The relationship between democracy and corruption and the global physician workforce.

Abstract

BackgroundUnderstanding how governance factors such as democracy and corruption impact the healthcare workforce is crucial for achieving Universal Health Coverage (UHC). Effective health workforce planning and resource allocation are influenced by these political constructs. This study examines the relationship between democracy and corruption and key healthcare workforce metrics.MethodsA cross-sectional study was conducted using a global dataset from 2020 to 2022. The primary outcome was Physician Density (medical doctors per 10000 people). Secondary outcomes included the generalist to specialist ratio and the percentage of female physicians (% Female). Partial correlations, multivariate analysis of variance (MANOVA), and univariate analysis of variance (ANOVA) were used to analyze the relationship between workforce variables and the democracy index (DI), and corruption perception index (CPI), controlling for domestic health expenditure.ResultsData from 134 countries showed significant positive associations between both DI (r = 0.32, p = 0.004) and CPI (r = 0.43, p DiscussionHigher levels of democracy and lower levels of corruption are associated with a greater density of medical doctors, independent of healthcare spending. Policymakers must advocate for governance reforms that support a robust healthcare workforce to support aim of universal health coverage.