How banking dependence shapes hospital debt maturity in small economies

Purpose This paper explores debt maturity determinants in Portugal’s health sector, a small bank-dependent economy, across different regions. Design/methodology/approach To investigate this, we analyzed data from 447 companies (2014–2022) to assess whether capital structure decisions are influenced by a country’s proximity to its capital. Using a dynamic panel data approach, we applied a GMM-System estimation model to test our hypothesis. Findings Our findings indicate that debt decisions stem from company-specific factors and macroeconomic conditions, varying by region and debt maturity. The study highlights Lisbon’s development stage, social challenges and managerial distinctions as the nation’s capital and institutional hub. Originality/value Regional debt maturity variations expose financial management disparities and risk levels, aiding policymakers in crafting targeted strategies for a more stable healthcare sector.