Regional Inequalities in the Allocation of Specialist Doctors Within the Portuguese NHS

William de Melo and Ana Sofia Ferreira

International Journal of Health Planning and Management, 2025, vol. 40, issue 4, 825-837

Abstract: This paper addresses regional disparities in the allocation of medical professionals within the Portuguese National Health Service (NHS) and its policy implications, drawing recommendations to address these inequalities. In a country with a universal and comprehensive healthcare system, ensuring equitable geographical distribution of healthcare professionals is crucial for the effectiveness and equity of the health system. The analysis uses data from the NHS payroll system (RHV), covering the period from 2017 to 2023, and focuses on active medical workers, including those on duty and retired but still in service, distributed among the five Regional Health Administrations that then existed. The analysis is based on Full‐Time Equivalents to provide a more realistic picture of the healthcare workforce. Population data comes from the official source. The Dissimilarity Index is used to measure regional disparities, focusing on the medical workforce (specialist doctors). The study aims to identify disparities in the distribution of these healthcare professionals throughout the five regions within the NHS and inform evidence‐based policies to address such inequalities in resource allocation of the healthcare workforce. The findings reveal that while the overall density of NHS healthcare workers per 1000 inhabitants grew, and global disparities in the allocation of NHS workers slightly diminished, some regional disparities have worsened, as it was the case of the distribution of specialist doctors among the territory. The Dissimilarity Index indicates increasing inequality among the allocation of the medical workforce in the national territory, with statistically significant growth in disparity over time. The study underscores the urgent need for targeted policies to address these growing inequalities in allocating specialist doctors within the NHS.

Date: 2025
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