SPATIAL INEQUALITIES IN HEALTH CARE PROVISION IN ROMANIA: MILESTONES FOR TERRITORIAL SUSTAINABLE DEVELOPMENT

Health has been and still remains a fundamental objective of sustainable development policies, reducing inequalities and inequities, in terms of healthcare access and healthcare provision representing milestones for national development. Underfinanced during the communist period and after 1989, the Romanian healthcare system is struggling to adapt to new challenges, trying to cope with the increasing demand for medical services. Several attempts at reform, in the absence of substantial investments and long-term strategies, brought this system numerous times into crisis, both providers as well as beneficiaries of medical services being dissatisfied. Geographic location of healthcare units, social and development status, represent other barriers that limit the access of certain population groups to health services, affecting quality of life and increasing their vulnerability. Using statistical and spatial analysis, this paper highlights the inequalities that arise in providing medical services at territorial level, emphasizing concentration of medical staff and medical units in Romania's major cities and severe shortage of physicians in small towns or rural areas. The reduced degree of coverage by medical personnel overlaps areas underdeveloped or socially deprived, characterized by high levels of unemployment, low levels of education and poor housing, contributing to the overall expansion of unprivileged areas, with precarious health and reduced quality of life that, in the absence of appropriate policies, no longer meet the principles of sustainable development.