This paper examines the relationship between the degree of administrative decentralisation across levels of government in health care decision-making and health care spending, life expectancy as well as hospital costs. This empirical analysis builds on previous analytical research carried out by...

Based on an OECD survey, this paper presents quantitative and qualitative data on the decentralisation of health systems, focusing on how they vary according to different institutional characteristics and what types of performance measurement systems are used in the health sector....

How do administrative and fiscal decentralisation relate to education system performance? The question is answered by exploiting a panel with several different measures of fiscal decentralisation: a measure of administrative decentralisation, as well as a measure of school autonomy (using six...

The Network on Fiscal Relations has been assessing the degree of sub-central government tax autonomy in OECD countries for almost two decades. This paper provides an in-depth description of the methodology used to characterise tax autonomy. After summarizing the wide-spread use of the tax...

The paper develops new measures of spending power and performance across five key sectors of sub-national government service delivery –- education, long-term care, transport services, social housing and health care. The new indicators reveal unique insights about how responsibilities are...

Globalisation accompanied by the growing importance of information technology and knowledge-based production pose challenging problems for federations. We summarise the difficulties that traditional decentralised federations face in addressing problems of competitiveness, innovation and...

This pilot study presents indicators that assess sub-central government (SCG) spending power by policy area. Traditional indicators – such as the share of SCG in total government spending – are often misleading as they underestimate the impact of central government regulation on sub-central...

Against a background of mounting demands for spending on services provided by sub-central governments, this paper examines how fiscal rules can help to ensure that pressure on resources is minimised and available resources are used efficiently. Drawing on questionnaire responses and other...

This paper compares and analyses the use of market mechanisms in core sub-central policy areas, namely education, health care, transport, social protection, and environment. Arrangements like tendering, outsourcing, user choice and competition, user fees and performance-related funding can help...

Performance systems are one tool available to central governments to improve the performance of sub-national service delivery. This paper provides a preliminary review of suitable metrics and mechanisms to reliably measure and monitor the efficiency and quality of public services that are...