Mapping healthcare resources and regional mortality in Europe: a spatial study of current service coverage

The NUTS classification, established by Eurostat, divides the European territories into three levels: NUTS 1 (major regions), NUTS 2 (basic regions), and NUTS 3 (small regions). Our study investigated regional disparities in mortality across 232 NUTS 2 regions in Europe by analysing the function of their spatial health services. Using a spatial error model, we assessed the influence of healthcare expenditures and the number of hospital beds and medical doctors on death rates across eight major disease categories. We employed global and local spatial statistics to capture spatial disparities in resource allocation and death rates. Spatial clustering techniques revealed distinctive but differing patterns regarding mortality and resource allocation, with central and East Europe experiencing higher mortality from circulatory and digestive diseases, with mental and neurological conditions being more prevalent in the more affluent West. Our findings demonstrated decreasing returns at scale across all resources, with varied elasticities depending on disease type. Improved financial resources significantly reduced mortality for most illnesses except for mental or neurological disorders, while outcomes with respect to neoplasms depended on systemic factors beyond spending levels. The number of hospital beds often correlated positively with mortality, indicating system strain and reactive action rather than with preventive healthcare factors. Access to doctors reduced mortality only for mental and neurological conditions, highlighting the importance of specialised, continuous care. Regional affluence was found to consistently reduce mortality for several disease categories, underscoring the role of socioeconomic context in public health. These insights offer crucial guidance for more equitable and disease-specific resource allocation in health policy.