Diversity and Regional Inequalities: Assessing the Outcomes of the Spanish 'System of Health Care Services'

UPF Working Paper No. 745

42 Pages Posted: 12 Jul 2004

See all articles by Guillem Lopez Casasnovas

Guillem Lopez Casasnovas

Universitat Pompeu Fabra - Faculty of Economic and Business Sciences

Ivan Planas

Universitat Pompeu Fabra - Faculty of Economic and Business Sciences

Joan Costa-Font

London School of Economics & Political Science (LSE)

Date Written: April 2004

Abstract

The consolidation of a universal health system coupled with a process of regional devolution characterise the institutional reforms of the National Health System (NHS) in Spain in the last two decades. However, scarce empirical evidence has been reported on the effects of both changes in health inputs, outputs and outcomes, both at the country and at the regional level. This paper examines the empirical evidence on regional diversity, efficiency and inequality of these changes in the Spanish NHS using cross-correlation, panel data and expenditure decomposition analysis. Results suggest that besides significant heterogeneity, once we take into account region-specific needs there is evidence of efficiency improvements whilst inequalities in inputs and outcomes, although more 'visible', do not appear to have increased in the last decade. Therefore, the devolution process in the Spanish Health System offers an interesting case for the experimentation of health reforms related to regional diversity but compatible with the nature of a public NHS, with no sizeable regional inequalities.

Keywords: Health expenditure, devolution, National Health System, regional inequalities, Spain

JEL Classification: H7, I38, H31

Suggested Citation

Lopez Casasnovas, Guillem and Planas, Ivan and Costa-Font, Joan, Diversity and Regional Inequalities: Assessing the Outcomes of the Spanish 'System of Health Care Services' (April 2004). UPF Working Paper No. 745. Available at SSRN: https://ssrn.com/abstract=563343 or http://dx.doi.org/10.2139/ssrn.563343

Guillem Lopez Casasnovas (Contact Author)

Universitat Pompeu Fabra - Faculty of Economic and Business Sciences ( email )

Ramon Trias Fargas 25-27
Barcelona, 08005
Spain

Ivan Planas

Universitat Pompeu Fabra - Faculty of Economic and Business Sciences ( email )

Ramon Trias Fargas 25-27
Barcelona, 08005
Spain

Joan Costa-Font

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

Houghton Street
London, WC2A 2AE
United Kingdom

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

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