Regional Health Care Decentralization in Unitary States: Equal Spending, Equal Satisfaction?

31 Pages Posted: 28 Jul 2016

See all articles by Joan Costa-Font

Joan Costa-Font

London School of Economics & Political Science (LSE)

Gilberto Turati

Catholic University of the Sacred Heart, Rome

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Date Written: June 30, 2016

Abstract

Does regional decentralization threaten the commitment to regional equality in government outcomes? We attempt to shed light on this question by drawing on unique evidence from the largest European unitary states to have engaged in countrywide health system decentralization: Italy and Spain. We estimate, decompose, and run counterfactual analysis of regional inequality in government output (health expenditure per capita) and outcome (health system satisfaction) during expansion of health care decentralization in both countries. We find no evidence of increase in regional inequalities in outcomes and outputs in the examined period. Inequalities are accounted for by differences in health system design.

Keywords: health care decentralization, regional inequality, health care, Oaxaca decomposition

JEL Classification: H700, I180, I300

Suggested Citation

Costa-Font, Joan and Turati, Gilberto, Regional Health Care Decentralization in Unitary States: Equal Spending, Equal Satisfaction? (June 30, 2016). CESifo Working Paper Series No. 5973. Available at SSRN: https://ssrn.com/abstract=2815359

Joan Costa-Font (Contact Author)

London School of Economics & Political Science (LSE) ( email )

Houghton Street
London, WC2A 2AE
United Kingdom

HOME PAGE: http://https://joancostaifont.org/

Gilberto Turati

Catholic University of the Sacred Heart, Rome ( email )

Largo F. Vito, 1
Rome, 00168
Italy

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