The European Journal of Health Economics

, Volume 15, Issue 2, pp 117–132 | Cite as

Is there room for containing healthcare costs? An analysis of regional spending differentials in Italy

Original Paper


This work aims at identifying the determinants of health spending differentials among Italian regions and at highlighting potential margins for savings. The analysis exploits a data set for the 21 Italian regions and autonomous provinces starting in the early 1990s and ending in 2006. After controlling for standard healthcare demand indicators, remaining spending differentials are found to be significant, and they appear to be associated with differences in the degree of appropriateness of treatments, health sector supply structure and social capital indicators. In general, higher regional expenditure does not appear to be associated with better reported or perceived quality in health services. In the regions that display poorer performances, inefficiencies appear not to be uniformly distributed among expenditure items. Overall, results suggest that savings could be achieved without reducing the amount of services provided to citizens. This seems particularly important given the expected rise in spending associated with the forecasted demographic developments.


Government Expenditure Health Regional inequalities 

JEL Classification

H51 I1 



We thank two anonymous referees for their comments, the discussants and the participants at conferences and seminars where previous versions of this work were presented, and the colleagues at the Public Finance Division of the Bank of Italy. The usual disclaimers apply.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Research and International RelationsBanca d’Italia-EconomicsRomeItaly

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