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Public health expenditure and spatial interactions in a decentralized national health system
Author(s) -
CostaFont Joan,
PonsNovell Jordi
Publication year - 2007
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.1154
Subject(s) - decentralization , public economics , politics , public expenditure , public health , health care , dimension (graph theory) , ideology , economics , public finance , economic growth , political science , macroeconomics , medicine , market economy , nursing , mathematics , pure mathematics , law
One of the limitations of cross‐country health expenditure analysis refers to the fact that the financing, the internal organization and political restraints of health care decision‐making are country‐specific and heterogeneous. Yet, a way through is to examine the influence of such effects in those countries that have undertaken decentralization processes. In such a setting, it is possible to examine potential expenditure spillovers across the geography of a country as well as the influence of the political ideology of regional incumbents and institutional factors on public health expenditure. This paper examines the determinants of public health expenditure within Spanish region‐states (Autonomous Communities, ACs), most of them subject to similar financing structures although exhibiting significant heterogeneity as a result of the increasing decentralization, region‐specific political factors along with different use of health care inputs, economic dimension and spatial interactions. Copyright © 2006 John Wiley & Sons, Ltd.