We analyze the determinants of caesarean sections and the role that regional policies and institutions can play in controlling for inappropriateness in healthcare. We consider Italy as a case study, given that: at the national level caesarean sections are above OECD average but regional...

Recent theories on fiscal decentralization support the view that sub-national governments who finance a larger share of their spending with taxes raised locally by themselves are more accountable towards their citizens. Whilst evidence on improvements in spending efficiency is relatively common,...

Does regional decentralization threaten the commitment to regional equality in government outcomes? We attempt to shed light on this question by drawing on unique evidence from the largest European unitary states to have engaged in countrywide health system decentralization: Italy and Spain. We...

We exploit variation across Italian Regions in the implementation of region-specific tariffs within a Prospective Pay System (PPS) for hospitals based on Diagnosis Related Groups (DRG) to assess their impact on health and on the use of health care services. We consider survey data for the years...