acr.23518. PMID: 29400009.
9. Mannion ML, Xie F, FitzGerald JD, Alexander A, Mudano A, Su Y, Saag KG, Curtis JR. Changes in the Workforce Characteristics of Providers Who Care for Adult Patients With Rheumatologic and Musculoskeletal Disease in the United States. Arthritis Rheumatol. 2024; 76 : 1153–1161. Dostupné na: https://doi. org/10.1002/art.42833
10. Dejaco C, Lackner A, Buttgereit F, Matteson EL, Narath M, Sprenger M. Rheumatology workforce planning in Western Countries: a systematic literature review. Arthritis Care Res. 2016; 68 : 1874–1882. doi:10.1002/acr.22894
11. Puchner R, Vavrovsky A, Pieringer H, Hochreiter R, Machold KP. The Supply of Rheumatology Specialist Care in Real Life. Results of a Nationwide Survey and Analysis of Supply and Needs. Front Med. (Lausanne) 2020; 7 : 16. doi:10.3389/fmed.2020.00016. PMID: 32083088; PMCID: PMC7002545.
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