In latest years there has been a growing interest on factors explaining health expenditure at a regional level. The existing literature on the determinants of health expenditure has followed two different approaches. Pioneering studies have focused on cross country health expenditure analyses but were not able to appropriately deal with the problem of country heterogeneity. Most recently, few papers have restricted the analysis to single countries with either federal system (e.g. Canada and Switzerland) or multiple highly autonomous jurisdictions (e.g.Spain). In the case of Italy, even though the health system was initially designed as a centralized one, the government has progressively undertaken a decentralization process up to the point of modifying the Constitution in order to appoint regions with exclusive health care responsibilities. In this paper, we analyze data on regional per capita health care expenditure(in real terms) for the period 1990-2003. The objective is to determine the effects of different variables and to evaluate the resulting implications for the design of a financial perequation model to be used in a future federal system.
The determinants of regional health expenditure in a decentralized system
CAVALIERI, MARINA;GUCCIO, Calogero
2006-01-01
Abstract
In latest years there has been a growing interest on factors explaining health expenditure at a regional level. The existing literature on the determinants of health expenditure has followed two different approaches. Pioneering studies have focused on cross country health expenditure analyses but were not able to appropriately deal with the problem of country heterogeneity. Most recently, few papers have restricted the analysis to single countries with either federal system (e.g. Canada and Switzerland) or multiple highly autonomous jurisdictions (e.g.Spain). In the case of Italy, even though the health system was initially designed as a centralized one, the government has progressively undertaken a decentralization process up to the point of modifying the Constitution in order to appoint regions with exclusive health care responsibilities. In this paper, we analyze data on regional per capita health care expenditure(in real terms) for the period 1990-2003. The objective is to determine the effects of different variables and to evaluate the resulting implications for the design of a financial perequation model to be used in a future federal system.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
