The Territorial Distribution of Hospital Installed Capacity in Ecuador: A Provincial Analysis, 2024

Abstract

Hospital installed capacity constitutes a fundamental component of health system performance and a key determinant of equitable access to health services. In Ecuador, the territorial distribution of hospital infrastructure reveals significant planning challenges that directly affect equity within the health system. This study analyzes hospital installed capacity at the provincial level during 2024, based on the availability of hospital beds, with the aim of identifying relevant territorial inequalities from a public health perspective. An observational, descriptive, ecological study was conducted using secondary data from the Statistical Registry of Hospital Beds and Discharges for the year 2024. All twenty-four provinces of the country were included. The analysis considered the absolute number of hospital beds, projected provincial population, and the relative availability of beds per 1,000 inhabitants, using descriptive statistics and comparative territorial analysis. The results reveal marked inequalities in the distribution of hospital installed capacity across provinces. Areas with higher population concentration and greater urban development exhibit higher absolute and relative availability of hospital beds, whereas less urbanized provinces show insufficient capacity relative to their population size, highlighting structural gaps in health planning. In conclusion, the territorial distribution of hospital infrastructure in Ecuador exhibits persistent inequalities that limit equitable access to hospital care and place pressure on the public health network. These findings underscore the need to strengthen health planning through a territorial approach aimed at reducing provincial disparities.