Regional disparities in access to health care : a multilevel analysis in selected OECD countries

This paper investigates regional disparities in access to healthcare, measured by self-reported unmet medical needs. It looks at disparities across 86 regions in 5 European countries: Czech Republic, France, Italy, Spain and the United Kingdom. The results show that in addition to individual factors, such as age, gender, health status, or education, the characteristics of the region where people live, such as the average skill endowment or employment rate, have a significant impact on the probability of unmet medical needs. Individual and regional determinants play different roles across regions in these five countries. Moreover, in three of these countries (Czech Republic, Italy and Spain), age and chronic illness have different impacts on unmet medical needs depending on the region of residence, when all the other conditions are kept the same. The result calls for further investigation on regionalspecific factors that could be modified with targeted policies in order to reduce the probability of foregone health care.