Convergence in Spanish Public health expenditure: Has the decentralization process generated disparities?

Abstract

This study examines the per capita public health expenditures among the Spanish regions. To that end, we employ the database elaborated by the BBVA Fundation and IVIE (2013) which covers the years 1991-2010. We first test for the null hypothesis of convergence by employing the methodology proposed in Phillips and Sul (2007) in order to determine whether the evolution of the public health expenditures has followed a similar path across the Spanish regions. This methodology leads us to reject the null hypothesis of convergence, which implies the absence of a unique pattern of behavior in the evolution of the Spanish regional public health expenditures. Instead, we find several convergence clubs which reveal the existence of different patterns of behavior and serious disparities in the Spanish health system. When trying to determine the forces which drive the creation of these clubs, we also find some partisan behavior, in the sense that the longer a right-wing party governs, the lower the per capita public health expenditure in this region of Spain.

Keywords: Convergence; Health system; Public health expenditure; pArtisan behavior.