Regional disparities in health services provision in the European Union: when territory matters

Detalhes bibliográficos
Autor(a) principal: Franco, Pedro
Data de Publicação: 2022
Outros Autores: Marques da Costa, Eduarda
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10451/54265
Resumo: Services of general interest (SGI) contribute to the European Union’s objectives, being fundamental to territorial cohesion and convergence, with a preeminent role in rural and peripheral territories. Hence, disparities in access to these services lead to critical regional disparities, impairing cohesion. It is in economic harsh times that SGI are preponderant, especially in more rural or peripheral regions and health services are one of the most impactful SGI, being an iconic representative of the Welfare State. Therefore, an assessment of regional health services must be developed in relation to Welfare State Regimes performance. This study is developed within this framework, with the objectives of understanding: how national and local expenditures in health are related to Welfare State Regimes; and how their expenses impact territorial cohesion through differentiated regional health service provision and population health status. The work was developed in two phases: one centred on the assessment of total and health expenditures made by national and local governments, discussed in the framework of distinct Welfare Regimes; another, that analyses regional health service provision and population health status, in their relationship with regional socio-economic characteristics and the framework of Welfare Regimes. Indicators regarding health expenditures countries' efforts, health status, and services at a regional scale were retrieved from Eurostat. Results confirm that the provision of services and health status differ among Welfare Regimes and territorial typologies. Urban regions showed better results than rural ones, with the Welfare Regime precluding this reality. We conclude that regional health disparities are a concerning factor that harms territorial cohesion.
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spelling Regional disparities in health services provision in the European Union: when territory mattersDisparidades regionais na prestação de serviços de saúde na União Europeia: quando o território importaServices of general interestHealthRegional disparitiesWelfare State RegimesServices of general interest (SGI) contribute to the European Union’s objectives, being fundamental to territorial cohesion and convergence, with a preeminent role in rural and peripheral territories. Hence, disparities in access to these services lead to critical regional disparities, impairing cohesion. It is in economic harsh times that SGI are preponderant, especially in more rural or peripheral regions and health services are one of the most impactful SGI, being an iconic representative of the Welfare State. Therefore, an assessment of regional health services must be developed in relation to Welfare State Regimes performance. This study is developed within this framework, with the objectives of understanding: how national and local expenditures in health are related to Welfare State Regimes; and how their expenses impact territorial cohesion through differentiated regional health service provision and population health status. The work was developed in two phases: one centred on the assessment of total and health expenditures made by national and local governments, discussed in the framework of distinct Welfare Regimes; another, that analyses regional health service provision and population health status, in their relationship with regional socio-economic characteristics and the framework of Welfare Regimes. Indicators regarding health expenditures countries' efforts, health status, and services at a regional scale were retrieved from Eurostat. Results confirm that the provision of services and health status differ among Welfare Regimes and territorial typologies. Urban regions showed better results than rural ones, with the Welfare Regime precluding this reality. We conclude that regional health disparities are a concerning factor that harms territorial cohesion.Os serviços de interesse geral (SIG) contribuem para os objetivos de coesão e convergência territorial da União Europeia, tendo um papel preponderante nos territórios rurais e periféricos. Assim, as disparidades no acesso a estes serviços levam a disparidades regionais críticas, limitando o alcance da coesão territorial. Entre estes, os serviços de saúde são um dos SIG mais impactantes, havendo diferenças que decorrem do Regime de Estado Social vigente. Este estudo desenvolve-se neste quadro, com os objetivos de: verificar se diferentes Regimes de Estado Social apresentam diferentes perfis de despesa (realizadas pelos níveis central e local) em funções sociais, destacando em particular o setor da saúde; e, em que medida é que estes perfis de despesas se traduzem em perfis regionais de prestação de serviços e de estado