BACKGROUND: Population accessibility to health care depends on the geographical distribution of health care professionals. The aim of this study is to analyse the provincial distribution of Spanish physicians, its recent evolution and the factors related with it. METHODS: Observational, cross-sectional, ecological, descriptive and analytical study on data from public official data sources (Statistics National Institute, Health and Consume Ministry). We obtained, on a provincial basis, variables related with physicians' distribution, socioeconomic conditions, health care resources and medical training capacity. We built some variability indicators for physicians' distribution, and we analysed the bivariated and multivariated correlations between provincial physicians' rate and the other variables. RESULTS: The ratio between the upper and lower values of the population based physicians' provincial ratio is 2,109 (2,158 in 1998), the variation coefficient is 0,19 (0,185 in 1998), and the Gini index is 0,103 (0,097 in 1998). There is a strong correlation between physicians' distribution and the specialist training capacity of each province in bivariated (r=0,87) and multivariated analysis (where socioeconomic and health care structure indicators and postgraduate training capacity explain 83,3% of physicians' distribution variance). CONCLUSIONS: The variability of physicians' distribution in Spain has been almost steady in the last decade, and its level is similar to that in other European countries. The provincial training capacity seems to play a fundamental role in physicians' distribution.
BACKGROUND: Population accessibility to health care depends on the geographical distribution of health care professionals. The aim of this study is to analyse the provincial distribution of Spanish physicians, its recent evolution and the factors related with it. METHODS: Observational, cross-sectional, ecological, descriptive and analytical study on data from public official data sources (Statistics National Institute, Health and Consume Ministry). We obtained, on a provincial basis, variables related with physicians' distribution, socioeconomic conditions, health care resources and medical training capacity. We built some variability indicators for physicians' distribution, and we analysed the bivariated and multivariated correlations between provincial physicians' rate and the other variables. RESULTS: The ratio between the upper and lower values of the population based physicians' provincial ratio is 2,109 (2,158 in 1998), the variation coefficient is 0,19 (0,185 in 1998), and the Gini index is 0,103 (0,097 in 1998). There is a strong correlation between physicians' distribution and the specialist training capacity of each province in bivariated (r=0,87) and multivariated analysis (where socioeconomic and health care structure indicators and postgraduate training capacity explain 83,3% of physicians' distribution variance). CONCLUSIONS: The variability of physicians' distribution in Spain has been almost steady in the last decade, and its level is similar to that in other European countries. The provincial training capacity seems to play a fundamental role in physicians' distribution.