An Analysis of the Proximity Based Polarisation of the Hospital Network of Moldavia’s Counties

Andra-Cosmina Albulescu,Daniela Larion

doi:10.15551/lsgdc.v46i2.01

Andra-Cosmina Albulescu, Daniela Larion

Open Access

https://doi.org/10.15551/lsgdc.v46i2.01

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Abstract

Since 1990, the deficiencies of the widely criticised health care system of Romania have been analysed from economic, political and management related points of view, but the territorial dimension of this system was often neglected. Identifying and understanding the shaping role of the spatial dimension are the prerequisites of any effective and compelling implementation of change. This paper aims to analyse the hospital network in Moldavia’s counties from the geographic proximity based influence point of view. The polarisation areas of territorial, emergency and specialised (pneumology and phthisiology, psychiatric) hospitals are generated as Thiessen proximal polygons. These geometric constructions help to determinate the locations that are the closest to a particular hospital, which proves to be useful in medical emergency situations, but also when distance becomes an important restrictive factor – as in the case of vulnerable population with limited financial resources, scarce mobility opportunities or constraints imposed by age. The hospital network may be considered the backbone of the medical system and its spatial distribution should be taken into account as an important shaping factor. This paper offers a regional approach of this matter, which can be used for planning bottom-up improvement strategies. DOI: http://dx.doi.org/10.15551/lsgdc.v46i2.01

Highlights

The health care system is one of the most important pillars that a country stands on, which means that its deficiencies may negatively affect the development process
In 1995-2013, Romania’s health expenditure as share of GDP increased, it was still surpassed by comparator countries such as Bulgaria, the Czech Republic, Hungary, Poland and Slovakia. (Vlădescu et al, 2016) the medical system of Romania has to deal with the migration of highly trained medical professionals, a low number of permanent health care units, a low ratio between the family doctors and the population of rural areas, informal payments, corruption, the focus on treatment rather than prevention, the sanitary migration and the widespread perception of the health system as an underperforming one. (Dumitrache et al, 2008; Ciutan et al, 2009; Farcasanu, 2010; Jankauskiene et al, 2011)
This paper aims to analyse the polarisation of the medical services provided by the hospital network in Moldavia region from a geographic proximity based influence point of view

Summary

Introduction

The health care system is one of the most important pillars that a country stands on, which means that its deficiencies may negatively affect the development process. (Dumitrache et al, 2008) While it appears that the issues that hindered the development of the medical system of Romania in the past reiterate, new unfavourable factors like the discordance between the public and the private medical sectors and the improper regulation and coordination of the subordinate institutions emerge. Romania ranks among the last EU countries in terms of health expenditure, in 2014 spending only 5.4% of its GDP on the health system. In 1995-2013, Romania’s health expenditure as share of GDP increased, it was still surpassed by comparator countries such as Bulgaria, the Czech Republic, Hungary, Poland and Slovakia. In 1995-2013, Romania’s health expenditure as share of GDP increased, it was still surpassed by comparator countries such as Bulgaria, the Czech Republic, Hungary, Poland and Slovakia. (Vlădescu et al, 2016) the medical system of Romania has to deal with the migration of highly trained medical professionals, a low number of permanent health care units, a low ratio between the family doctors and the population of rural areas, informal payments, corruption, the focus on treatment rather than prevention, the sanitary migration and the widespread perception of the health system as an underperforming one. (Dumitrache et al, 2008; Ciutan et al, 2009; Farcasanu, 2010; Jankauskiene et al, 2011)

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