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Applied Health Economics and Health Policy
Published in: Applied Health Economics and Health Policy 6/2017

01-12-2017 | Original Research Article

Health Expenditure and All-Cause Mortality in the ‘Galaxy’ of Italian Regional Healthcare Systems: A 15-Year Panel Data Analysis

Authors: Davide Golinelli, Fabrizio Toscano, Andrea Bucci, Jacopo Lenzi, Maria Pia Fantini, Nicola Nante, Gabriele Messina

Published in: Applied Health Economics and Health Policy | Issue 6/2017

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Abstract

Background

The sustainability of healthcare systems is a topic of major interest. During periods of economic instability, policy makers typically reallocate resources and execute linear cuts in different areas of public spending, including healthcare.

Objectives

The aim of this paper was to examine whether and how per capita public healthcare expenditure (PHE) in the Italian regions was related to the all-cause mortality rate (MR) between 1999 and 2013 and to determine which expenditure item most affected mortality in the short and very short term.

Methods

We conducted a pooled cross-sectional time series study. Secondary data were extracted from ‘Health for All’, a database released periodically by the Italian National Institute of Statistics. PHE is subdivided into directly provided services (DPS), pharmaceutical care, general practitioner care, specialist medical care, privately delivered hospital care, other privately delivered medical services, and psychiatric support and rehabilitation. We used a fixed-effects regression to assess the effects of PHE items on the MR after controlling for a number of socioeconomic and supply variables.

Results

Higher spending on DPS was associated with a lower MR. Other expenditure variables were not significantly associated with the MR.

Conclusions

The results highlight the importance of medical services and goods provided directly by public services (i.e. hospital-based general and specialized wards and offices, emergency departments, etc.). DPS represents the driving force of the system and should be considered a determinant of the health of the Italian population. Our results suggest that the context and financing methods of a healthcare system should be carefully analysed before linear cuts are made or resources are reallocated.
Appendix
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Footnotes
1
“Death is indefinable—the only certainty and the only thing about which nothing is certain”. Søren Aabye Kierkegaard, philosopher [1813–1855].
 
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Metadata
Title
Health Expenditure and All-Cause Mortality in the ‘Galaxy’ of Italian Regional Healthcare Systems: A 15-Year Panel Data Analysis
Authors
Davide Golinelli
Fabrizio Toscano
Andrea Bucci
Jacopo Lenzi
Maria Pia Fantini
Nicola Nante
Gabriele Messina
Publication date
01-12-2017
Publisher
Springer International Publishing
Published in
Applied Health Economics and Health Policy / Issue 6/2017
Print ISSN: 1175-5652
Electronic ISSN: 1179-1896
DOI
https://doi.org/10.1007/s40258-017-0342-x

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