Juan Ventura

Measuring Quality of Life in Spanish Municipalities

Abstract Measuring quality of life in municipalities entails two empirical challenges. First, collecting a set of relevant indicators that can be compared across the municipalities in the sample. Secondly, using an appropriate aggregating tool in order to construct a synthetic index. This paper measures quality of life for the largest 237 Spanish municipalities using Value Efficiency Analysis (VEA) to derive comparative scores by combining the information contained in 19 partial indicators. VEA is a refinement of DEA (Data Envelopment Analysis) that imposes some consistency in the weights of the indicators used to construct the aggregate index. The indicators cover aspects related to consumption, social services, housing, transport, environment, labour market, health, culture and leisure, education and security. The results show that the Northern and Central regions in Spain attain the highest levels of quality of life, while the Southern regions report low living conditions. Education is the variable that requires the largest improvement in low performing municipalities, followed by health and culture facilities, pollution and crime. Population density, growth and ageing seem to relate positively to quality of life.

Value efficiency analysis of health systems: does public financing play a role?

Aims/BackgroundThis study measures the performance of the health system in 165 countries and its relationship with public financing.MethodsWe use value efficiency analysis (VEA), a refinement of data envelopment analysis (DEA), to measure the efficiency of the health systems using data on healthy life expectancy and disability adjusted life years as health outcomes. Expenditure on health and education are used as inputs to the health system.ResultsThe group of high income OECD countries shows the largest indexes of efficiency and also the lowest dispersion. In contrast, low income countries also have the most inefficient health systems, which implies that there are more opportunities for improvement. The average efficiency score is 0.96 for high income countries, 0.83 for upper-middle income countries, 0.86 for lower-middle income countries and only 0.76 for low income countries. Only 17 countries have a score equal to 1 and therefore are completely efficient and can be taken as referents. The index of efficiency is found to be positively associated with government expenditure on health as a percentage of total expenditure on health.ConclusionsThe analysis of the results shows that the public share in health expenditure and the weight of health expenditure in public budgets are two factors positively associated with the performance of the health systems. The study also highlights the advantages of using VEA over DEA in the measurement of performance.

Weight Constrained DEA Measurement of the Quality of Life in Spanish Municipalities in 2011

This paper measures quality of life (QoL) in the 393 largest Spanish municipalities in 2011. We follow recent descriptions of QoL dimensions to propose an integrated framework composed of eight dimensions: material living conditions, health, education, environment, economic and physical safety, governance and political voice, social interaction, and personal activities. Using different sources of information we construct 16 indicators, two per each of the QoL dimensions considered. Weight constrained data envelopment analysis (DEA) is then used to estimate a composite indicator of the QoL of each municipality. Robustness is checked by altering the weight ranges introduced within the DEA specification. Results show that the Northern and Central regions in Spain attain the highest levels of QoL, while the Southern and Mediterranean regions report lower scores. These figures are consistent with those obtained by González et al. (Soc Ind Res 82:111–145 2011) for the Spanish municipalities in 2001, although both the sample and the indicators used are different. The analysis also shows that, while it is important to restrict weights in DEA, the specific restrictions used are less important, since all the composite indicators computed are highly correlated. The results also show important differences between per capita gross domestic product and QoL at the provincial level.

Social Progress in Spanish Municipalities (2001–2011)

This paper proposes a methodology for the assessment of social progress in the biggest Spanish municipalities between years 2001 and 2011. We follow recent descriptions of QoL to elaborate a measurement framework composed of eight dimensions, for which 16 subindicators are elaborated from information collected using different data sources. Weight constrained Data Envelopment Analysis is used to estimate QoL composite indicators in both periods and to compute a Malmquist index of social progress, which assesses the evolution of the indicators during the decade. The results evidence positive social progress with an average improvement of about 5% during the decade. While the Central-Northern regions still show the highest levels of QoL, the Southern regions (including the islands) dominate the improvement trend. We then decompose the Malmquist index into a catching-up effect and a frontier shift effect. Positive catching-up is measured in almost all the regions. The worst performing municipalities in 2001 experienced the largest catching-up effects, a trend that contributes to territorial convergence. The frontier shift also shows a positive trend.

Spain: Quo Vadis? From Cost Containment to Structural Reforms

The aim of this chapter is to critically describe the evolution of the Spanish National Health System (NHS) in the last 25 years and its current situation. We will also revise the main reforms which are currently under debate. During these years, even with its ups and downs, the NHS has become a cornerstone of the Spanish welfare state. Mostly financed through taxes and with the predominance of public provision, the system has been able to incorporate the latest medical advances, offering quality health services almost universally. At the same time, in an ad hoc and rather hasty manner, the system has gone through a decentralization process that started with the devolution of health competences to the so-called historical regions, and was finally extended in 2002 to the 17 Spanish Autonomous Communities (ACs).

Managed competition and user satisfaction ‐ The case of Spanish work accident mutuals

Analyzes one of the three options of insurance against workplace accidents that Spanish companies can choose from: work accident and occupational disease mutual insurance companies. Although the taking out of insurance cover is obligatory, the choice is totally voluntary. The fact that these entities manage 90 per cent of premiums destined towards workplace accident cover collected by the Department of Social Security, allows us to assume that user satisfaction must be, consequently, quite high. In order to explore this, a study was made of the incentives that the combination of competition, regulation and ownership generated in these entities, and a postal survey of 443 companies affiliated to mutuals was carried out. Our results confirm the high rate of user satisfaction, although they also reveal some of the limitations associated with managed competition.