The design of intergovernmental fiscal relations can help to ensure that tax and spending powers are assigned in a way to promote sustainable and inclusive economic growth. Decentralisation can enable sub-central governments to provide better public services for households and firms, while it...

This article sheds light on the role of subnational governments in health systems across OECD countries. The views in this article show a move away from traditional measures of decentralisation, such as the share of subnational government expenditure of total expenditure, to measures capturing a...

The Coronavirus pandemic has put extreme pressure on public health services, often delivered at the local and regional levels of government. The paper focuses on how countries made changes to the configuration of federalism during the first wave of the pandemic. These changes typically have...

Globalisation accompanied by the growing importance of information technology and knowledge-based production pose challenging problems for federations. We summarise the difficulties that traditional decentralised federations face in addressing problems of competitiveness, innovation and...

This paper examines the relationship between the degree of administrative decentralisation across levels of government in health care decision-making and health care spending, life expectancy as well as hospital costs. This empirical analysis builds on previous analytical research carried out by...

Based on an OECD survey, this paper presents quantitative and qualitative data on the decentralisation of health systems, focusing on how they vary according to different institutional characteristics and what types of performance measurement systems are used in the health sector....