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Healthcare under pressure: modelling COVID-19 fatalities with multiscale geographically weighted regressions

Zizi Goschin (Bucharest University of Economic Studies, Bucharest, Romania)
Gina Cristina Dimian (Bucharest University of Economic Studies, Bucharest, Romania)


ISSN: 0368-492X

Article publication date: 1 October 2021

Issue publication date: 17 January 2023




The paper aims to disentangle the factors behind territorial disparities in the coronavirus disease 2019 (COVID-19) case fatality ratio, focusing on the pressure put by the pandemic on healthcare services and adopting a spatial perspective.


Multiscale geographically weighted regression (MGWR) models have been used for uncovering the spatial variability in the impact of healthcare services on COVID-19 case fatality ratio, allowing authors to better capture the real spatial patterns at local level. The authors proved that this approach yields better results, and the MGWR model outperforms traditional regression methods. The selected case studies are two of the biggest UE countries, among the first affected by a high incidence of COVID-19 cases, namely Italy and Germany.


The authors found sizeable regional differences in COVID-19 mortality rates within each of the analysed countries, and the stress borne by local healthcare systems seems to be the most powerful factor in explaining them. In line with other studies, the authors found additional factors of influence, such as age distribution, gender ratio, population density and regional development.


This research clearly indicated that COVID-19 related deaths are strongly associated with the degree of resilience of the local healthcare systems. The authors supply localized results on the factors of influence, useful for assisting the decision-makers in prioritizing limited healthcare resources. The authors provide a scientific argument in favour of the decentralization of the pandemic management towards local authorities not neglecting, however, the necessary regional or national coordination.



This work was partially supported by a grant of the Romanian Ministry of Research and Innovation, CNCS – UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0166: “ReGrowEU – Advancing ground-breaking research in regional growth and development theories, through a resilience approach: towards a convergent, balanced and sustainable European Union”.


Goschin, Z. and Dimian, G.C. (2023), "Healthcare under pressure: modelling COVID-19 fatalities with multiscale geographically weighted regressions", Kybernetes, Vol. 52 No. 1, pp. 138-157.



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