de saúde, com impacto na coesão territorial. O trabalho tem duas fases: uma centrada na avaliação das despesas totais e de saúde das administrações federais e locais e a sua relação com os Regimes de Estado Social dominantes; outra que analisa a oferta regional de serviços de saúde e o estado de saúde da população, tendo em conta a tipologia de regiões europeias (urbanas, rurais e intermédias). Conclui-se que o nível de prestação de serviços e os estados de saúde dos residentes nas regiões da UE diferem entre os Regimes Sociais vigentes em cada país, mas também são sensíveis ao tipo de território. As regiões urbanas apresentaram melhores resultados do que as rurais, mas dependendo do Regime Social podemos ter melhores performances em áreas rurais que em áreas urbanas de países economicamente mais débeis. Concluímos assim, que para além dos regimes sociais vigentes, as características socioeconómicas e territoriais, explicam as disparidades regionais na prestação de serviços de saúde, comprometendo a coesão territorial.Les services d'intérêt général (SIG) contribuent aux objectifs de l'Union européenne, étant fondamentaux pour la cohésion territoriale et la convergence, avec un rôle prééminent dans les territoires ruraux et périphériques. Par conséquent, les disparités dans l'accès à ces services entraînent des disparités régionales critiques, compromettant la cohésion. C'est dans les périodes économiques difficiles que les SIG sont prépondérants, en particulier dans les régions plus rurales ou périphériques et les services de santé sont l'un des avec plus d’impact, étant un représentant emblématique de l'État-providence. Par conséquent, une évaluation des services de santé régionaux doit être développée par rapport à la performance des régimes d'État-providence. Cette étude est développée dans ce cadre, avec les objectifs de comprendre: comment les dépenses nationales et locales en santé sont liées aux régimes d'État providence; et dans quelle mesure ces profils de dépenses se traduisent en profils régionaux de prestation de services et d'état de santé, ayant un impact sur la cohésion territoriale. Le travail a été développé en deux phases: l'une centrée sur l'évaluation des dépenses totales et de santé effectuée par les gouvernements nationaux et locaux, discutées dans le cadre de régimes sociaux distincts ; une autre, qui analyse l'offre régionale de services de santé et l'état de santé de la population, dans leur relation avec les caractéristiques socio-économiques régionales et le cadre des régimes de protection sociale. Les indicateurs concernant les efforts des pays en matière de dépenses de santé, l'état de santé et les services à l'échelle régionale ont été extraits d'Eurostat. Les résultats confirment que la prestation de services et l'état de santé diffèrent selon les régimes de protection sociale et les typologies territoriales. Les régions urbaines ont montré de meilleurs résultats que les régions rurales, mais selon le régime social, il peut avoir de meilleures performances dans les zones rurales notamment dans des pays économiquement plus faibles. Nous concluons que les disparités régionales en matière de santé sont un facteur préoccupant qui nuit à la cohésion territoriale.Los servicios de interés general (SIG) contribuyen a los objetivos de la Unión Europea, siendo fundamentales para la cohesión y convergencia territorial, con un papel preeminente en los territorios rurales y periféricos. De ahí que, las disparidades en el acceso a estos servicios conducen a disparidades regionales críticas, lo que perjudica la cohesión. Es en tiempos de crisis económica cuando los SIG son preponderantes, especialmente en las regiones más rurales o periféricas, y los servicios de salud son uno de los SIG de mayor impacto, siendo un representante icónico del Estado del Bienestar. Por tanto, debe desarrollarse una evaluación de los servicios sanitarios autonómicos en relación con el desempeño de los Regímenes del Estado del Bienestar. Este estudio se desarrolla en este marco, con los objetivos de comprender: cómo se relacionan los gastos nacionales y locales en salud con los Regímenes del Estado de Bienestar; y, cómo sus gastos impactan en la cohesión territorial, a través de la prestación diferenciada de servicios regionales de salud y el estado de salud de la población. El trabajo se desarrolló en dos fases: una centrada en la evaluación de los gastos totales y en salud realizados por los gobiernos nacionales y locales, discutidos en el marco de distintos Regímenes de Bienestar; otro, que analiza la prestación regional de servicios de salud y el estado de salud de la población, en su relación con las características socioeconómicas regionales y el marco de los Regímenes de Bienestar. Los indicadores sobre los esfuerzos de los países en materia de gastos de salud, el estado de salud y los servicios a escala regional se obtuvieron de Eurostat. Los resultados confirman que la provisión de servicios y el estado de salud difieren entre Regímenes de Bienestar y tipologías territoriales. Las regiones urbanas mostraron mejores resultados que las rurales, con el Régimen de Bienestar impidiendo esta realidad. Concluimos que las disparidades regionales en salud son un factor preocupante que perjudica la cohesión territorial.Universidade de Lisboa, Centro de Estudos GeográficosRepositório da Universidade de LisboaFranco, PedroMarques da Costa, Eduarda2022-08-31T15:14:02Z20222022-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/54265engFranco, P. & Marques da Costa, E. (2022). Disparidades regionais na prestação de serviços de saúde na União Europeia: quando o território importa. Finisterra, 57(120), (ahead-of-print). https://doi.org/10.18055/Finis269940430-502710.18055/Finis26994info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-08T17:00:41Zoai:repositorio.ul.pt:10451/54265Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T22:05:10.440350Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Regional disparities in health services provision in the European Union: when territory matters
Disparidades regionais na prestação de serviços de saúde na União Europeia: quando o território importa
title Regional disparities in health services provision in the European Union: when territory matters
spellingShingle Regional disparities in health services provision in the European Union: when territory matters
Franco, Pedro
Services of general interest
Health
Regional disparities
Welfare State Regimes
title_short Regional disparities in health services provision in the European Union: when territory matters
title_full Regional disparities in health services provision in the European Union: when territory matters
title_fullStr Regional disparities in health services provision in the European Union: when territory matters
title_full_unstemmed Regional disparities in health services provision in the European Union: when territory matters
title_sort Regional disparities in health services provision in the European Union: when territory matters
author Franco, Pedro
author_facet Franco, Pedro
Marques da Costa, Eduarda
author_role author
author2 Marques da Costa, Eduarda
author2_role author
dc.contributor.none.fl_str_mv Repositório da Universidade de Lisboa
dc.contributor.author.fl_str_mv Franco, Pedro
Marques da Costa, Eduarda
dc.subject.por.fl_str_mv Services of general interest
Health
Regional disparities
Welfare State Regimes
topic Services of general interest
Health
Regional disparities
Welfare State Regimes
description Services of general interest (SGI) contribute to the European Union’s objectives, being fundamental to territorial cohesion and convergence, with a preeminent role in rural and peripheral territories. Hence, disparities in access to these services lead to critical regional disparities, impairing cohesion. It is in economic harsh times that SGI are preponderant, especially in more rural or peripheral regions and health services are one of the most impactful SGI, being an iconic representative of the Welfare State. Therefore, an assessment of regional health services must be developed in relation to Welfare State Regimes performance. This study is developed within this framework, with the objectives of understanding: how national and local expenditures in health are related to Welfare State Regimes; and how their expenses impact territorial cohesion through differentiated regional health service provision and population health status. The work was developed in two phases: one centred on the assessment of total and health expenditures made by national and local governments, discussed in the framework of distinct Welfare Regimes; another, that analyses regional health service provision and population health status, in their relationship with regional socio-economic characteristics and the framework of Welfare Regimes. Indicators regarding health expenditures countries' efforts, health status, and services at a regional scale were retrieved from Eurostat. Results confirm that the provision of services and health status differ among Welfare Regimes and territorial typologies. Urban regions showed better results than rural ones, with the Welfare Regime precluding this reality. We conclude that regional health disparities are a concerning factor that harms territorial cohesion.
publishDate 2022
dc.date.none.fl_str_mv 2022-08-31T15:14:02Z
2022
2022-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10451/54265
url http://hdl.handle.net/10451/54265
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Franco, P. & Marques da Costa, E. (2022). Disparidades regionais na prestação de serviços de saúde na União Europeia: quando o território importa. Finisterra, 57(120), (ahead-of-print). https://doi.org/10.18055/Finis26994
0430-5027
10.18055/Finis26994
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade de Lisboa, Centro de Estudos Geográficos
publisher.none.fl_str_mv Universidade de Lisboa, Centro de Estudos Geográficos
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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