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Decentralization as a determinant of health care expenditure: empirical analysis for OECD countries

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  • Ilaria Mosca

Abstract

Territorial decentralization involves the transfer of responsibilities from a central government to lower levels of government. A common trend in different developed countries has been to decentralize some health functions (managerial and/or financial) to local governments. The set-up of the health care system and its degree of decentralization are here utilized in a panel data analysis as a determinant of health care expenditure in a sample of 20 Organization for Economic Co-operation and Development (OECD) countries for the period 1990 to 2000. These findings lend support that demographic, supply-related and socio-economic factors impact on overall health care costs and a decentralized health care setting implies higher health expenditure.

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  • Ilaria Mosca, 2007. "Decentralization as a determinant of health care expenditure: empirical analysis for OECD countries," Applied Economics Letters, Taylor & Francis Journals, vol. 14(7), pages 511-515.
    • Handle: RePEc:taf:apeclt:v:14:y:2007:i:7:p:511-515
    DOI: 10.1080/13504850500438736
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    1. Fabio Pammolli & Francesco Porcelli & Francesco Vidoli & Monica Auteri & Guido Borà, 2017. "La spesa sanitaria delle Regioni in Italia - Saniregio2017," Working Papers CERM 01-2017, Competitività, Regole, Mercati (CERM).
    2. Jochen Hartwig & Jan-Egbert Sturm, 2012. "An outlier-robust extreme bounds analysis of the determinants of health-care expenditure growth," KOF Working papers 12-307, KOF Swiss Economic Institute, ETH Zurich.
    3. Cristian Barra & Raffaele Lagravinese & Roberto Zotti, 2022. "Exploring hospital efficiency within and between Italian regions: new empirical evidence," Journal of Productivity Analysis, Springer, vol. 57(3), pages 269-284, June.
    4. Błażej Łyszczarz, 2018. "Determinanty wydatków na zdrowie w gospodarstwach domowych w Polsce," Gospodarka Narodowa. The Polish Journal of Economics, Warsaw School of Economics, issue 1, pages 137-157.
    5. Asim, Aysha & Ismail, Aisha, 2019. "Impact of Leverage on Earning Management: Empirical Evidence from the Manufacturing Sector of Pakistan," Journal of Finance and Accounting Research, University of Management and Technology, Lahore, vol. 1(1), pages 70-91, February.
    6. Fan, Victoria Y. & Savedoff, William D., 2014. "The health financing transition: A conceptual framework and empirical evidence," Social Science & Medicine, Elsevier, vol. 105(C), pages 112-121.
    7. Matt Andrews & Roger Hay & Jerrett Myers, 2010. "Governance Indicators Can Make Sense: Under-five Mortality Rates are an Example," CID Working Papers 207, Center for International Development at Harvard University.
    8. Clemente, Jesús & Lazaro, Angelina & Montanes, Antonio, 2016. "Public health expenditure in Spain: is there partisan behaviour?," MPRA Paper 69781, University Library of Munich, Germany.
    9. Rafaela Oliveira & Gonçalo Santinha & Teresa Sá Marques, 2023. "The Impacts of Health Decentralization on Equity, Efficiency, and Effectiveness: A Scoping Review," Sustainability, MDPI, vol. 16(1), pages 1-32, December.
    10. Andrews, Matthew, 2008. "Are One-Best-Way Models of Effective Government Suitable for Developing Countries?," Working Paper Series rwp08-014, Harvard University, John F. Kennedy School of Government.
    11. Vidoli, Francesco & Auteri, Monica, 2022. "Health-care demand and supply at municipal level: A spatial disaggregation approach," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).
    12. Andrews, Matthew R. & Hay, Roger & Myers, Jerrett, 2010. "Governance Indicators Can Make Sense: Under-five Mortality Rates are an Example," Scholarly Articles 4448994, Harvard Kennedy School of Government.
    13. Coelho, André Luiz Ribeiro Coutinho Berardo de Moraes & Menezes, Tatiane Almeida de & Paes , Nelson Leitão, 2018. "The impact of physicians’ decentralization on health services and economic growth," Revista Brasileira de Estudos Regionais e Urbanos, Associação Brasileira de Estudos Regionais e Urbanos (ABER), vol. 12(3), pages 277-291.
    14. Caravaggio, Nicola & Resce, Giuliano, 2023. "Enhancing Healthcare Cost Forecasting: A Machine Learning Model for Resource Allocation in Heterogeneous Regions," Economics & Statistics Discussion Papers esdp23090, University of Molise, Department of Economics.
    15. Matt Andrews & Roger Hay & Jerrett Myers, 2010. "Can Governance Indicators Make Sense? Towards a New Approach to Sector-Specific Measures of Governance," Oxford Development Studies, Taylor & Francis Journals, vol. 38(4), pages 391-410.
    16. Vitor Castro, 2017. "Pure, White and Deadly… Expensive: A Bitter Sweetness in Health Care Expenditure," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1644-1666, December.
    17. Victoria Fan and William Savedoff, 2014. "The Health Financing Transition: A Conceptual Framework and Empirical Evidence - Working Paper 358," Working Papers 358, Center for Global Development.
    18. Laura Botega & Mônica Viegas Andrade & Gilvan Ramalho Guedes, 2020. "Brazilian hospitals’ performance: an assessment of the unified health system (SUS)," Health Care Management Science, Springer, vol. 23(3), pages 443-452, September.
    19. Jochen Hartwig & Jan-Egbert Sturm, 2014. "Robust determinants of health care expenditure growth," Applied Economics, Taylor & Francis Journals, vol. 46(36), pages 4455-4474, December.
    20. Stadhouders, Niek & Kruse, Florien & Tanke, Marit & Koolman, Xander & Jeurissen, Patrick, 2019. "Effective healthcare cost-containment policies: A systematic review," Health Policy, Elsevier, vol. 123(1), pages 71-79.

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