Divided We Survive? Multi-level Governance and policy uncertainty during the first wave of COVID-19

M. Angelici, P. Berta, Joan Costa-Font and Gilberto Turati ()

Health, Econometrics and Data Group (HEDG) Working Papers from HEDG, c/o Department of Economics, University of York

Abstract: We compare health system responses to the first wave of COVID-19 pandemic in Italy and Spain. Although in both countries, healthcare is managed at the regional level, the central government behaved differently in the uncertainty surrounding the first wave, leaving more autonomy to regional governments in Italy than in Spain. Upon documenting evidence of national and regional health system responses, we show important differences in the number of infected cases, alongside regular and emergency hospital admissions, and mortality in the two countries, both at the national and at the regional level. We then discuss several potential mechanisms, such as policy stringency, the localization of the pandemic and mobility restrictions, measurement error, and especially the regional autonomy, enjoyed by Italian regions but not by Spanish regional governments amidst a state of alarm in both countries. We conclude that, given the strong localized effect of the pandemic, allowing more autonomy, and fostering experimentation and local solutions explains the gap between Italy and Spain in the first wave of the pandemic.

Keywords: regional health systems; decentralization; policy stringency; health care; COVID-19; Italy; Spain (search for similar items in EconPapers)
JEL-codes: H75 I18 (search for similar items in EconPapers)
Date: 2021-10
New Economics Papers: this item is included in nep-eur and nep-hea
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Citations: View citations in EconPapers (1)

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