Assessing formal accountability for public policies: the case of health policy in Spain

Abstract

The aim of this study is to present a framework for analyzing and assessing accountability for public policies. First, I suggest two dimensions for analyzing accountability for policies (the informative/justifying dimension, and the evaluative/sanctioning dimension), applied to the implementation phase of the policy and, in particular, to three central elements that make up this phase (the actors responsible, the resources, and the policy results). Second, I suggest assessing accountability for a public policy starting from the degree of formalization and, specifically, from compliance with four characteristics of its regulatory framework: specific, binding, public and autonomous character. Third, I develop an empirical application of this proposal to the analysis of health policy in Spain, whose decentralized design, where regional governments are responsible for its implementation, allows us to analyze the differences in the levels of accountability for this policy across regions. Points for practitioners This study identifies and limits the components that can be incorporated into the analysis of accountability for public policies by providing an analytical framework that can be used to measure and compare levels of accountability for different kinds of policies (e.g. health, education, pensions) in different contexts (e.g. countries, regions, local governments). In order to test the validity of the proposal developed here, this article presents an empirical application to the analysis of health policy in Spain, whose decentralized design allows us to analyze the differences in accountability across regional governments.