Regional disparities in health services provision in the European Union. When territory matters

Abstract Services of general interest (SGI) contribute to the European Union’s objectives, being fundamental to territorial cohesion and convergence, with a preeminent role in rural and peripheral territories. Hence, disparities in access to these services lead to critical regional disparities, impairing cohesion. It is in economic harsh times that SGI are preponderant, especially in more rural or peripheral regions and health services are one of the most impactful SGI, being an iconic representative of the Welfare State. Therefore, an assessment of regional health services must be developed in relation to Welfare State Regimes performance. This article is developed within this framework, with the objectives of understanding: how national and local expenditures in health are related to Welfare State Regimes; and how their expenses impact territorial cohesion through differentiated regional health service provision and population health status. The work was developed in two phases: one centred on the assessment of total and health expenditures made by national and local governments, discussed in the framework of distinct Welfare Regimes; another, that analyses regional health service provision and population health status, in their relationship with regional socio-economic characteristics and the framework of Welfare Regimes. Indicators regarding health expenditures countries’ efforts, health status, and services at a regional scale were retrieved from Eurostat. Results confirm that the provision of services and health status differ among Welfare Regimes and territorial typologies. Urban regions showed better results than rural ones, with the Welfare Regime precluding this reality. We conclude that regional health disparities are a concerning factor that harms territorial cohesion.