Concentration and inequality in the geographic distribution of physicians in the European Union, 2006-2018

The shortage and uneven geographic distribution of health workers is considered a severe global problem nowadays. Recent studies examining inequalities in health workforce supply at various spatial scales suggest that health workers' geographic distribution follows a core-periphery pattern as the more developed areas are generally better supplied with health labour than the less developed ones. Here, we explore the regional patterns and temporal changes of the geographic distribution of physicians in the European Union (EU) at the Nomenclature of territorial units for statistics (Nomenclature des unites territoriales statistiques - NUTS) 2 level between 2006 and 2018. We also compare the levels of concentration and inequality in the geographic distribution of physicians, economic development, and health outcomes. We utilise a mix of statistical methods such as descriptive statistics, indices of concentration and inequality, and bivariate correlation analysis based on Eurostat data. Our results provide evidence that the regional distribution of physicians in the EU shows a core-periphery pattern: NUTS regions with capital cities or metropolitan areas have more physicians. In addition, the regional patterns of the distribution of physicians in the EU are stable in time, and their geographic concentration is strengthening in the long run. Our results also suggest that there is a positive relationship between the geographic distribution of physicians and health outcomes;however, this relationship needs further investigation.