Abstract
The main aim of this paper is to analyse the spatial dynamic of public hospital beds in Romania (1992-2018) in order to grasp the potentially uneven development of the health care infrastructure following state policies of austerity and cost reduction. The paper uses quantitative data and descriptive statistics to show the reduction of public hospital beds after 1990 in line with the state’s health care reform aiming to decrease the use of hospital services and strengthen the role of alternative types of care. The results show that public hospital beds significantly decreased (approx. by 40%), mostly in smaller towns and rural areas. The main conclusion of the paper is that the neoliberal healthcare policies generated patterns of uneven spatial development. Public hospital beds were used in the paper as an indicator of public healthcare physical infrastructure, and across time they follow a pattern of clustering in more prosperous and more competitive areas.
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Authors Affiliations
Giorgian Guțoiu* (1)
1) Lucian Blaga University of Sibiu, Romania
* Correspondence address.
Email: giorgian.gutoiu@ulbsibiu.ro
References
Ban, C. (2016), Ruling Ideas: How Global Neoliberalism Goes Local, Oxford University Press.
Brenner, N. and Theodore, N. (2002), “Cities and the Geographies of Actually Existing Neoliberalism, Antipode, vol. 34, no. 3, p. 349-379.
Comber, A.J., Brunsdon, C. and Radburn, R. (2011), “A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions”, International Journal of Health Geography, vol. 44, no. 10.
Dixon, A. and Mossialos, E. (2000), “Has the Portuguese NHS Achieved its Objectives of Equity and Efficiency?”, International Social Security Review, vol. 56, no. 4, p. 49-78.
Duma, O., Roșu S., Manole M., Petrariu F.D. and Constantin B. (2014), “Disparities in the Access to Primary Healthcare in the Rural Areas from the county of Iași – Romania”, Revista medico-chirurgicala a Societății de Medici și Naturaliști din Iași, vol. 118, no. 3, p. 743-748.
Dumitrache, L., Nae, M., Dumbraveanu, D., Simion, G. and Suditu, B. (2016), “Contrasting Clustering in Health Care Provision in Romania: Spatial and Aspatial Limitations”, Procedia Environmental Science, vol. 32, p. 290-299.
Economou, C., Kaitelidou, D., Kentikelenis, A., Sissouras, A. and Maresso, A. (2014), “The Impact of the Financial Crisis on Health and the Health System in Greece”, World Health Organization, 30 March 2020, shorturl.at/fosSZ.
European Observatory on Health Systems and Policies (2017), “Romania: Country Health Profile 2017”, State of Health in the EU, OECD & World Health Organization.
Eurostat(a) (N.D.), Healthcare resource statistics, 30 March 2020, shorturl.at/lnrFG.
Eurostat(b) (N.D.), Mortality and life expectancy statistics, 20 April 2020, shorturl.at/svAP1.
Eurostat(c) (N.D.), Healthcare expenditure statistics, 9 April 2020, shorturl.at/qwFL4.
Evans, D., Hsu, J. and Ties, B. (2013), “Universal health coverage and universal access”, Bulletin of the World Health Organisation, vol. 91, no. 8, p. 546-546.
Government of Romania (2011), Hotărâre nr. 345 din 31 martie 2011 privind aprobarea pentru anul 2011 a Raportului comisiei de selecţie a unităţilor sanitare cu paturi care nu pot încheia contracte cu casele de asigurări de sănătate, precum şi a listei acestor unităţi sanitare, 5 May 2021, shorturl.at/fioyL.
Granados, J. and Rodriguez, J. (2016), “Health, economic crisis, and austerity: A comparison of Greece, Finland and Iceland”, Health Policy, vol. 119, no. 7, p. 941-953.
Gulliford, M., Figueroa-Munoz, J., Morgan, M., Hughes, D., Gibson, B., Beech, R. and Hudson, M, (2002), “What does access to health care mean?”, Journal of Health Services Research & Policy, vol. 7, no. 3, p. 186-188.
Guțoiu, G. (2019), “Spatial and Temporal Patterns of Polarization and Population Decline in Romania’s Demography: 1992-2018”, Revista Universitară de Sociologie, vol. 15, no. 2, p. 41-58.
Harvey, D. (1999), The Limits to Capital, Blackweel, Oxford.
Harvey, D. (2005), A Brief History of Neoliberalism, Oxford University Press.
Harvey, D. (2006), Spaces of Global Capitalism: Towards a Theory of Uneven Geographical Development, Verso, New York.
Institutul Național de Statistică (2019), Database on healthcare infrastructure, 23 January 2020, www.insse.ro.
Kroneman, M. and Siegers, J. (2004), “The effect of hospital bed reduction on the use of beds: A comparative study of 10 European countries”, Social Science & Medicine, vol. 59, no. 8, p. 1731-1740.
Legido-Quigley, H., Karanikolos, M., Hernandez-Plaza, S., Freitas, C., Bernando, L., Padilla, B., Machado, R., Diaz-Ordaz, K., Stuckler, D. and McKee, M. (2016), “Effects of the financial crisis and Troika austerity measures on health and health care access in Portugal”, Health Policy, vol. 120, no. 7, p. 833-839.
McGregor, S. (2001), “Neoliberalism and health care”, International Journal of Consumer Studies, vol. 25, p. 82-89.
Mureșan, C. (1996), “L’évolution démographique en Roumanie: Tendances passées (1948-1994) et perspectives d’avenir (1995-2030)”, Population, vol. 51, no. 4-5, p. 813-844.
Pan, J. and Shallcross, D. (2016), “Geographic distribution of hospital beds throughout China: a county-level econometric analysis”, International Journal for Equity in Health, vol. 15, no. 79.
Popescu, C. (2014), “Deindustrialization and Urban Shrinkage in Romania. What Lessons for the Spatial Policy?”, Transylvanian Review of Administrative Sciences, vol. 10, no. 42, p. 181-202.
Popescu, D. (2013), “Rural Population in Romania. Development and Tendencies (2000-2010)”, Procedia Economics and Finance, vol. 6, p. 120-127.
Rotarou, E. and Sakellariou, D. (2017), “Neoliberal reforms in health systems and the construction of long-lasting inequalities in health care: A case study from Chile”, Health Policy, vol. 121, no. 5, p. 495-503.
Sakellariou, D. and Rotarou, E.S. (2017), “The effects of neoliberal policies on access to healthcare for people with disabilities”, International Journal for Equity in Health, vol. 16, no. 199.
Saltman, R.B. and Figueras, J. (1998), “Analyzing the evidence on European health care reforms”, Health Affairs, vol. 17, no. 2, p. 85–108.
United Nations (1948), Universal Declaration of Human Rights, 3 March 2020, shorturl.at/axyGX.
Vlădescu, C., Scintee, G., Olsavszky, V., Allin, S. and Mladovsky, P. (2008), “Romania: Health system review”, Health Systems in Transition, vol. 10, no. 3.
Vlădescu, C., Scintee, G., Olsavszky, V., Hernández-Quevedo, C. and Sagan, A., (2016), “Romania: Health system review”, Health Systems in Transition, vol. 18, no. 4.
World Bank(a) (N.D.), Hospital beds per 1000 people, 9 April 2020, shorturl.at/euwS0.
World Bank(b) (N.D.), Physicians per 1000 people, 13 April 2020, shorturl.at/dhFS7.
World Health Organisation (2015), “Health and human rights”, Fact sheet no. 323, 9 April 2020, shorturl.at/rKMQ7.
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