TERRITORIAL INEQUALITIES OF PRACTICING PHYSICIANS IN HUNGARY AND THE DACH COUNTRIES IN 2024: A GINI AND THEIL INDEX-BASED ANALYSIS
Author(s)
Diána Elmer, MSc, PhD1, Imre Boncz, MSc, PhD, MD1, Uwe Siebert, MPH, MSc, ScD2, István Ágoston, JD, PhD1, Tímea Csákvári, MSc, PhD3, Beate Jahn, PhD4.
1Institute for Health Insurance, University of Pécs, Faculty of Health Sciences, Pécs, Hungary, 2UMIT TIROL - University for Health Sciences and Technology; Harvard Chan School of Public Health, Hall in Tirol, Austria, 3Institute for Health Insurance, University of Pécs, Faculty of Health Sciences, Zalaegerszeg, Hungary, 4UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria.
1Institute for Health Insurance, University of Pécs, Faculty of Health Sciences, Pécs, Hungary, 2UMIT TIROL - University for Health Sciences and Technology; Harvard Chan School of Public Health, Hall in Tirol, Austria, 3Institute for Health Insurance, University of Pécs, Faculty of Health Sciences, Zalaegerszeg, Hungary, 4UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria.
OBJECTIVES: To assess and compare spatial inequalities in physician supply across Hungary and the DACH countries in 2024 using population- and area-based indicators, with emphasis on Gini and Theil inequality measures.
METHODS: We conducted a cross-sectional study of spatial inequalities in physician supply in Hungary, Austria, Germany, and Switzerland in 2024. Practicing physicians were examined across functionally comparable administrative units (federal states, counties, and cantons). Physician availability was measured using two indicators: number of physicians per population and per area. Lorenz curves demonstrating the physician distribution were constructed from cumulative shares. Inequalities were quantified using the Gini coefficient as a weighted measure. Theil T (T) and Theil L (L) indices were calculated using population- and area-based indicators. Data were obtained from OECD Health Statistics database, Statistics Austria, the German Medical Association, the Federal Statistical Office of Germany, the Hungarian Central Statistical Office, the FMH Swiss Medical Association, and the Federal Statistical Office of Switzerland.
RESULTS: Substantial cross-country and within-country differences were observed in 2024. Among the included countries, Austria had the highest physician density per 100,000 population (568), while Hungary had the lowest (448). Internal disparities were most pronounced in Switzerland (6.59-fold) and Hungary (3.45-fold), whereas Austria and Germany showed smaller differences (1.59-fold and 1.92-fold, respectively). Population-based inequalities were moderate: Gini coefficients ranged from 0.058 (Germany) and 0.096 (Austria) to 0.153 (Switzerland) and 0.226 (Hungary). Theil indices confirmed low-to-moderate inequality (Germany: T=0.008, L=0.007; Austria: T=0.015, L=0.014; Switzerland: T=0.041, L=0.040; Hungary: T=0.087, L=0.084). Area-based inequalities were substantially higher. Gini values reached 0.501 in Hungary and 0.557 in Switzerland, while Austria and Germany remained more moderate (G=0.353; G=0.373). Theil indices (Germany: T=0.357, L=0.251; Austria: T=0.909, L=0.321; Switzerland: T=0.711, L=0.618; Hungary: T=1.056, L=0.466) highlighted strong spatial concentration.
CONCLUSIONS: Population-based indicators substantially underestimate spatial inequalities in physician supply compared with area-based measures.
METHODS: We conducted a cross-sectional study of spatial inequalities in physician supply in Hungary, Austria, Germany, and Switzerland in 2024. Practicing physicians were examined across functionally comparable administrative units (federal states, counties, and cantons). Physician availability was measured using two indicators: number of physicians per population and per area. Lorenz curves demonstrating the physician distribution were constructed from cumulative shares. Inequalities were quantified using the Gini coefficient as a weighted measure. Theil T (T) and Theil L (L) indices were calculated using population- and area-based indicators. Data were obtained from OECD Health Statistics database, Statistics Austria, the German Medical Association, the Federal Statistical Office of Germany, the Hungarian Central Statistical Office, the FMH Swiss Medical Association, and the Federal Statistical Office of Switzerland.
RESULTS: Substantial cross-country and within-country differences were observed in 2024. Among the included countries, Austria had the highest physician density per 100,000 population (568), while Hungary had the lowest (448). Internal disparities were most pronounced in Switzerland (6.59-fold) and Hungary (3.45-fold), whereas Austria and Germany showed smaller differences (1.59-fold and 1.92-fold, respectively). Population-based inequalities were moderate: Gini coefficients ranged from 0.058 (Germany) and 0.096 (Austria) to 0.153 (Switzerland) and 0.226 (Hungary). Theil indices confirmed low-to-moderate inequality (Germany: T=0.008, L=0.007; Austria: T=0.015, L=0.014; Switzerland: T=0.041, L=0.040; Hungary: T=0.087, L=0.084). Area-based inequalities were substantially higher. Gini values reached 0.501 in Hungary and 0.557 in Switzerland, while Austria and Germany remained more moderate (G=0.353; G=0.373). Theil indices (Germany: T=0.357, L=0.251; Austria: T=0.909, L=0.321; Switzerland: T=0.711, L=0.618; Hungary: T=1.056, L=0.466) highlighted strong spatial concentration.
CONCLUSIONS: Population-based indicators substantially underestimate spatial inequalities in physician supply compared with area-based measures.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
P16
Topic
Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas