ArticleInternational journal of health policy and management2022
The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis.
Article in International journal of health policy and management, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- Exploring the World, Minimizing Risks: Travelers' Awareness and Risk Perception of Infectious Diseases in the Post-Pandemic Era.Vaccines · 2026Article
- Uncovering hidden patterns: How good governance and health outcomes are shaped by the public healthcare funding?Frontiers in public health · 2026Article
- Assuring Primary Healthcare Services to Vulnerable Children in a Disadvantaged Suburb of Rome Metropolitan City During the Pandemic: Responses to the Crisis.Children (Basel, Switzerland) · 2025Article
- Medical deserts in Finland: measuring the accessibility and availability of primary health care services.BMC health services research · 2025Article
- Article
- Risk and sex-specific trends of dementia and stroke in Italy Compared to European and high-income countries and the world: global implications.Journal of neurology · 2024Article
- The implementation process of decentralization of health services: a qualitative perspective from Sudan.Frontiers in public health · 2024Article
- Identifying the Drivers of Inter-Regional Patients' Mobility: An Analysis on Hospital Beds Endowment.Healthcare (Basel, Switzerland) · 2023Article
- The Dangers of Fiscal Decentralisation in Healthcare: A Response to the Recent Commentaries.International journal of health policy and management · 2023Article
- Making Sense of the Complexity of Decentralised Governance Comment on "The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis".International journal of health policy and management · 2023Article
- Challenges in Assessment of Health Systems Decentralization: The Role of Path Dependence and Choice of Indicators Comment on "The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis".International journal of health policy and management · 2023Article
- Unequal Access to Testing and Vaccination Services for the Homeless and Undocumented Population During COVID-19 Pandemic.International journal of public health · 2022Article
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Comment on
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFiscal decentralisation (FD) is a widely implemented decentralisation policy consisting of the allocation of pooling and spending responsibilities from the central government to lower levels of governance within a country. In 2001, The Italian National Health System (Servizio Sanitario Nazionale, SSN) has introduced a strong element of FD, making regions responsible for their own pooling of resources and for their budgets. Despite the relevance, only few studies exist on health sector-FD in Italy, mostly looking at the effects of FD on infant mortality.
methodsThis study performs a fixed-effects panel data analysis of Italian Regions and Autonomous provinces between the years 2001 and 2017, to investigate the effects of health sector-FD on availability, accessibility, and utilisation of healthcare services in Italy.
resultsFD decreases availability of staff and hospital beds, decreases utilisation of care, measured by hospitalisation rates, and increases interregional patients' mobility for healthcare purposes, a finding suggesting increased disparities in access to healthcare. These effects seem to be stronger for public - rather than private - services, and are more prominent in poorer areas.
conclusionThis evidence suggest that FD has created a fragmented and unequal healthcare system, in which levels of availability, utilisation of, and accessibility to resources - as well as the extent of public sector's retrenchment - coincide with the wealth of the area.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.