Does austerity drives healthcare accessibility?

Maria da Conceição Constantino Portela, Adalberto Campos Fernandes

Research output: Contribution to journalArticlepeer-review



The financial crisis may impact on healthcare systems, and challenge healthcare accessibility by increasing the percentage of patients with unmet medical needs due to the cost, the distance, and waiting lists. In order to analyze if austerity drives healthcare accessibility, we take annual data at country level, for Germany, United Kingdom, Spain, France, Italy, Ireland, Greece, and Portugal, from 2005 to 2011 (n=56). The countries were clustered according to the external intervention during financial crisis. We consider a period ex-ante and another one ex-post crisis, and assess the difference in averages, by using the t Student test. This is followed by a correlation analysis by calculating Spearman’s coefficient, to assess if there is an association between the unemployment rate and the percentage of patients with unmet medical needs, considering the educational levels and income quintiles, regarding each one of the clusters. We found that during austerity there is an increase in the percentage of patients with unmet medical needs due to excessive cost, except for Germany and United Kingdom, but a decrease in the percentage of patients with unmet medical needs due to the distance and waiting lists. These figures were higher for low income and educational levels. For the cluster of France, Italy and Spain, the healthcare accessibility improves with increasing unemployment rates; but for Greece, Ireland and Portugal there is no association between accessibility and unemployment rate.
Translated title of the contributionAusteridade conduz acessibilidade à assistência médica?
Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalRevista de Gestão em Sistemas de Saúde
Issue number2
Publication statusPublished - 1 Dec 2014


  • Accessibility
  • Healthcare system
  • Economic crisis
  • Healthcare
  • Healthcare costs
  • Waiting lists


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