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Abstract
Demographic trends in population ageing have put increasing pressure on health care costs. These include spa care expenses. Thus, the aim of this article is to analyse the importance of public health insurance in the utilisation of spa accommodation capacities, the health insurers' spa care expenses, and the trends in the number of self-payers. Besides, it analyses spa care by treatment specialisation and the number of foreign visitors to Slovak spas. The health insurers' limited spa care expenses place greater emphasis on the creation by spas of wellness products and on the building up of relationships through destination management organisations that enable the integration of resources for marketing activities.