This paper analyses the empirical relationship between growth, country size and tourism specialization by using a data set covering the period 1980–2003. It finds that tourism countries are small and grow significantly faster than all the other subgroups considered in the analysis. Tourism appears to be an independent determining factor for growth: controlling for initial per capita income and for trade openness does not weaken the positive correlation between tourism specialization and growth. Another finding of the paper is that small states are fast growing only when they are highly specialized in tourism. In contrast with some previous conclusions in the literature, smallness per se is not good for growth.

Abstract. Specializing in tourism is an option available to a number of less developed countries and regions. But is it a good option? To answer this question, we have compared the relative growth performance of 14 "tourism countries" within a sample of 143 countries, observed during the period 1980-95. Using standard OLS cross-country growth regressions, we have documented that the tourism countries grow significantly faster than all the other sub-groups considered in our analysis (OECD, Oil, LDC, Small). Moreover, we have shown that the reason why they are growing faster is neither that they are poorer than the average; nor that they have particularly high saving/investment propensities; nor that they are very open to trade. In other words, the positive performance of the tourism countries is not significantly accounted for by the traditional growth factors of the Mankiw, Romer and Weil type of models. Tourism specialization appears to be an independent determinant.

This paper investigates long-term home care utilization in Europe. Data from the first wave of the Survey on Health, Ageing and Retirement (SHARE) on formal (nursing care and paid domestic help) and informal care (support provided by relatives) are used to study the probability and the quantity of both types of care. The overall process is framed in a fully simultaneous equation system that takes the form of a bivariate two-part model where the reciprocal interaction between formal and informal care is estimated. Endogeneity and unobservable heterogeneity are addressed using a common latent factor approach. The analysis of the relative impact of age and disability on home care utilization is enriched by the use of a proximity to death (PtD) indicator built using the second wave of SHARE. All these indicators are important predictors of home care utilization. In particular, a strong significant effect of PtD is found in the paid domestic help and informal care models. The relationship between formal and informal care moves from substitutability to complementarity depending on the type of care considered, and the estimated effects are small in absolute size. This might call for a reconsideration of the effectiveness of incentives for informal care as instruments to reduce public expenditure for home care services.

Interregional patient mobility in a decentralized healthcare system. Regional Studies. Interregional patient mobility,\ud measured as origin–destination patient flows between any two regions, is analysed within a dynamic spatial panel data\ud framework using 2001–10 data on Italian hospital discharges. The aim is to assess the effects of the main determinants\ud of patient flows, distinguishing between the impacts of regional health policies and those exerted by exogenous factors\ud (geography, size, neighbouring regions, national policies). Empirical results indicate that the main drivers of mobility are\ud regional income, hospital capacity, organizational structure, performance and technology. Moreover, neighbouring\ud regions’ supply factors, specialization and performance largely affect mobility by generating significant local externalities

Patient mobility is often described as a marginal phenomenon in Europe since the overall number of patients that receive cross border care remains minor compared to the total population. However this phenomenon is increasing markedly. The process of globalization and the availability of medical information means that patients are more informed on treatment available well beyond their national boundaries. Patient empowerment implies that new generations will actively ask to be treated by the health care system that best meets their needs. A succession of individuals has already challenged the status quo and, in many cases, the European Court of Justice has upheld their arguments. At a political level, the EU has issued the EU Directive no. 24/2011/CE of 9th March 2011 concerning the application of patients' rights in cross border healthcare. This Directive has reformed the authorization procedures that were previously required to allow patients to go abroad to access health care services. In this respect, the Directive has contributed to improving the level of freedom of choice for the European citizen, but it does not seem to have increased actual patient mobility across Europe. Freedom to choose is a necessary condition to grant the people of Europe the same access to public sector health care services. The latter is a key instrument for an efficiently functioning ''single market'' ensuring real mobility within the EU. The aim of this book is to study the current European health care market and discuss the hypothesis of a European right of citizenship with reference to health care services. The book is intended to provide a deeper understanding of the health market and stimulate reflection on European integration studies at a university level. The hypothesis for a fully coordinated European Health System will be investigated in great detail, highlighting the connected social and economic implications. This publication is a result of the Jean Monnet Lifelong Programme. Patient mobility for health within the EU borders is an issue of great interest in the European Union debate. The health side of European integration is generally undervalued but, on the contrary, it is crucial to fostering an effective internal market and to ensuring economic and social progress in Europe. Effective health integration in the European Union would represent a value-added resource in the path toward the effective mobility of people. For this purpose, it is extremely important that policy-makers of different European States agree on a unique international agreement to regulate the economic implications of patient mobility. v