Do individuals’ health preferences validate the decentralisation of the public health system in Spain?

•The need to balance the desired health services and the limited economic resources.•The need to identify public health preferences when maximizing public welfare.•There exist differences on estimated health preferences between Spanish regions.•The decentralisation of public health policies leads us...

Full description

Saved in:
Bibliographic Details
Published in:Health policy (Amsterdam) 2022-07, Vol.126 (7), p.680-687
Main Authors: Sigüenza, Waleska, Artabe, Alaitz
Format: Article
Language:English
Subjects:
Decentralised policy
Health services
Individual preferences
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:•The need to balance the desired health services and the limited economic resources.•The need to identify public health preferences when maximizing public welfare.•There exist differences on estimated health preferences between Spanish regions.•The decentralisation of public health policies leads us to efficient level of services in Spain. The objective of this paper is to estimate individuals’ preferences about public health services in two Spanish regions, the Basque Country (BC) and Canary Islands (CI) and analyse whether they differ. This work was motivated by the actual economic situation, where it is necessary to obtain equilibrium between the needed health services and limited economic resources. With this limitation in mind, politicians have tried to design health policies that maximise individuals’ welfare. Based on the theory of decentralisation, the devolution of public expenditure decisions and management to regional government maximises individuals’ welfare more when individual preferences differ among regions. A discrete choice experiment was implemented with a survey designed to obtain data about individuals’ choices. Using this data and discrete choice models, individual preferences for health services were estimated. Our findings indicate that these preferences differ among regions, so, for reasons of efficiency, decentralising decisions and management of public health policies to regional governments would be recommended. Once health policies are decentralised, our results provide a tool for identifying the health services most valued by the individuals in each region. This information would be useful policymakers designing health policies.
ISSN:0168-8510
1872-6054
DOI:10.1016/j.healthpol.2022.04.010