Access and Cost of Education and Health Services

Preparing Regions for Demographic Change

image of Access and Cost of Education and Health Services

Current population trends and the COVID-19 pandemic reinforce the need for efficient public service provision while guaranteeing good access to all. Population decline and ageing in rural regions affect the provision of services through lower economies of scale and scope, professional shortages and longer distances. Reliable estimates of the costs and access arising from demographic and geographical differences can help adapt the provision of services to different territorial realities. This report provides internationally comparable fine-grained present and future estimates of the cost and physical access to education (primary and secondary) and health services (cardiology, maternity and obstetrics) in European countries. The report finds that demographic change in the next decades will likely further strain the trade-off between costs and access, especially in remote rural areas. Adapting to changes in demand following lower fertility rates and ageing implies that services will need to become more widely available, while others will have to concentrate more. This report aims to support evidence-based policy decisions to ensure service provision allows for both cost efficiency and a sufficient level of access in all territories.


Present and future school costs and access

This chapter analyses present and future estimates of primary and secondary school cost and access across Europe. It first reviews the main discussions and concepts around the balance between school costs and access, including the effects of consolidation of the school network on this balance. It then presents a detailed analysis of present cost and access estimates for Europe at different territorial aggregations including the regional, municipal and degree of urbanisation levels. Finally, the chapter presents a similar discussion for future school cost and access estimates, highlighting the most pressing cases facing challenges in the face of demographic change.



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