Regional Institutional Quality and Territorial Equity in LTC Provision

Anna Marenzi (), Dino Rizzi, Michele Zanette () and Francesca Zantomio
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Anna Marenzi: Department of Economics, Ca' Foscari University of Venice; CRIEP
Michele Zanette: Department of Economics, Ca' Foscari University of Venice CÃ Foscari; CRIEP

No 2022:15, Working Papers from Department of Economics, University of Venice "Ca' Foscari"

Abstract: We show how regional governments affect the appropriate – in terms of territorial equity - assignment of a national LTC benefit. We analyse a three-layers setting, where eligibility criteria are defined by the central government (which bears the fiscal cost of transfers) but the assignment decision is taken by regional medical commissions, while applications are activated by individual potential beneficiaries. Combining administrative and survey data, and accounting for regional variation in eligibility prevalence, we document large territorial disparities in need-adjusted benefit assignment. We investigate the determinants of such disparities both in terms of individuals' differential propensity to claim, and of regional discretionary behaviour, as shaped by the underlying quality of regional institutions. Regional discretion appears to play a major role, with local institutional quality accounting for about one fifth of explained variation in need-adjusted benefit coverage. Lower regional institutional quality results in more opportunistic benefit adjudication decisions, although the relationship is attenuated in highly deprived areas.

Keywords: Territorial equity; regional discretion; multi-level government; institutional quality; long-term care; benefit targeting (search for similar items in EconPapers)
JEL-codes: C13 H11 H53 H75 J14 (search for similar items in EconPapers)
Pages: 35 pages
Date: 2022
New Economics Papers: this item is included in nep-eur, nep-geo and nep-ure
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Journal Article: Regional institutional quality and territorial equity in LTC provision (2023)
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Persistent link: https://EconPapers.repec.org/RePEc:ven:wpaper:2022:15

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