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Experiencia comparada europea y el reto de la descentralización sanitaria/Comparative European Experience and the Decentralization Health Challenge



    (Universidad de Cantabria, Facultad CC.EE., Avenida de los Castros, s/n., 39005 Santander, España.)



    (Universidad de Cantabria, Facultad CC.EE., Avenida de los Castros, s/n., 39005 Santander, España.)



    (Universidad de Cantabria, Facultad CC.EE., Avenida de los Castros, s/n., 39005 Santander, España.)

El trabajo analiza las principales características de los modelos de descentralización sanitaria en Europa prestando especial atención a los determinantes de resultados en salud y gasto. Con datos de la OECD Healht Data, se propone un modelo de panel explicativo de su comportamiento y evolución. Los resultados muestran que la renta es estática y dinámicamente el factor más importante en la explicación del volumen de gasto sanitario, mientras que otros factores de demanda y de oferta así como el grado de descentralización o tipo de sistema sanitario, son menos importantes. Mientras, en resultados en salud la descentralización tiene un efecto más dispar frente al resto de factores. This paper analyzes the main characteristics of European health care decentralization models with special attention to the determinants of health outcomes and expenditures and proposes using panel data models, and data from OECD Health Data, an econometric model explaining their behaviour and evolution. The results show that income is the most important factor in explaining the volume of health expenditure both statically and dynamically, while other factors of demand and supply and the degree of decentralization or type of health system, despite also influence are less important. Instead, in health outcomes fiscal decentralization has a more mixed against other factors

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Article provided by Estudios de Economía Aplicada in its journal Estudios de Economía Aplicada.

Volume (Year): 32 (2014)
Issue (Month): (Mayo)
Pages: 841-860

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Handle: RePEc:lrk:eeaart:32_2_15
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  1. D. Cantarero & Marta Pascual, 2007. "Analysing the impact of fiscal decentralization on health outcomes: empirical evidence from Spain," Applied Economics Letters, Taylor & Francis Journals, vol. 15(2), pages 109-111.
  2. M Arellano & O Bover, 1990. "Another Look at the Instrumental Variable Estimation of Error-Components Models," CEP Discussion Papers dp0007, Centre for Economic Performance, LSE.
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  6. Nadir Habibi & Cindy Huang & Diego Miranda & Victoria Murillo & Gustav Ranis & Mainak Sarkar & Frances Stewart, 2003. "Decentralization and Human Development in Argentina," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 4(1), pages 73-101.
  7. Gbesemete, Kwame P. & Gerdtham, Ulf-G., 1992. "Determinants of health care expenditure in Africa: A cross-sectional study," World Development, Elsevier, vol. 20(2), pages 303-308, February.
  8. Vincenzo Atella & Giorgia Marini, 2007. "Is Health Care Expenditure Really a Luxury Good? Re-assessment and New Evidence Based on OECD Data," Rivista di Politica Economica, SIPI Spa, vol. 97(2), pages 87-120, March-Apr.
  9. 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.
  10. Pedro Pita Barros, 1998. "The black box of health care expenditure growth determinants," Health Economics, John Wiley & Sons, Ltd., vol. 7(6), pages 533-544.
  11. Anindya Sen, 2005. "Is Health Care a Luxury? New Evidence from OECD Data," International Journal of Health Care Finance and Economics, Springer, vol. 5(2), pages 147-164, June.
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