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Spend Less, Get More? Explaining Health Spending and Outcome Differences Between Canada and Italy


  • Livio Di Matteo

    (Lakehead University, Canada)

  • Thomas Barbiero

    (Ryerson University, Canada; Rimini Centre for Economic Analysis)


Canada spends more than Italy on health in per capita terms and as a share of GDP and yet Italy’s two main health indicators as measured by life expectancy and infant mortality are better and have improved more than Canada's in recent years. Research at the national and international level has noted that more health spending does not always result in improved outcomes. Moreover, other social determinants have also been seen as important to health outcomes. Social spending relative to health spending has been tied to improvements in life expectancy and mortality rates. A key difference between Canada and Italy is that Italy spends relatively more on social transfers – particularly pensions. We find that more social spending and health spending in either Italy or Canada does not explain the differences in health outcomes. Moreover, once we consider more social spending in Italy, the Italian health care system may not be much more efficient than the Canadian system.

Suggested Citation

  • Livio Di Matteo & Thomas Barbiero, 2020. "Spend Less, Get More? Explaining Health Spending and Outcome Differences Between Canada and Italy," Working Paper series 20-04, Rimini Centre for Economic Analysis.
  • Handle: RePEc:rim:rimwps:20-04

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