Changing the Management of Epidemics: Evidence from the Crispi-Pagliani Health Reform in post-Unification Italy

This study investigates the evolution of epidemic management in post-Unification Italy, focusing on the impact of the Crispi-Pagliani Health Reform of 1888. Specifically, it examines and compares the cholera epidemics of 1884 and 1893 to assess the effectiveness of changes in healthcare reporting, monitoring, and accounting systems. The research aims to determine whether the post-reform measures led to a more effective response in controlling and reducing cholerarelated deaths, particularly through improved medical resource allocation. Drawing on historical data from the Italian National Statistical Institute (ISTAT) and archival sources from the State Archive of Naples, this study employs econometric analysis to compare the outcomes of the 1884 and 1893 epidemics. The analysis uses the difference-in-differences (DID) method to explore how innovations introduced by the Crispi-Pagliani Reform enhanced the accuracy and efficiency of epidemic reporting, thus enabling more targeted public health interventions. From a Foucauldian perspective, this research also examines how accounting practices in epidemic management support bio-political strategies, allowing governments to exercise bio-power through the regulation of population health. By exploring these historical developments, the study sheds light on the role of accounting in epidemic management and disease prevention. This study contributes to both accounting history and public health history by providing insights into the relationship between administrative reforms and public health outcomes. It also highlights the utility of econometric approaches in historical research, particularly in evaluating government interventions during health crises. This work could offer valuable lessons for managing current and future health emergencies, presenting a historically grounded understanding of effective epidemic management strategies.