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Austerity, health care provision, and health outcomes in Spain

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  • Borra, Cristina
  • Pons-Pons, Jeronia
  • Vilar-Rodriguez, Margarita

Abstract

The recession that started in the United States in December 2007 has had a significant impact on the Spanish economy through a large increase in the unemployment rate and a long recession which led to tough austerity measures imposed on public finances. Taking advantage of this quasi-natural experiment, we use data from the Spanish Ministry of Health from 1997 to 2014 to provide novel causal evidence on the short-term impact of health care provision on health outcomes. The fact that regional governments have discretionary powers in deciding health care budgets and that austerity measures have not been implemented uniformly across Spain helps isolate the impact of these policy changes on health indicators of the Spanish population. Using Ruhm’s (2000) fixed effects model, we find that staff or hospital bed reductions account for a significant increase in mortality rates from cardiovascular disease and external causes, for 25-34 and 65-74 year-old groups, and in the late foetal mortality rate. Mortality rates, however, do not seem to be robustly affected by the 2012 changes in retirees’ pharmaceutical co-payments. Contrary to expectations, we find some evidence of reduced mortality rates for cancer and female cancer as a result of the 2012 changes in migrants’ access restrictions to the Spanish NHS. Overall, our analyses suggest that short-term impacts of decreases in health care provision on mortality are significant but small. However, impacts prove to be economically and quantitatively significant in the case of fatalities due to external causes, especially accidental deaths.

Suggested Citation

  • Borra, Cristina & Pons-Pons, Jeronia & Vilar-Rodriguez, Margarita, 2017. "Austerity, health care provision, and health outcomes in Spain," MPRA Paper 79736, University Library of Munich, Germany.
    • Handle: RePEc:pra:mprapa:79736
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    3. Laura Otero-García & José Tomás Mateos & Alexo Esperato & Laia Llubes-Arrià & Vanesa Regulez-Campo & Carles Muntaner & Helena Legido-Quigley, 2023. "Austerity Measures and Underfunding of the Spanish Health System during the COVID-19 Pandemic—Perception of Healthcare Staff in Spain," IJERPH, MDPI, vol. 20(3), pages 1-10, January.
    4. Andrea Ciaccio, 2023. "The Impact of a Cost-containment Measure on the Quality of Regional Health Services in Italy: a Parametric and a Non-parametric Approach," Working Papers 2023: 24, Department of Economics, University of Venice "Ca' Foscari".
    5. Emanuele Arcà & Francesco Principe & Eddy Van Doorslaer, 2020. "Death by austerity? The impact of cost containment on avoidable mortality in Italy," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1500-1516, December.

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    More about this item

    Keywords

    Health care provision; Mortality; Health cuts;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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