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Electoral accountability and local government efficiency: quasi-experimental evidence from the Italian health care sector reforms

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  • Francesco Porcelli

Abstract

This paper evaluates the effect of two policy changes on the efficiency of Italian regional governments in the provision of health care services: first a change in the electoral system, second a process of fiscal decentralisation. The paper provides two main contributions: (1) a comprehensive analysis of the two main reforms that involved Italian regional governments and the health care sector during the 1990s, (2) the evaluation of the impact of the electoral reform in a quasi-experimental setting. Final results are in line with recent theoretical predictions that show a positive relationship between government efficiency and the electoral accountability enhanced by institutions such as electoral rules and fiscal decentralisation. Copyright Springer-Verlag Berlin Heidelberg 2014

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  • Francesco Porcelli, 2014. "Electoral accountability and local government efficiency: quasi-experimental evidence from the Italian health care sector reforms," Economics of Governance, Springer, vol. 15(3), pages 221-251, August.
    • Handle: RePEc:spr:ecogov:v:15:y:2014:i:3:p:221-251
    DOI: 10.1007/s10101-014-0143-8
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    Cited by:

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    2. Kyriacou, Andreas & Roca-Sagalés, Oriol, 2023. "Fiscal Decentralization and Health Care Access and Quality: Evidence from Local Governments Around the World," MPRA Paper 116860, University Library of Munich, Germany.
    3. Emma Galli & Ilde Rizzo & Carla Scaglioni, 2018. "Transparency and Performance in the Italian Large Municipalities," ECONOMIA PUBBLICA, FrancoAngeli Editore, vol. 2018(2-3), pages 5-25.
    4. Boffardi, Raffaele, 2022. "How efficient is the Italian health system? Evidence on the role of political-institutional dynamics," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).
    5. Andreas P. Kyriacou & Oriol Roca-Sagalés, 2019. "Local Decentralization and the Quality of Public Services in Europe," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 145(2), pages 755-776, September.
    6. Raffaele Lagravinese & Paolo Liberati & Giuliano Resce, 2017. "Exploring health outcomes by stochastic multi-objective acceptability analysis: an application to Italian regions," Working Papers. Collection B: Regional and sectoral economics 1703, Universidade de Vigo, GEN - Governance and Economics research Network.
    7. Resce, Giuliano, 2022. "The impact of political and non-political officials on the financial management of local governments," Journal of Policy Modeling, Elsevier, vol. 44(5), pages 943-962.
    8. Rambe, Roosemarina Anggraini & Wibowo, Kodrat & Febriani, Ratu Eva & Septriani, Septriani, 2020. "Assessing the Local Government Efficiency: Evidence from Sumatra, Indonesia," Asian Journal of Applied Economics, Kasetsart University, Center for Applied Economics Research, vol. 27(2).
    9. David Bartolini & Agnese Sacchi & Domenico Scalera & Alberto Zazzaro, 2018. "The closer the better? Institutional distance and information blurring in a political agency model," Mo.Fi.R. Working Papers 146, Money and Finance Research group (Mo.Fi.R.) - Univ. Politecnica Marche - Dept. Economic and Social Sciences.
    10. Resce, Giuliano, 2022. "Political and Non-Political Officials in Local Government," Economics & Statistics Discussion Papers esdp22079, University of Molise, Department of Economics.
    11. 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.
    12. Cavalieri, Marina & Ferrante, Livio, 2016. "Does fiscal decentralization improve health outcomes? Evidence from infant mortality in Italy," Social Science & Medicine, Elsevier, vol. 164(C), pages 74-88.
    13. Lagravinese, Raffaele & Liberati, Paolo & Resce, Giuliano, 2019. "Exploring health outcomes by stochastic multicriteria acceptability analysis: An application to Italian regions," European Journal of Operational Research, Elsevier, vol. 274(3), pages 1168-1179.

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    More about this item

    Keywords

    Electoral accountability; DEA; Decentralisation ; Efficiency; Health; IRAP; Italy; Panel data ; Stochastic frontier; H11; H51; H77; I11;
    All these keywords.

    JEL classification:

    • D71 - Microeconomics - - Analysis of Collective Decision-Making - - - Social Choice; Clubs; Committees; Associations
    • D91 - Microeconomics - - Micro-Based Behavioral Economics - - - Role and Effects of Psychological, Emotional, Social, and Cognitive Factors on Decision Making
    • I32 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Measurement and Analysis of Poverty

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