Health Expenditure in Italy: a Regional Analysis of the Public-private Mix
نویسندگان
چکیده
In latest years there has been a growing interest on factors explaining health expenditure at a regional level. Indeed, in the case of Italy, even though the health care 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. Starting from 1992, a set of reforms was specifically designed to increase the autonomy of Regional Health Authorities in both the financing and delivery of health care. Regions have thus carried out differentiated policies, which have exacerbated rather than shorten interregional inequalities. Unlike previous studies, in this paper we intend to investigate the impact of institutional and non institutional variables on the public-private mix in health care expenditure. Using pooled time-series cross-section observations over the period 1990-2003, different models for the ratio of public to total health expenditure as well as for private health spending are estimated at a regional level. Among the other findings, there is evidence that public expenditure is not sufficiently able to mitigate regional differences in income levels. JEL classification: H7, H51, I18
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