Report: Romania has among the lowest number of doctors, nurses per thousand inhabitants

The number of doctors and nurses per 1,000 inhabitants in Romania remains below the EU average: in 2021, there were 3.5 practicing physicians per 1,000 inhabitants - among the lowest rates in the European Union (where the average was 4.1 per 1,000), according to a report by Save the Children Romania.

The organization also highlights other issues impacting access to healthcare in Romania.

Health expenditures per capita in the country amounted to less than half of the EU average, namely EUR 1,626 compared to EUR 3,684 in the EU.

Underfunded as a whole, the Romanian healthcare system remains very hospital-centered, with relatively high spending on hospitals and a very high number of beds (7.2 per 1,000 inhabitants in 2021) compared to the EU average (4.8 per 1,000). As a result, primary care remains underutilized, while hospital services are overburdened. Nearly half of Romania’s healthcare funding is allocated to hospital care.

Problems are also especially evident in rural areas. In 2023, urban areas had 13,700 independent specialty medical practices, while rural areas had 17.3 times fewer (793 practices). As a result, the number of residents per general practitioner is 50% higher in rural than in urban areas (2,312 residents in rural areas compared to 1,157 in urban areas per general practitioner).

The lack of access to medicine in rural areas leads to tragedies. In 2023, the infant mortality rate in rural areas was 6.9 per 1,000 live births, exceeding the national average of 5.8 per 1,000.

Furthermore, more than a quarter of Romanians residing in the countryside lack coverage under the national health insurance system. Although health insurance is mandatory, approximately 25% of the population remained uninsured in 2022 - especially in rural areas.

According to the National Federation of Family Physicians (FNPMF), access to medical care is extremely important for people in vulnerable communities living in remote regions. Less than half (47%) of Romanian localities have enough general practitioners, and 328 municipalities lack a family doctor altogether.

“Romania remains a country of social inequalities, which means discriminatory access to basic social services such as health and education. Our priority is to be present in communities and respond to people’s real social needs. One of the essential needs is direct and rapid access to doctors and medical services,” said Gabriela Alexandrescu, Executive President of Save the Children Romania.

While family physicians help, patients need specialists for certain conditions. As a result, they often seek hospital care directly, even for non-urgent conditions, because this is widely regarded as the fastest and/or simplest way to access specialized care.