Objectives. The effectiveness of local government's social expenditure in mitigating the future use of health care resources is a relevant policy question for the National Health Service. Whether social expenditure may substitute, complement, prevent or postpone the use of NHS resources is seldom investigated in the health economics literature, and previous studies lack evidence on the impact of local government's social expenditure on health care use. This paper exploits exogenous environmental shocks (daily temperatures and earthquake events) to explore the relationship between local social expenditure and hospital admissions for different causes of disease and different social groups. Data and methods. To analyze the impact of social expenditure on hospital admissions we exploit detailed municipality-level data from Italy, where decisions on social expenditure are delegated to local governments and, therefore, provide a large source of heterogeneity across the country. This dataset is then combined with data from the universe of hospital admissions for mental health and cardiovascular diseases for the period 2001-2015 aggregated by municipality. We use daily data on extreme temperature shocks and earthquake occurrences to identify exogenous hospital admission surges, and analyze if heterogeneity in past social expenditure causes differences in hospital admissions when climate and seismic shocks occur. This strategy allows us to overcome endogeneity due to reverse causality between hospitalizations and social expenditure. Finally, the detail of hospital admission data allows us to explore the effects of social expenditure by socio-demographic groups. Results. Preliminary findings suggest that social expenditure mitigates hospitalizations with age-group specific effects. People in the age group 35-65 seem to benefit more from social expenditure than the oldest age cohorts. This is likely due to the nature of local social expenditure, whichenhances families' financial well-being but is rather ineffective for severe health problems.

Does social expenditure mitigate the effect of environmental shocks on health? [conference presentation (unpublished) - intervento a convegno (paper non pubblicato)]. Retrieved from http://hdl.handle.net/10446/151116

Does social expenditure mitigate the effect of environmental shocks on health?

Masiero, G.;

Abstract

Objectives. The effectiveness of local government's social expenditure in mitigating the future use of health care resources is a relevant policy question for the National Health Service. Whether social expenditure may substitute, complement, prevent or postpone the use of NHS resources is seldom investigated in the health economics literature, and previous studies lack evidence on the impact of local government's social expenditure on health care use. This paper exploits exogenous environmental shocks (daily temperatures and earthquake events) to explore the relationship between local social expenditure and hospital admissions for different causes of disease and different social groups. Data and methods. To analyze the impact of social expenditure on hospital admissions we exploit detailed municipality-level data from Italy, where decisions on social expenditure are delegated to local governments and, therefore, provide a large source of heterogeneity across the country. This dataset is then combined with data from the universe of hospital admissions for mental health and cardiovascular diseases for the period 2001-2015 aggregated by municipality. We use daily data on extreme temperature shocks and earthquake occurrences to identify exogenous hospital admission surges, and analyze if heterogeneity in past social expenditure causes differences in hospital admissions when climate and seismic shocks occur. This strategy allows us to overcome endogeneity due to reverse causality between hospitalizations and social expenditure. Finally, the detail of hospital admission data allows us to explore the effects of social expenditure by socio-demographic groups. Results. Preliminary findings suggest that social expenditure mitigates hospitalizations with age-group specific effects. People in the age group 35-65 seem to benefit more from social expenditure than the oldest age cohorts. This is likely due to the nature of local social expenditure, whichenhances families' financial well-being but is rather ineffective for severe health problems.
intervento a convegno (paper non pubblicato)
Masiero, Giuliano; Mazzonna, F.; Santarossa, M.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10446/151116
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