Healthcare Across Borders: Changes in Physician Numbers and Spatial Inequalities in Hungary and the DACH Countries (Austria, Germany, Switzerland)
Author(s)
Diána Elmer, MSc, PhD1, Imre Boncz, MSc, PhD, MD1, Uwe Siebert, MD, MPH, MSc, ScD2, István Ágoston, JD, PhD3, Tímea Csákvári, MSc, PhD4, Beate Jahn, PhD2;
1University of Pécs, Faculty of Health Sciences, Institute for Health Insurance, Pécs, Hungary, 2UMIT TIROL – University for Health Sciences and Technology, Institute for Public Health, Medical Decision Making and Health Technology Assessment, Hall in Tirol, Austria, 3University of Pécs, Faculty of Health Sciences, Institution of Nutritional Science and Dietetics, Pécs, Hungary, 4University of Pécs, Faculty of Health Sciences, Institute for Health Insurance, Zalaegerszeg, Hungary
1University of Pécs, Faculty of Health Sciences, Institute for Health Insurance, Pécs, Hungary, 2UMIT TIROL – University for Health Sciences and Technology, Institute for Public Health, Medical Decision Making and Health Technology Assessment, Hall in Tirol, Austria, 3University of Pécs, Faculty of Health Sciences, Institution of Nutritional Science and Dietetics, Pécs, Hungary, 4University of Pécs, Faculty of Health Sciences, Institute for Health Insurance, Zalaegerszeg, Hungary
OBJECTIVES: The aim of this study is to analyze the changes of the number of practicing physicians and to map the spatial inequalities in Hungary and in the DACH countries (Austria, Germany, Switzerland).
METHODS: We conducted a time series analysis, analyzing the total practicing physicians between 1960-2021 for Hungary, Austria, Germany and Switzerland. Practicing physicians indicators include the following professionals: licensed physicians, interns, and residents working under supervision and salaried or self-employed physicians. Changes in the proportion of total physicians by gender and age group were also analyzed between 1995-2021. At the national level, we calculated weighted average/100,000 population and the extent of spatial inequalities. Data were derived from the following sources: Organization for Economic Co-operation and Development Health Statistics database; Statistics Austria; German Medical Association; Federal Statistical Office of Germany; Hungarian Central Statistical Office; FMH Swiss Medical Association; Federal Statistical Office of Switzerland.
RESULTS: Starting in the 1980s, the availability of practicing physicians in Austria and Switzerland exceeded that in Hungary. An increasing trend can be observed in the number of practicing physicians in the DACH countries and in Hungary as well. The average number of practicing physicians/100,000 population in Austria was 552 (SD:106), in Germany 507 (SD:70), in Hungary 417 (SD:185) and in Switzerland 458 (SD:143) in 2022. Within countries, the spatial (Bundesland/Vármegye/Kanton) difference between the highest and lowest practicing physicians was 1.62 times in Austria, 1.97 times in Germany, 3.65 times in Hungary and 7.05 times in Switzerland in 2022.
CONCLUSIONS: The number of practicing physicians significantly increased in all four countries. There are also large differences between the territorial units (Bundesland/Vármegye/Kanton). Spatial inequalities in physician availability are more moderate in Austria and Germany. These results can support policy decision-making regarding health care resource planning and mobility trends.
METHODS: We conducted a time series analysis, analyzing the total practicing physicians between 1960-2021 for Hungary, Austria, Germany and Switzerland. Practicing physicians indicators include the following professionals: licensed physicians, interns, and residents working under supervision and salaried or self-employed physicians. Changes in the proportion of total physicians by gender and age group were also analyzed between 1995-2021. At the national level, we calculated weighted average/100,000 population and the extent of spatial inequalities. Data were derived from the following sources: Organization for Economic Co-operation and Development Health Statistics database; Statistics Austria; German Medical Association; Federal Statistical Office of Germany; Hungarian Central Statistical Office; FMH Swiss Medical Association; Federal Statistical Office of Switzerland.
RESULTS: Starting in the 1980s, the availability of practicing physicians in Austria and Switzerland exceeded that in Hungary. An increasing trend can be observed in the number of practicing physicians in the DACH countries and in Hungary as well. The average number of practicing physicians/100,000 population in Austria was 552 (SD:106), in Germany 507 (SD:70), in Hungary 417 (SD:185) and in Switzerland 458 (SD:143) in 2022. Within countries, the spatial (Bundesland/Vármegye/Kanton) difference between the highest and lowest practicing physicians was 1.62 times in Austria, 1.97 times in Germany, 3.65 times in Hungary and 7.05 times in Switzerland in 2022.
CONCLUSIONS: The number of practicing physicians significantly increased in all four countries. There are also large differences between the territorial units (Bundesland/Vármegye/Kanton). Spatial inequalities in physician availability are more moderate in Austria and Germany. These results can support policy decision-making regarding health care resource planning and mobility trends.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HPR8
Topic
Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity, Insurance Systems & National Health Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas