Decentralization and regionalization in health in Spain: trajectories, characteristics and conditions

The article discusses the decentralization and regionalization of the Spanish health system from 1980 to 2012. Considering the historical institutionalism approach, the study analyzed the trajectory, characteristics and conditions of these processes, in broader the context of democratization and reform of the State. The results suggest different degrees of power between the central and subnational governments in the political, administrative and fiscal/financial dimension. It is concluded that the return to democracy, the regionalist pressures, the politicalterritorial decentralization and the antecedent of the health system were the main factors that influenced the configuration of the health system in Spain.