Decentralization and health performance in Italy: theoretical and empirical issues
type: CreativeWork
description: Three chapters constitute the main structure of this contribution. The first chapter investigates the relationship between fiscal decentralization and regional health outcomes, as measured by infant mortality rates, in Italy. The paper employs a panel of all Italian regions over a period of 17 years (from 1996 to 2012), applying a linear Fixed-Effect model. Two different quantitative measures of fiscal decentralization are used, which capture the degree of regional decision-making autonomy in the allocation of tax revenues and the extent of regional transfer dependency from the central government (i.e vertical fiscal imbalance). Methodologically, to account for the temporal dynamics of the decentralization impact, the robustness of the findings is checked, among others, with respect to the use of an Error Correction Model, which allows to disentangle short and long run effects. The analysis also deals with the issue of heterogeneous distributional geographical responses by modelling the asymmetric impact of decentralization on infant mortality rates according to the level of regional wealth. The second chapter addresses the issue of convergence. Here the main research questions are whether health outcomes in Italy converge/diverge over time and, more importantly, whether decentralization has played a somewhat role in the convergence/divergence process. Using a pooled dataset with the same time span as the previous one, the conventional measures of sigma- and beta- (both absolute and conditional) convergence are estimated for two different regional health outcomes (i.e. infant mortality rate and life expectancy at birth). Again, two measures of decentralization are employed in order to catch both the degree of fiscal regional decision-making autonomy (i.e. the same indicator as in chapter 1) and the political decentralization dynamics (i.e. a dummy variable taking the value of 1 after the introduction of the 2001 constitutional reform). From a methodological point of…
abstract: Three chapters constitute the main structure of this contribution. The first chapter investigates the relationship between fiscal decentralization and regional health outcomes, as measured by infant mortality rates, in Italy. The paper employs a panel of all Italian regions over a period of 17 years (from 1996 to 2012), applying a linear Fixed-Effect model. Two different quantitative measures of fiscal decentralization are used, which capture the degree of regional decision-making autonomy in the allocation of tax revenues and the extent of regional transfer dependency from the central government (i.e vertical fiscal imbalance). Methodologically, to account for the temporal dynamics of the decentralization impact, the robustness of the findings is checked, among others, with respect to the use of an Error Correction Model, which allows to disentangle short and long run effects. The analysis also deals with the issue of heterogeneous distributional geographical responses by modelling the asymmetric impact of decentralization on infant mortality rates according to the level of regional wealth. The second chapter addresses the issue of convergence. Here the main research questions are whether health outcomes in Italy converge/diverge over time and, more importantly, whether decentralization has played a somewhat role in the convergence/divergence process. Using a pooled dataset with the same time span as the previous one, the conventional measures of sigma- and beta- (both absolute and conditional) convergence are estimated for two different regional health outcomes (i.e. infant mortality rate and life expectancy at birth). Again, two measures of decentralization are employed in order to catch both the degree of fiscal regional decision-making autonomy (i.e. the same indicator as in chapter 1) and the political decentralization dynamics (i.e. a dummy variable taking the value of 1 after the introduction of the 2001 constitutional reform). From a methodological point of…
author: FERRANTE, LIVIO
language: eng
keywords: Health economics, Italy, fiscal decentralization, distributional effects, healthcare reforms, convergence, spatial dependence, infant mortality, life expectancy, payment systems, incentive schemes, quality, pay for performance
date published: 2016-12-09
date modified: 2026-07-24T01:35:10Z
provider: Università degli Studi di Catania
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Università degli studi di Catania

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property ID: Handle
value: https://hdl.handle.net/20.500.11769/583412