Is decentralization good for your health? Transformations in the Italian NHS
Bibliographic Data
| ID | 2305643 |
|---|---|
| Authors | Emmanuele Pavolini (0000-0002-3308-1551, Macerata University, Italy), Giovanna Vicarelli (Marche Polytechnic University) |
| Year | 2012 |
| Volume | 60 |
| Issue | 4 |
| Pages | 472-488 |
| Publication date | 2012-07-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Current Sociology (JOURNAL) |
| Journal identifiers | ISSN: 0011-3921 • E-ISSN: 1461-7064 |
| Publisher | SAGE Publications Inc (PUBLISHER) |
| DOI | 10.1177/0011392112438332 |
| OpenAlex | W2122602158 |
| Language | EN |
| Citations received | 15 |
| References cited | 22 |
Decentralization is a cornerstone of health policy reforms across Europe and beyond. This article analyses some of the effects of decentralization using the Italian National Health System (NHS) as a case study. The authors evaluate the risks of welfare state retrenchment and the rise of territorial inequalities in accessing healthcare, using document analysis, secondary sources and micro-data elaboration. The analysis does not confirm an overall welfare state retrenchment, but reveals an increase in territorial inequalities. The results highlight a paradox: if decentralization is to be implemented in a country with strong territorial socioeconomic divides and a critical financial situation, it needs a strong central government in order to support and control local authorities. Otherwise, decentralization may cause a zero-sum game where the gains for the better-off regions counterbalance the losses in performance of the weaker ones; a situation which could lead to the growth of social inequalities, including gender inequalities
Central government · Cornerstone · Decentralization · Development economics · Economic growth · Economics · Geography · Government (linguistics) · Health care · Inequality · Local government · Market economy · Political science · Public economics · Retrenchment · Social Welfare · Socioeconomic status · Sociology · State (computer science) · Welfare · Welfare state · Employment and Welfare Studies · Global Health Care Issues · Public Administration · Social Policy and Reform Studies
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| Unique citing works | 15 |
|---|---|
| Citations per year | 1,07 |
| Citation span | 2012 - 2023 (12) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 13 |