Mergers in Public Health and Education: A Policy Evaluation Design

Over the last decades, in Italy, the increase of life expectancy and the consequent population aging raised concerns on the dynamics of health spending in such a way that institutional settings have changed and policies mostly oriented at containing costs have been implemented. The mergers of Local Health Authorities (LHAs henceforth) represents a prominent example. Indeed, the Italian LHAs experienced a drastic reduction in their number, passing from 659 in 1992 to 101 in 2017. The same pattern characterizes the educational system in Italy. New centralized criteria were introduced with the School Consolidation Process, established by the D.P.R. 233/1998. The schools with less than 500 students (300 in mountain areas and small islands) would have been merged to another school or managed by a regent School Principal (SP hereafter), namely a SP “borrowed" from another school. This doctoral thesis investigates the impact of such consolidation policies in health and education institutions on patients' and students' outcomes, respectively.