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

Costa-i-Font, Joan and Moscone, Francesco (2008) The impact of decentralization and inter-territorial interactions on Spanish health expenditure. Empirical Economics, 34 (1). pp. 167-184. ISSN 0377-7332

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Identification Number: 10.1007/s00181-007-0166-x


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.

Item Type: Article
Official URL:
Additional Information: © 2008 Springer
Subjects: H Social Sciences > HB Economic Theory
H Social Sciences > HJ Public Finance
R Medicine > RA Public aspects of medicine
Sets: Departments > European Institute
Departments > Social Policy
Collections > Economists Online
Research centres and groups > Centre for Economic Performance (CEP)
Research centres and groups > LSE Health
Date Deposited: 14 Feb 2008
Last Modified: 17 Dec 2014 09:58

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