Regional access to health

Health services and doctors are distributed unequally across different regions in most OECD countries, and this causes concern about how to ensure access to health everywhere and foster better health outcomes.

The most important regional differences in the number of hospital beds per 10 000 inhabitants can be found in Japan, Poland and Germany. Very low levels of hospital beds are found in Nuevo Leon (Mexico), Tarapaca (Chile), Yukon (Canada) and Southeastern Anatolia-East (Turkey), where the hospital beds were below 20 per every 10 000 inhabitants in 2013 (Figure 4.17).

In 2013, the largest regional disparities in the density of physicians were found in the United States, Greece, the Czech Republic and the Slovak Republic. While regions such as the District of Columbia (United States) and Attica (Greece) had levels close to 9 active physicians per every 1 000 inhabitants, in Illinois (United States) and Central Greece the density of physicians was below 3 doctors per 1 000 people (Figure 4.18).

In the period 2008-13, the change in the density of physicians has been modest in the lagging regions, i.e. those regions with the lowest density of physicians and concentrating 20% of the country’s population; on average it increased only by 0.2 doctors per 1 000 inhabitants. Nevertheless, some improvements can be observed in the lagging regions of Israel, Portugal, Finland, Estonia, Norway and Slovenia (an average increase of 0.5 physicians per 1 000 inhabitants); whereas the lagging regions of Spain and Belgium have worsened over the same period (an average decrease of 0.7 doctors per 1 000 inhabitants) (Figure 4.19).


The number of physicians includes general practitioners and specialists actively practicing medicine during the year in both public and private institutions. Density of physicians is defined as the number of active physicians per every 1 000 people.

The number of hospital beds refers to beds in all hospitals, including general hospitals, mental health and substance abuse hospitals, and other specialty hospitals. Hospital bed rate is defined as the number of hospital beds for every 10 000 people.

Lagging regions are here defined as the regions with the lowest density of physicians and that concentrate 20% of the country’s population.


OECD (2015), OECD Regional Statistics (database),

See Annex B for data sources and country-related metadata.

Reference years and territorial level

Density of physicians: 2013 or latest available; TL2 except for Estonia which is presented at the TL3 level, and for New Zealand for which data is available only for the regions of North Island and South Island.

Hospital bed rate: 2013 or latest available; TL2 except for Estonia which is presented at the TL3 level.

Further information

OECD (2015), How’s Life? 2015: Measuring Well-being, OECD Publishing, Paris,

Ono,T., M. Schoenstein and J. Buchan (2014), “Geographic Imbalances in Doctor Supply and Policy Responses”, OECD Health Working Papers, No. 69, OECD Publishing, Paris,

Figure notes

 4.17: Iceland, Korea, New Zealand and United Kingdom are not included. Latest available years: Netherlands 2002; Chile and United States 2009; Belgium, Canada, Japan and Luxembourg 2010; Greece and Mexico 2011; Australia, Israel, Italy and Sweden 2012.

 4.18- 4.19: Iceland and Ireland are not included. Reference years: Peru 2007; Chile 2010. Latest available years: New Zealand and United Kingdom 2010; Canada, Chile, Luxembourg and United States 2011; Australia, Belgium, Denmark, Israel, Japan, Peru and Sweden 2012; and Korea 2014.

 4.19: The change from the reference year to the latest year available corresponds to the change in the density of physicians (active physicians per 1 000 inhabitants) of the regions with the lowest density of physicians and with 20% of the country’s population.

Information on data for Israel:

4.17. Regional variation in hospital bed rate (per 10 000 inhabitants), 2013 (TL2)

4.18. Regional variation in density of physicians (per 1 000 inhabitants), 2013 (TL2)

4.19. Change in density of physicians (per 1 000 inhabitants) between 2008 and 2013, (TL2)