Inter‐regional patient mobility in decentralised Spain: Explaining regional budget imbalances

Inter‐regional patient mobility represents both a resource and a challenge for the organization and financing of health systems, particularly in decentralised countries. We use cross‐sectional time series regression analysis to test the determinants of imbalances in regional funds to finance inter‐regional patient mobility for the 17 Spanish regions for the period 2014–2020. The findings indicate that highly specialised health centres and bilateral agreements partly explain the budget imbalance from inter‐regional patient referrals, while local tourism partly explains the budget imbalance from non‐referred patient mobility. Developing effective national schemes to compensate net patient recipient regions would be fundamental to addressing territorial imbalances.