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Regional Health Care Decentralization in Unitary States: Equal Spending, Equal Satisfaction?

Author

Listed:
  • Joan Costa-Font

    () (Department of Social Policy, London School of Economics and Political Science (LSE), UK)

  • Gilberto Turati

    () (Department of Economics and Statistics (Dipartimento di Scienze Economico-Sociali e Matematico-Statistiche), University of Torino, Italy)

Abstract

Does regional decentralization threaten the commitment to regional equality in government outcomes? We attempt to shed light on this question by drawing on unique evidence from the largest European unitary states to have engaged in countrywide health system decentralization: Italy and Spain. We estimate, decompose, and run counterfactual analysis of regional inequality in government output (health expenditure per capita) and outcome (health system satisfaction) during expansion of health care decentralization in both countries. We find no evidence of increase in regional inequalities in outcomes and outputs in the examined period. Inequalities are accounted for by differences in health system design.

Suggested Citation

  • Joan Costa-Font & Gilberto Turati, 2016. "Regional Health Care Decentralization in Unitary States: Equal Spending, Equal Satisfaction?," Working papers 037, Department of Economics and Statistics (Dipartimento di Scienze Economico-Sociali e Matematico-Statistiche), University of Torino.
  • Handle: RePEc:tur:wpapnw:037
    as

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    File URL: http://www.bemservizi.unito.it/repec/tur/wpapnw/m37.pdf
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    References listed on IDEAS

    as
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    More about this item

    Keywords

    Health Care Decentralization; Regional Inequality; Health Care; Oaxaca Decomposition;

    JEL classification:

    • H7 - Public Economics - - State and Local Government; Intergovernmental Relations
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I3 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty

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