IDEAS home Printed from https://ideas.repec.org/p/sef/csefwp/580.html
   My bibliography  Save this paper

Do Harder Local Budget Constraints Affect Patient Mobility?

Author

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
    as

    Download full text from publisher

    File URL: http://www.csef.it/WP/wp580.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Antonio Abatemarco & Massimo Aria & Sergio Beraldo & Francesca Stroffolini, 2020. "Measuring Disparities in Access to Health Care: A Proposal Based on an Ex-ante Perspective," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 150(2), pages 549-568, July.
    2. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    3. Francese, Maura & Piacenza, Massimiliano & Romanelli, Marzia & Turati, Gilberto, 2014. "Understanding inappropriateness in health spending: The role of regional policies and institutions in caesarean deliveries," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 262-277.
    4. Giovanni Perucca & Massimiliano Piacenza & Gilberto Turati, 2019. "Spatial inequality in access to healthcare: evidence from an Italian Alpine region," Regional Studies, Taylor & Francis Journals, vol. 53(4), pages 478-489, April.
    5. Charles M. Tiebout, 1956. "A Pure Theory of Local Expenditures," Journal of Political Economy, University of Chicago Press, vol. 64(5), pages 416-416.
    6. Massimo Bordignon & Silvia Coretti & Massimiliano Piacenza & Gilberto Turati, 2020. "Hardening subnational budget constraints via administrative subordination: The Italian experience of recovery plans in regional health services," Health Economics, John Wiley & Sons, Ltd., vol. 29(11), pages 1378-1399, November.
    7. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Antonio Abatemarco & Massimo Aria & Sergio Beraldo & Michela Collaro, 2023. "Measuring Access and Inequality of Access to Health Care: a Policy-Oriented Decomposition," CSEF Working Papers 666, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Massimo Bordignon & Silvia Coretti & Massimiliano Piacenza & Gilberto Turati, 2020. "Hardening subnational budget constraints via administrative subordination: The Italian experience of recovery plans in regional health services," Health Economics, John Wiley & Sons, Ltd., vol. 29(11), pages 1378-1399, November.
    2. Allen C. Goodman & Miron Stano, 2000. "Hmos and Health Externalities: A Local Public Good Perspective," Public Finance Review, , vol. 28(3), pages 247-269, May.
    3. Di Novi, C. & Piacenza, M. & Robone, S. & Turati, G., 2015. "How does fiscal decentralization affect within-regional disparities in well-being? Evidence from health inequalities in Italy," Health, Econometrics and Data Group (HEDG) Working Papers 15/23, HEDG, c/o Department of Economics, University of York.
    4. Bruno Lanz, 2015. "Avertive expenditures, endogenous quality perception, and the demand for public goods: An instrumental variable approach," CIES Research Paper series 36-2015, Centre for International Environmental Studies, The Graduate Institute.
    5. Joshua Graff Zivin & Matthew Neidell, 2013. "Environment, Health, and Human Capital," Journal of Economic Literature, American Economic Association, vol. 51(3), pages 689-730, September.
    6. Miller, Cristina & Pender, John & Hertz, Thomas, 2017. "Employment Spillover Effects of Rural Inpatient Healthcare Facilities," Economic Research Report 266290, United States Department of Agriculture, Economic Research Service.
    7. Giovanni Carnazza & Raffaele Lagravinese & Paolo Liberati & Irene Torrini, 2024. "Monetary flows for health mobility: The Italian NHS from a network perspective," SERIES 01-2024, Dipartimento di Economia e Finanza - Università degli Studi di Bari "Aldo Moro", revised Mar 2024.
    8. Antonio Abatemarco & Massimo Aria & Sergio Beraldo & Michela Collaro, 2023. "Measuring Access and Inequality of Access to Health Care: a Policy-Oriented Decomposition," CSEF Working Papers 666, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.
    9. Erik Lundin, 2017. "Price mimicking under cost-of-service regulation: the Swedish water sector," Journal of Regulatory Economics, Springer, vol. 52(3), pages 313-332, December.
    10. Lanz, Bruno & Provins, Allan, 2017. "Using averting expenditures to estimate the demand for public goods: Combining objective and perceived quality," Resource and Energy Economics, Elsevier, vol. 47(C), pages 20-35.
    11. bucci, valeria & ferrara, giancarlo & resce, giuliano, 2022. "Fiscal decentralization and efficiency: empirical evidence from Italian municipalities," MPRA Paper 111515, University Library of Munich, Germany.
    12. Eric French & Elaine Kelly & Richard Cookson & Carol Propper & Miqdad Asaria & Rosalind Raine, 2016. "Socio‐Economic Inequalities in Health Care in England," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 371-403, September.
    13. Anura Amarasinghe & Gerard D'Souza & Cheryl Brown & Tatiana Borisova, 2006. "A Spatial Analysis of Obesity in West Virginia," Working Papers Working Paper 2006-13, Regional Research Institute, West Virginia University.
    14. Salih Ozgur SARICA, 2014. "Regional Economic Growth. Socio-Economic Disparities among Counties," Journal of Economic Development, Environment and People, Alliance of Central-Eastern European Universities, vol. 3(4), pages 25-36, December.
    15. Martin Fischer & Martin Karlsson & Therese Nilsson, 2013. "Effects of Compulsory Schooling on Mortality: Evidence from Sweden," IJERPH, MDPI, vol. 10(8), pages 1-23, August.
    16. Tansel, Aysit & Keskin, Halil Ibrahim, 2017. "Education Effects on Days Hospitalized and Days out of Work by Gender: Evidence from Turkey," IZA Discussion Papers 11210, Institute of Labor Economics (IZA).
    17. Hongliang Wang & Yiwen Yu, 2016. "Increasing health inequality in China: An empirical study with ordinal data," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 14(1), pages 41-61, March.
    18. Sandy Fréret & Denis Maguain, 2017. "The effects of agglomeration on tax competition: evidence from a two-regime spatial panel model on French data," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 24(6), pages 1100-1140, December.
    19. Lurås, Hilde, 2009. "A healthy lifestyle: The product of opportunities and preferences," HERO Online Working Paper Series 2001:11, University of Oslo, Health Economics Research Programme.
    20. Charles Hokayem & James P. Ziliak, 2014. "Health, Human Capital, and Life Cycle Labor Supply," American Economic Review, American Economic Association, vol. 104(5), pages 127-131, May.

    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

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sef:csefwp:580. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Dr. Maria Carannante (email available below). General contact details of provider: https://edirc.repec.org/data/cssalit.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.