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Do Harder Local Budget Constraints Affect Patient Mobility?

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Abstract

A recent article by Bordignon et al. (2020) looks at the experience of Financial Recovery Plans (FRPs) imposed on regional governments running large fiscal deficits in the management of Health Services, finding convincing evidence that FRPs led in Italy to a significant containment in health spending and almost entirely wiped out regional deficits. The article also suggests that FRPs did not produce any significant deterioration in the quality of health services and in citizens’ health. In this paper we reconsider the effects that FRPs may have produced on health services, by focusing on patient migration. By reframing the empirical analysis within the relevant strand of literature that considers migration as mainly driven by the supply side features of the healthcare systems (Levaggi and Zanola, 2004) and by considering the announcement effects related to this form of fiscal discipline, we estimate an increase in patient mobility in the range 15-18% as due to FRPs (18-25% when a commissioner is appointed). Our results suggest that the improvements in fiscal discipline may have widened the quality gap in the health services regionally delivered, with undesirable consequences in terms of increased disparities in the distribution of access opportunities to healthcare.

Suggested Citation

  • Sergio Beraldo & Michela Collaro & Immacolata Marino, 2020. "Do Harder Local Budget Constraints Affect Patient Mobility?," CSEF Working Papers 580, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.
    • Handle: RePEc:sef:csefwp:580
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    References listed on IDEAS

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    4. Beraldo, Sergio & Caruso, Raul & Turati, Gilberto, 2013. "Life is now! Time preferences and crime: Aggregate evidence from the Italian regions," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 47(C), pages 73-81.
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    More about this item

    Keywords

    Recovery Plans; Patient mobility; Equality of access to healthcare;
    All these keywords.

    JEL classification:

    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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