Sobre el Reparto de la Financiación Sanitaria
In this paper we develop a methodology that can be used to estimate the cost function implicit in the sharing rule for health-related financing that is used in the Spanish regional financing system using data on observed expenditure and controlling in a specific way for total financing. Even though the results of the estimation are not very precise, they can be used to draw some conclusions about the way in which the financing formula should be modified in order to provide all regions with the necessary resources to provide health care of uniform quality. We find, in particular, that it is very likely that the current formula underestimates aging-related costs. We also find evidence of economies of scale and conclude that health care costs are higher in the island regions, rise with land area and decrease with disposable income through a lower rate of utilization of public health care facilities. We also quantify the impact of regional differences in price levels on wage cos ts. Allowing for this factor, we construct indicators of relative regional “expenditure needs” at equal real wages for public health care personnel in all regions.
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