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The impact of decentralization and inter-territorial interactions on Spanish health expenditure

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Abstract

This paper examines the determinants of regional public health expenditure in a decentralised health system. Unlike previous studies we take into account possible policy and political interactions among authorities, as well as unobserved heterogeneity. Our emprirical contribution lies in running a spatial panel specification using a dataset of all Spanish region states on aggregated and disaggregated health expenditures (pharmaceuticals, inpatient and primary care). Results are consistent with some degree of interdependence between neighboring regions in spending decisions. Empirical evidence of long term efficiency effects of health care decentralisation, suggests that a specific spatial-institutional design might improve the health system efficiency as well as regional cohesion. Political and scale effects are consistent with theoretical predictions.

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Authors and Affiliations

  1. European Institute, LSE Health and Social Care, London School of Economics, London, UK

    Joan Costa-Font

  2. CAEPS & Departament de Teoria Econòmica, Universitat de Barcelona, Barcelona, Catalonia, Spain

    Joan Costa-Font

  3. Department of Economics and Girton College, University of Leicester, Leicester, UK

    Francesco Moscone

  4. Department of Economics and Girton College, University of Cambridge, Cambridge, UK

    Francesco Moscone

Authors
  1. Joan Costa-Font
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  2. Francesco Moscone
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Correspondence to Joan Costa-Font.

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Costa-Font, J., Moscone, F. The impact of decentralization and inter-territorial interactions on Spanish health expenditure. Empirical Economics 34, 167–184 (2008). https://doi.org/10.1007/s00181-007-0166-x

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  • DOI: https://doi.org/10.1007/s00181-007-0166-x

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