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Decentralisation and convergence in health among the provinces of Spain (1980-2001)

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  • Montero-Granados, Roberto
  • de Dios Jiménez, Juan
  • Martín, José

Abstract

This study measures the process of convergence in the state of health among the provinces and regions of Spain during 1980-2001 in order to analyse the possible influence of the decentralisation of healthcare management to the regions in this period. Sigma and beta convergence models, traditionally employed in macroeconomics, have been used, taking Life Expectancy at Birth (LEB) and Infant Mortality (IM) as health indicators. The analysis was carried out at two territorial levels: provinces and regions. The results reveal that the process of decentralisation either does not affect convergence or leads to divergence in health. Indeed, in the case of IM the so-called change of role scenario seems to have occurred. Thus, certain provinces with initially poor indicators have improved, overtaking those that were originally in a better position. The final result, however, is of greater dispersion than initially.

Suggested Citation

  • Montero-Granados, Roberto & de Dios Jiménez, Juan & Martín, José, 2007. "Decentralisation and convergence in health among the provinces of Spain (1980-2001)," Social Science & Medicine, Elsevier, vol. 64(6), pages 1253-1264, March.
    • Handle: RePEc:eee:socmed:v:64:y:2007:i:6:p:1253-1264
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    1. Andrea Leiter & Engelbert Theurl, 2012. "The convergence of health care financing structures: empirical evidence from OECD-countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(1), pages 7-18, February.
    2. Ahmad, Ehtisham & Brosio, Giorgio, 2009. "Decentralization and local service provision: what do we know?," LSE Research Online Documents on Economics 38347, London School of Economics and Political Science, LSE Library.
    3. Jiménez-Rubio, Dolores & García-Gómez, Pilar, 2017. "Decentralization of health care systems and health outcomes: Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 188(C), pages 69-81.
    4. José Villaverde & Adolfo Maza & María Hierro, 2014. "Health care expenditure disparities in the European Union and underlying factors: a distribution dynamics approach," International Journal of Health Economics and Management, Springer, vol. 14(3), pages 251-268, September.
    5. Fanny Janssen & Leo van Wissen & Joop de Beer & Anthe van den Hende, 2016. "Sigma and beta convergence in regional mortality: A case study of the Netherlands," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 35(4), pages 81-116.
    6. Masayoshi Hayashi, 2011. "The effects of medical factors on transfer deficits in Public Assistance in Japan: a quantile regression analysis," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 287-307, December.
    7. Sergey Timonin & Inna Danilova & Evgeny Andreev & Vladimir M. Shkolnikov, 2017. "Recent Mortality Trend Reversal in Russia: Are Regions Following the Same Tempo?," European Journal of Population, Springer;European Association for Population Studies, vol. 33(5), pages 733-763, December.
    8. Soto, Victoria Eugenia & Farfan, Maria Isabel & Lorant, Vincent, 2012. "Fiscal decentralisation and infant mortality rate: The Colombian case," Social Science & Medicine, Elsevier, vol. 74(9), pages 1426-1434.
    9. Jacob Martin & Carlo Giovanni Camarda & Timothy Riffe, 2025. "Spatial Trends in Mortality Convergence: The Cases of France, Italy, and Spain, 1975–2019," European Journal of Population, Springer;European Association for Population Studies, vol. 41(1), pages 1-28, December.
    10. Cavalieri, Marina & Ferrante, Livio, 2020. "Convergence, decentralization and spatial effects: An analysis of Italian regional health outcomes," Health Policy, Elsevier, vol. 124(2), pages 164-173.
    11. Lo, Charlene & Anselmi, Laura & Sutton, Matt, 2025. "Horizontal equity in primary care financing: An assessment of payments to general practices in England, 2014–2022," Social Science & Medicine, Elsevier, vol. 373(C).
    12. Martin Gächter & Engelbert Theurl, 2010. "Convergence of the Health Status at the Local Level: Empirical Evidence from Austria," NRN working papers 2010-09, The Austrian Center for Labor Economics and the Analysis of the Welfare State, Johannes Kepler University Linz, Austria.
    13. Jiménez-Rubio, Dolores, 2011. "The impact of fiscal decentralization on infant mortality rates: Evidence from OECD countries," Social Science & Medicine, Elsevier, vol. 73(9), pages 1401-1407.

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