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Regional health care decentralization in unitary states: equal spending, equal satisfaction?

Costa-Font, Joan and Turati, Gilberto (2018) Regional health care decentralization in unitary states: equal spending, equal satisfaction? Regional Studies, 52 (7). pp. 974-985. ISSN 0034-3404

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Identification Number: 10.1080/00343404.2017.1361527


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 the expansion of health care decentralization in both countries. We find no evidence of an increase in regional inequalities in outcomes and outputs in the examined period. Inequalities are accounted for by differences in health system design and management by regional governments.

Item Type: Article
Official URL:
Additional Information: © 2017 Regional Studies Association
Divisions: Health Policy
LSE Health
Subjects: H Social Sciences > HC Economic History and Conditions
H Social Sciences > HN Social history and conditions. Social problems. Social reform
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Sets: Departments > Health Policy
Research centres and groups > LSE Health and Social Care
Research centres and groups > LSE Health
Date Deposited: 31 Jul 2017 10:59
Last Modified: 29 Oct 2018 11:49

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