Does Institutional Structure Effect Public Health Expenditures

This paper explores supply-side costs and institutional structure in a shared authority state public health system. It is found that in a shared governance public health system, intermediary district structure influences the movement of limited resources to serve populations and persons most in need. This early empirical test suggests that policy making and public administration concerning public health expenditures in a shared governance system are in a practical sense local, but decisions made at the intermediary level by regional district administration are an important influence on local public health expenditures.