Health System Decentralization and Recentralization

Terlizzi, Andrea

doi:10.1007/978-3-030-11757-3

Cited by 15 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Whereas expenditures for goods and services were 39% for the period studied, the disparity of capital expenditures was even higher, reaching 57% both in 2011 and in 2012 for Skopje municipalities. This research supports the assertion that decentralization processes favor more densely populated municipalities, and, in reality, did not improve regional distribution of resources (Feruglio, Martinez-Vazquez, and Timofeev 2008;Levitas 2009Levitas , 2011Nikolov and Brosio 2015).…”

Section: Discussionsupporting

confidence: 81%

“…With the disintegration of Yugoslavia in 1991, Macedonia inherited a highly decentralized system of local governments. Macedonia started a centralization reform process following independence and continued the process until July 2005 (Feruglio, Martinez-Vazquez, and Timofeev, 2008;Todorovski, 2001). The Law on Financing Local Self-Government Units passed in 2004 (and amended in 2004, 2007, 2009, 2011, 2015, and 2018) earmarked 3% of the personal income tax and 100% of the personal income tax on independent artisans to fund decentralization.…”

Section: Decentralization Reforms In Macedoniamentioning

confidence: 99%

See 1 more Smart Citation

Measuring Municipal Spending Efficiency: Evidence from Macedonia's Decentralization Reforms

Andonoska,

Alda

2020

Public Finance and Management

View full text Add to dashboard Cite

Debates have been ongoing for decades about the efficiency of municipal services in centralized or decentralized systems. the fundamental argument for decentralization is that it shifts decisionmaking authority to local governments which are closer to citizens’ needs and preferences and thus are better to know what is wanted. This study contributes to the growing literature on measuring local government efficiency by using data from 79 Macedonian municipalities from 2008 to 2015 and assessing whether decentralization results in greater efficiency. the results indicate that more decentralized municipalities are, on average, more efficient than less decentralized ones. There was, however, a significant disparity in performance throughout the decentralization period, with small municipalities often under-performing relative to larger ones. These results indicate that decentralization has limited effects on the efficiency of municipal spending, and does not reduce disparities across municipalities. the evidence suggests that many of the inequalities could be alleviated by implementing equalization programs as a substantial part of a regional development strategy.

show abstract

Section: Discussionsupporting

confidence: 81%

Section: Decentralization Reforms In Macedoniamentioning

confidence: 99%

Measuring Municipal Spending Efficiency: Evidence from Macedonia's Decentralization Reforms

Andonoska,

Alda

2020

Public Finance and Management

View full text Add to dashboard Cite

show abstract

“…They concluded that this kind of managerial structure leads to more space and freedom and that staff can possibly have a better advantage in improving the KM process. Based on the output of various studies, increasing employee participation is the first and major impact of decentralised managing (Jung et al, 2018;Bao et al, 2019;Terlizzi, 2019). In decentralised structured management, members are eager and excited to transmit and express their beliefs and, therefore, they are more encouraged to share ideas, personal knowledge, experiences and skills.…”

Section: Decentralisationmentioning

confidence: 99%

Seeking traces of democracy in the workplace: effects on knowledge sharing

Rezaei

Ferraris

Busso

et al. 2021

JKM

View full text Add to dashboard Cite

Purpose This study aims to examine the role of organisational democracy (OD) in facilitating the knowledge sharing (KS) process within companies, thus considering the effect of different OD principles. Design/methodology/approach The authors used data collected through a questionnaire on a sample of 254 employees at private universities and colleges to test the relationship between OD and KS. Data were analysed using the structural equation modelling technique. Findings Overall, OD has a direct and significant effect on facilitating KS in organisations. Also, the results showed that there are different degrees and intensities among the individual principles (sub-concepts) of OD and KS. Practical implications The findings highlight the important role of democracy in an organisation to enhance the organisational climate and employees’ behaviours, thus leading to higher KS outcomes. Also, results, provide an opportunity for managers to consider enhancing democracy in an organisation for improving internal collaboration effectiveness in KS. Originality/value This paper sheds light and adds new knowledge to embryonic studies that are directed towards the integration of democracy within the main concept of knowledge management (KM). This emphasises the need to use and stimulate OD and its principles for improving the effectiveness of KM practices with specific attention to KS.

show abstract

“…Decentralization in the health sector has been considered a significant factor in improving efficiency, quality and access to healthcare services and health outcomes and in ensuring as much social equality as possible (Costa-Font, 2010;Jim enez-Rubio, 2010). In many healthcare systems, decision-making authority, power and responsibility are distributed to a greater or lesser degree between the different levels of government (Terlizzi, 2019). The goal of decentralization in the health sector is to make healthcare more responsive to the specific needs of local populations and to increase efficiency and effectiveness in the use of resources.…”

Section: Introductionmentioning

confidence: 99%

Does the healthcare decentralization provide better public health security capacity and health services satisfaction? An analysis of OECD countries

Durmuş

2024

JHOM

View full text Add to dashboard Cite

PurposeDecentralization has profound implications for many health systems. This study investigates the effect of health system decentralization in Organization for Economic Co-operation and Development (OECD) countries on public health security capacity and health service satisfaction.Design/methodology/approachMultiple linear regression analyses were employed for variables related to the level of health security capacity and satisfaction with the healthcare system while controlling for all socio-demographic variables from the European Social Survey, including over 44,000 respondents from 25 OECD countries. The Health Systems in Transition series of countries were used for assessing the decentralization level.FindingsThe result of multiple linear regression analyses showed that the level of decentralization in health systems was significantly associated with higher health security capacity (ß-coefficient 3.722, 95% confidence interval (CI) [3.536 3.908]; p=<0.001) and health service satisfaction (ß-coefficient 1.463, 95% CI [1.389 1.536]; p=<0.001) in the study. Countries with a higher level of decentralization in health policy tasks and areas were significantly likely to have higher health services satisfaction, whereas this satisfaction had a significant negative relation with the lower level of decentralization status of secondary/tertiary care services in OECD countries (ß-coefficient −5.250, 95% CI [−5.757–4.743]; p = 0.001).Originality/valueThis study contributes to a better understanding of the extent to which decentralization of health services affects public health safety capacity and satisfaction with health services, whereas the level of decentralization in OECD countries varies considerably. Overall, the findings highlight the importance of public health security and satisfaction with health care delivery in assessing the effects of decentralization in health services.

show abstract

Health System Decentralization and Recentralization

Cited by 15 publications

References 0 publications

Measuring Municipal Spending Efficiency: Evidence from Macedonia's Decentralization Reforms

Measuring Municipal Spending Efficiency: Evidence from Macedonia's Decentralization Reforms

Seeking traces of democracy in the workplace: effects on knowledge sharing

Does the healthcare decentralization provide better public health security capacity and health services satisfaction? An analysis of OECD countries

Contact Info

Product

Resources

About