Leader: Francesca Zantomio (UNIVE); Other collaborator(s):
In Italy, health and social care public policies are charachterised by wide territotial heterogoneities, in the light of a multi-level public governance invoving also regions and municipalities. The task contributes to mapping territorial disparities in LTC and disability benefit public provision and understaing its determinants, including local governments discretion in allocating public resources and the underlying local institutional quality, while accounting for local variation in population needs.
Work on the analysis of public spending by the State, Regions, and Municipalities in the field of health and assistance to the elderly, aiming to provide an aggregated overview of the phenomenon and financial flows between government levels.
There are no industrial implications; the scientific and policy implication are intertwined and concern on the one hand a reconstruction of the regulatory framework related to the social assistance in Italy; on the other, statistical analyses aimed at measuring municipal spending for the elderly and some basic determinants (e.g. local demographic indicators).
Work on documenting and measuring territorial inequities at the regional level in public expenditure for the disabled, including both LTC and disability programmes (pension/benefit).
There are no industrial implications. Scientific and policy Implications (intertwined): evidence on the existence of territorial disparities in public provision and on how benefit participation responds to specific policy parameters.
Work on documenting and measuring territorial heterogeneities at the provincial level in public expenditure for the disabled and the role of local institutional quality.
There are no industrial implications. Scientific and policy Implications (intertwined): evidence on the existence of territorial disparities in public provision at the provisional level and the role played by institutional quality.
Further work on documenting and measuring territorial heterogeneities at the provincial level in public expenditure for the disabled and the role of local institutional quality.
There are no industrial implications. Scientific and policy Implications (intertwined): Evidence on the existence of territorial disparities in public provision at the provisional level and the role played by institutional quality.
A panel database of Italian municipalities has been prepared. This includes the real per capita expenditure of municipalities for elderly care and the main data on municipal finances and on the socio-economic characteristics of municipalities. A review of the international literature on municipal spending choices has then been conducted and a draft theoretical model has been developed to guide the econometric analysis. Preliminary analyses have highlighted large disparities in municipal spending on the elderly, especially between municipalities in Northern and Southern Italy. The amount of current revenues of municipalities seems to significantly explain the disparities in spending on the elderly.
The greatest impact concerns the public and private construction sector. Municipalities need to invest in infrastructure (transports) and facilities to accommodate the elderly, like retirement homes and smaller apartments.
This work represents the first study that analyses the expenditure for the elderly of Italian municipalities within a model that explicitly considers the role of municipal finance and the expenditure of other public bodies for the elderly. The results allow to guarantee greater territorial equity in the provision of services to the elderly.
The collection of scientific material and the list of bibliographic references on the topic of municipal spending behavior have been completed. A critical review of the existing literature was carried out and the inadequacy of the proposed approaches for the problem under exam was highlighted. A theoretical model that better represents the decisions of municipalities regarding spending for the elderly was developed. The database has been updated based on the indications of the theoretical model and some initial econometric analyses have been carried out in order to verify the validity of the proposed theoretical model.
For industrial implications, the physical and social well-being of the elderly is the direct impact of municipal spending. However, this spending also stimulates demand for numerous services, products, and investments. Professional training in the social and healthcare sectors is promoted, and there is strong demand for numerous medical aids, such as wheelchairs and special beds. This encourages the creation and development of businesses operating in these sectors. In addition, municipal spending on residential facilities stimulates construction and facilities, while spending on canteens and transportation supports collective catering and private transportation activities.
Scientific and policy Implications (intertwined): The proposed model differs substantially from the standard models (i.e. the Median Voter models and the Linear Expenditure Sistem models) which consider the municipal policy maker as an individual who maximizes a utility function under a stringent budget constraint. The proposed model assumes instead that the municipal policy maker decides the optimal amount of spending on the elderly by minimizing a quadratic loss function under a soft budget constraint. This approach highlights both the role of different demand components, such as the presence of elderly people, and that of supply, essentially represented by the availability of financial revenues of the Municipality. The proposed model provides guidelines for achieving a more equitable territorial distribution of services for the elderly, a fundamental objective of national planning.
The econometric analyses based on the proposed theoretical model have been completed. The results of the estimates, in terms of signs and significance, confirm the validity of the proposed model. The results have been examined and a number of indicators relevant to welfare policy have been calculated and illustrated. A draft of the study has been prepared, including a description of the institutional framework, a critical review of the literature, a presentation of the theoretical model describing the behavior of municipalities with regard to spending on the elderly, the econometric analysis, and, finally, the results obtained.
Industrial implications. The analysis has implications primarily for the sector of services for older people in their various forms. These services aim to improve the quality of life of older people, as well as to promote their mobility, social integration, and the performance of primary functions. However, these services also influence demand for consumer goods, healthcare products, and investment in residential properties for the elderly. The labor market is also affected by possible increases in municipal spending, as this promotes vocational training in the social and health sectors.
Scientific and policy Implications (intertwined). The theoretical and empirical analysis carried out allows us to understand the determinants of municipal spending on the elderly and, therefore, to explain the reasons for the great territorial heterogeneity of this spending in Italy. This heterogeneity depends in part on the characteristics of the demand expressed by the territory, but also on the resources available to municipal policymakers and, finally, on the latter's propensity to satisfy demand. The analysis made it possible to estimate an unobservable variable such as the potential financial needs expressed by the elderly population. This made it possible to calculate the degree of coverage of potential financial needs, given by the ratio between actual expenditure and potential financial needs. This degree is fairly low on average. Unlike other empirical analyses, it was possible to estimate the propensity of policymakers in each individual municipality for this expenditure function. There are many policy implications, primarily the possibility of assessing the amount of resources that should be made available to municipalities to enable a certain level of spending and therefore services for the elderly.