Austerity, Healthcare Provision, and Health Outcomes in Spain
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Austerity, Healthcare Provision, and Health Outcomes in SpainFecha
2020Cita bibliográfica
Borra, C., Pons-Pons, J. & Vilar-Rodríguez, M. (2020). Austerity, healthcare provision, and health outcomes in Spain. The European Journal of Health Economics, 21(3), 409–423. 10.1007/s10198-019-01141-3
Resumen
[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 1996 to 2015 to
provide novel causal evidence on the short-term impact of healthcare provision on health
outcomes. The fact that regional governments have discretionary powers in deciding healthcare
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 medicalstaff and hospital bed reductions
account for a significant increase in mortality rates from circulatory diseases and external causes,
but not from other causes of death. Similarly, mortality rates do not seem to be robustly affected
by the 2012 changes in retirees’ pharmaceutical co-payments and access restrictions for illegal
immigrants. Our results are robust to changes in model specification and sample selection and
are primarily driven by accidental and emergency deaths rather than in-hospital mortality, which
suggests a larger role for decreases in accessibility rather than decreases in healthcare quality as
impact channels.
Palabras clave
Healthcare provision
Mortality
Health cuts
Mortality
Health cuts
Versión del editor
ISSN
1618-7598