Decentralisation of health care and its impact on health outcomes

Dolores Jiménez Rubio and Peter C Smith

Discussion Papers from Department of Economics, University of York

Abstract: This paper explores the impact of health care decentralisation on a characteristic of human development: the overall level of a population's health. While much of the literature on decentralisation in health care has stressed the advantages of sub national provision of health services, in the absence of a quantitative measure of the magnitude of the effect of decentralisation, there is little that can be said in terms of its benefits and costs for the health sector. The purpose of this study is therefore to contribute to the limited empirical literature on this issue by investigating the hypothesis that shifts towards more decentralisation would be accompanied by improvements in population health. The analysis draws on a theoretical model of local government's public finance applied to health. We use the ten provinces of Canada as a case study. Apart from being one of the most decentralised countries in the world, Canadian data required to estimate our model was found to be one of the best. The results of the empirical analysis suggest that decentralisation in Canada has had a positive and substantial influence on the effectiveness of public policy in improving population's health.

Keywords: Fiscal decentralisation; health outcomes; Canada (search for similar items in EconPapers)
JEL-codes: H77 I12 (search for similar items in EconPapers)
New Economics Papers: this item is included in nep-hea and nep-pbe
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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