This file is part of IDEAS, which uses RePEc data


[ Papers | Articles | Software | Books | Chapters | Authors | Institutions | JEL Classification | NEP reports | Search | New papers by email | Author registration | Rankings | Volunteers | FAQ | Blog | Help! ]

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

Author info | Abstract | Publisher info | Download info | Related research | Statistics
Author Info
Guillem López ()
Joan Costa-Font
Ivan Planas

Additional information is available for the following registered author(s):

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 inequalitiest.

Download Info
To download:

If you experience problems downloading a file, check if you have the proper application to view it first. Information about this may be contained in the File-Format links below. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

File URL: http://www.econ.upf.edu/docs/papers/downloads/745.pdf
File Format: application/pdf
File Function: Whole Paper
Download Restriction: no

Publisher Info
Paper provided by Department of Economics and Business, Universitat Pompeu Fabra in its series Working Papers, Research Center on Health and Economics with number 745.

Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
Length:
Date of creation: Apr 2004
Date of revision:
Handle: RePEc:upf:upfses:745

Contact details of provider:
Web page: http://www.econ.upf.edu/

For technical questions regarding this item, or to correct its listing, contact: ().

Related research
Keywords: Health expenditure; devolution; National Health System; regional inequalities; Spain;

Other versions of this item:

Find related papers by JEL classification:
H7 - Public Economics - - State and Local Government; Intergovernmental Relations
I38 - Health, Education, and Welfare - - Welfare and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
H31 - Public Economics - - Fiscal Policies and Behavior of Economic Agents - - - Household

This paper has been announced in the following NEP Reports:

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Beatriz Gonzalez Lopez-Valcarcel & Patricia Barber Perez, 1996. "Changes in the efficiency of spanish public hospitals after the introduction of program-contracts," Investigaciones Economicas, Fundación SEPI, vol. 20(3), pages 377-402, September. [Downloadable!]
  2. Diego Prior & Magda Solà, 2000. "Technical efficiency and economies of diversification in health care," Health Care Management Science, Springer, vol. 3(4), pages 299-307, September. [Downloadable!] (restricted)
  3. Esther Martínez, 1998. "Las deducciones en el IRPF por gasto sanitario privado: situación actual y posibilidades de reforma," Economics Working Papers 307, Department of Economics and Business, Universitat Pompeu Fabra. [Downloadable!]
  4. Guillem López-Casasnovas & Marc Saez, 1999. "The impact of teaching status on average costs in Spanish hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 641-651.
  5. Mireia Jofre-Bonet, 2000. "Public health care and private insurance demand: The waiting time as a link," Health Care Management Science, Springer, vol. 3(1), pages 51-71, January. [Downloadable!] (restricted)
  6. Eulália Dalmau-Atarrodona & Jaume Puig-Junoy, 1998. "Market Structure and Hospital Efficiency: Evaluating Potential Effects of Deregulation in a National Health Service," Review of Industrial Organization, Springer, vol. 13(4), pages 447-466, August. [Downloadable!] (restricted)
  7. Wagstaff, Adam, 1989. "Estimating Efficiency in the Hospital Sector: A Comparison of Three Statistical Cost Frontier Models," Applied Economics, Taylor and Francis Journals, vol. 21(5), pages 659-72, May.
  8. Giannoni, Margherita & Hitiris, Theodore, 2002. "The Regional Impact of Health Care Expenditure: The Case of Italy," Applied Economics, Taylor and Francis Journals, vol. 34(14), pages 1829-36, September. [Downloadable!] (restricted)
  9. Joan Costa & Jaume Garcia, 2003. "Demand for private health insurance: how important is the quality gap?," Health Economics, John Wiley & Sons, Ltd., vol. 12(7), pages 587-599. [Downloadable!]
  10. Esther Martínez, 1998. "Las deducciones en el IRPF por gasto sanitario privado: situación actual y posibilidades de reforma," Working Papers, Research Center on Health and Economics 307, Department of Economics and Business, Universitat Pompeu Fabra. [Downloadable!]
Full references

Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Joan Costa & Jaume Puig, 2004. "Regulatory Ambivalence and the Limitations of Pharmaceutical Policy in Spain," Economics Working Papers 762, Department of Economics and Business, Universitat Pompeu Fabra. [Downloadable!]
  2. Joan Costa & Jaume Puig, 2004. "Regulatory Ambivalence and the Limitations of Pharmaceutical Policy in Spain," Working Papers, Research Center on Health and Economics 762, Department of Economics and Business, Universitat Pompeu Fabra. [Downloadable!]
  3. Joan Costa-Font & Jordi Pons-Novell, 2007. "Public health expenditure and spatial interactions in a decentralized national health system," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 291-306. [Downloadable!]
    Other versions:
  4. Joan Costa-Font & Ana Rico, 2006. "Devolution and the Interregional Inequalities in Health and Healthcare in Spain," Regional Studies, Taylor and Francis Journals, vol. 40(8), pages 875-887, November. [Downloadable!] (restricted)
  5. Guillem Lopez-Casasnovas & Joan Costa-Font & Ivan Planas, 2005. "Diversity and regional inequalities in the Spanish 'system of health care services'," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S221-S235. [Downloadable!]
  6. Joan Costa-Font & Francesco Moscone, 2008. "The impact of decentralization and inter-territorial interactions on Spanish health expenditure," Empirical Economics, Springer, vol. 34(1), pages 167-184, February. [Downloadable!] (restricted)
  7. Joan Costa Font & Joan Gil Trasfi, 2007. "Generational Effects on Adult Height in Contemporary Spain: Exploring Gender and Individual Heterogeneity," Working Papers in Economics 169, Universitat de Barcelona. Espai de Recerca en Economia. [Downloadable!]
Statistics
Access and download statistics

Did you know? Each page is provided with a technical contact, in case something is not right with the supplied information. See under "publisher info".

This page was last updated on 2009-11-20.

This information is provided to you by IDEAS at the Department of Economics, College of Liberal Arts and Sciences, University of Connecticut using RePEc data on a server sponsored by the Society for Economic Dynamics.