Immigration, policies of integration and healthcare expenditure: a longitudinal analysis of the INHS (2002‒2018)

Background: Immigration has become a structural phenomenon in Italy, a country reputed as being ‘immigrant-friendly’. The increase in the proportion of immigrants has led to increasing efforts to design and implement health policies throughout the country while controlling public spending. Method: Being interested in both the cross-sectional and time series dimensions of analysis, we used a PVAR (Panel Vector Autoregression) model, which combines the VAR technique with panel data models, to estimate the impact of regular immigration on health expenditure. Findings: Our results confirm that an increase in the share of regular immigrants in the total population decreases the amount of aggregate public health expenditure. Conclusion: Despite the intense activity by Italian governments on social and health integration policies for immigrants, policymakers may focus more on the implementation of national policies at regional and local levels, on their costs and with a specific focus on undocumented immigrants. © 2023