Efficiency and equity consequences of decentralization in health: an economic perspective

Efficiency and equity consequences of decentralization in health: an economic perspective

Over the recent years, decentralization has been adopted in many health systems. The question however remains of whether local actors do better than the central government. We summarize the main insights from economic theory on the impact of decentralization and its empirical validation. Theory suggests that the decision to decentralize results from a trade-off between its advantages (like its capacity to cater to local tastes) and costs (like inter-regional spillovers). Empirical contributions point that decentralization results in better health outcomes and higher expenditures, resulting in ambiguous consequences on efficiency; equity consequences are controversial and address the relevance of redistribution mechanisms.

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Main Authors: Alves,Joana, Peralta,Susana, Perelman,Julian
Format: Digital revista
Language:English
Published: Escola Nacional de Saúde Pública 2013
Online Access:http://scielo.pt/scielo.php?script=sci_arttext&pid=S0870-90252013000100008
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spelling oai:scielo:S0870-902520130001000082015-06-15Efficiency and equity consequences of decentralization in health: an economic perspectiveAlves,JoanaPeralta,SusanaPerelman,Julian Decentralization Efficiency Equity Health economics Incentives Over the recent years, decentralization has been adopted in many health systems. The question however remains of whether local actors do better than the central government. We summarize the main insights from economic theory on the impact of decentralization and its empirical validation. Theory suggests that the decision to decentralize results from a trade-off between its advantages (like its capacity to cater to local tastes) and costs (like inter-regional spillovers). Empirical contributions point that decentralization results in better health outcomes and higher expenditures, resulting in ambiguous consequences on efficiency; equity consequences are controversial and address the relevance of redistribution mechanisms.info:eu-repo/semantics/openAccessEscola Nacional de Saúde PúblicaRevista Portuguesa de Saúde Pública v.31 n.1 20132013-01-01info:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0870-90252013000100008en10.1016/j.rpsp.2013.01.002
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country Portugal
countrycode PT
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region Europa del Sur
libraryname SciELO
language English
format Digital
author Alves,Joana
Peralta,Susana
Perelman,Julian
spellingShingle Alves,Joana
Peralta,Susana
Perelman,Julian
Efficiency and equity consequences of decentralization in health: an economic perspective
author_facet Alves,Joana
Peralta,Susana
Perelman,Julian
author_sort Alves,Joana
title Efficiency and equity consequences of decentralization in health: an economic perspective
title_short Efficiency and equity consequences of decentralization in health: an economic perspective
title_full Efficiency and equity consequences of decentralization in health: an economic perspective
title_fullStr Efficiency and equity consequences of decentralization in health: an economic perspective
title_full_unstemmed Efficiency and equity consequences of decentralization in health: an economic perspective
title_sort efficiency and equity consequences of decentralization in health: an economic perspective
description Over the recent years, decentralization has been adopted in many health systems. The question however remains of whether local actors do better than the central government. We summarize the main insights from economic theory on the impact of decentralization and its empirical validation. Theory suggests that the decision to decentralize results from a trade-off between its advantages (like its capacity to cater to local tastes) and costs (like inter-regional spillovers). Empirical contributions point that decentralization results in better health outcomes and higher expenditures, resulting in ambiguous consequences on efficiency; equity consequences are controversial and address the relevance of redistribution mechanisms.
publisher Escola Nacional de Saúde Pública
publishDate 2013
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S0870-90252013000100008
work_keys_str_mv AT alvesjoana efficiencyandequityconsequencesofdecentralizationinhealthaneconomicperspective
AT peraltasusana efficiencyandequityconsequencesofdecentralizationinhealthaneconomicperspective
AT perelmanjulian efficiencyandequityconsequencesofdecentralizationinhealthaneconomicperspective
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