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- Title
The impact of government decentralization on county health spending for the uninsured in California.
- Authors
Scheffler, Richard; Smith, Richard B.
- Abstract
We analyze Program Realignment, California's 1991 policy of decentralizing control of health, mental health, and social services, from the state to the counties. Drawing from the economics literature on intergovernmental transfers and using data constructed for this study, we analyze the impact of Realignment on uninsured health spending. We find a change in the pattern of spending on indigent health services by counties following decentralization. Our results suggest, however, that county-level governments maintain a level of commitment to social-service spending that recent studies indicate may be lacking at the state level.
- Subjects
CALIFORNIA; DECENTRALIZATION in government; DECENTRALIZATION of public health administration; MEDICALLY uninsured persons; FEDERAL aid to community health services; COMMUNITY mental health services; MEDICAL economics; MENTAL health services; COMPARATIVE studies; LOCAL government; RESEARCH methodology; MEDICAL care costs; MEDICAL cooperation; PRACTICAL politics; POVERTY; RESEARCH; SOCIAL case work; STATE governments; LOGISTIC regression analysis; COST analysis; GOVERNMENT policy; EVALUATION research; CROSS-sectional method; STATISTICAL models; UNCOMPENSATED medical care; ECONOMICS
- Publication
International Journal of Health Care Finance & Economics, 2006, Vol 6, Issue 3, p237
- ISSN
1389-6563
- Publication type
journal article
- DOI
10.1007/s10754-006-9003-6