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Diversity and regional inequalities: Assessing the outcomes of the Spanish 'System of Health Care Services'

Guillem López Casasnovas, Joan Costa-Font and Ivan Planas
Authors registered in the RePEc Author Service: Joan Costa-i-Font ()

Working Papers, Research Center on Health and Economics from Department of Economics and Business, Universitat Pompeu Fabra

Abstract: The consolidation of a universal health system coupled with a process of regional devolution characterise the institutional reforms of the National Health System (NHS) in Spain in the last two decades. However, scarce empirical evidence has been reported on the effects of both changes in health inputs, outputs and outcomes, both at the country and at the regional level. This paper examines the empirical evidence on regional diversity, efficiency and inequality of these changes in the Spanish NHS using cross-correlation, panel data and expenditure decomposition analysis. Results suggest that besides significant heterogeneity, once we take into account region-specific needs there is evidence of efficiency improvements whilst inequalities in inputs and outcomes, although more ‘visible’, do not appear to have increased in the last decade. Therefore, the devolution process in the Spanish Health System offers an interesting case for the experimentation of health reforms related to regional diversity but compatible with the nature of a public NHS, with no sizeable regional inequalitiest.

Keywords: Health expenditure; devolution; National Health System; regional inequalities; Spain (search for similar items in EconPapers)
JEL-codes: H7 I38 H31 (search for similar items in EconPapers)
Date: 2004-04
New Economics Papers: this item is included in nep-edu, nep-eec, nep-hea, nep-pbe and nep-ure
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