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...

This study provides an in-depth examination of the fiscal and governance decentralisation of long-term care (LTC) across OECD countries, offering projections of future fiscal burdens of LTC spending across levels of government. With rapid population ageing and a decrease in the supply of...

Fiscal equalisation refers to the transfer of financial resources to and between subnational governments with the aim of mitigating regional differences in fiscal capacity and expenditure needs. However, the determination of fiscal capacity and expenditure needs is not a straightforward task....

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...

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....

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...

OECD economies are undergoing a seemingly inevitable process of population ageing that has been changing income and consumption patterns. Notably, the demand for health services is expected to increase, while labour forces are projected to shrink. Both factors are projected to negatively impact...

Government revenues may be affected by economic growth and changes in demographics over time. The effect of economic growth can be captured by long-run buoyancy – responsiveness of government revenues to GDP growth – while the demographic effect can be captured by changes in labour income,...

Fiscal rules are increasingly used at state and local levels to promote fiscal sustainability in OECD countries. Following the Global Financial Crisis, multiple reforms to fiscal rule frameworks were made so that governments could better tackle crises and build buffers for future downturns. This...