Regional disparities in health care supply in eleven European countries: does politics matter?
There are large differences both among and within European countries in the supply of health care facilities and personnel. In 1979 Smith posed the hypothesis that spatial disparities in health care supply will be smaller in countries with socialist (or social-democratic) governments. The aim of this paper is to examine this hypothesis by analysing whether or not regional disparities in health care supply within countries are smaller in countries that have been governed predominantly by socialist governments. We have collected regional data on the number of hospital beds and the number of physicians for 211 regions in 11 European countries for 1970 and 1990. Countries were classified according to the political composition of governments in the post-war era. It is concluded that: (1) the amount of regional variation is greater for hospital beds than for doctors; (2) for both aspects of supply, regional disparities decreased over time; (3) the decrease in regional disparities between 1970 and 1990, both for beds and for doctors in hospitals, was stronger for countries that had more years of socialist government in that period and (4) there is no relation between the number of years of socialist government between 1945 and 1990 and regional variation in health care supply in 1970, nor for government participation between 1970 and 1990 and variation in supply in 1990.
Westert
G P
GP
Department of Human Geography, Utrecht University, The Netherlands. gert.westert@rivm.nl
Groenewegen
P P
PP
D003710:Demography; D005060:Europe; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D006291:Health Policy; D006302:Health Services Research; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data / Q000600:supply & distribution*; D010820:Physicians / Q000706:statistics & numerical data / Q000600:supply & distribution*; D011057:Politics; D012935:Social Justice; D012950:Socialism