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Public health expenditure and spatial interactions in a decentralized national health system

Author

Listed:
  • Joan Costa-Font
  • Jordi Pons-Novell

    (CAEPS & Departament d'Econometria, Estadística i Economia Espanyola, Universitat de Barcelona, Catalonia, Spain)

Abstract

One of the limitations of cross-country health expenditure analysis refers to the fact that the financing, the internal organization and political restraints of health care decision-making are country-specific and heterogeneous. Yet, a way through is to examine the influence of such effects in those countries that have undertaken decentralization processes. In such a setting, it is possible to examine potential expenditure spillovers across the geography of a country as well as the influence of the political ideology of regional incumbents and institutional factors on public health expenditure. This paper examines the determinants of public health expenditure within Spanish region-states (Autonomous Communities, ACs), most of them subject to similar financing structures although exhibiting significant heterogeneity as a result of the increasing decentralization, region-specific political factors along with different use of health care inputs, economic dimension and spatial interactions. Copyright © 2006 John Wiley & Sons, Ltd.

Suggested Citation

  • 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.
  • Handle: RePEc:wly:hlthec:v:16:y:2007:i:3:p:291-306
    DOI: 10.1002/hec.1154
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    References listed on IDEAS

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    JEL classification:

    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • H73 - Public Economics - - State and Local Government; Intergovernmental Relations - - - Interjurisdictional Differentials and Their Effects
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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