Death by Austerity? The Impact of Cost Containment on Avoidable Mortality in Italy

23 Pages Posted: 2 Mar 2020

See all articles by Emanuele Arcà

Emanuele Arcà

affiliation not provided to SSRN

Francesco Principe

University of Bergamo - Department of Economics

Eddy van Doorslaer

Erasmus University Rotterdam (EUR) - Institute of Health Policy and Management

Date Written: January 30, 2020

Abstract

Does austerity in healthcare affect health and healthcare outcomes? We examine the intended and unintended effects of the Italian austerity policy Piano di Rientro aimed at containing the cost of the healthcare sector. Using an instrumental variable strategy that exploits the temporal and geographical variation induced by the policy rollout, we find that the policy was successful in alleviating deficits by reducing expenditure, mainly in the southern regions, but also resulted in a 3% rise in avoidable deaths among both men and women, a reduction in hospital capacity and a rise in south-to-north patient migration. These findings suggest that - even in a high income country with relatively low avoidable mortality like Italy - spending cuts can hurt survival.

Keywords: avoidable mortality, health care expenditure, recovery plan

JEL Classification: I10, I18

Suggested Citation

Arcà, Emanuele and Principe, Francesco and van Doorslaer, Eddy, Death by Austerity? The Impact of Cost Containment on Avoidable Mortality in Italy (January 30, 2020). Available at SSRN: https://ssrn.com/abstract=3529892 or http://dx.doi.org/10.2139/ssrn.3529892

Emanuele Arcà

affiliation not provided to SSRN

Francesco Principe (Contact Author)

University of Bergamo - Department of Economics ( email )

Piazza Rosate 2
I-24100 Bergamo, 24127
Italy

Eddy Van Doorslaer

Erasmus University Rotterdam (EUR) - Institute of Health Policy and Management

Netherlands

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