How does accounting save lives? An econometric analysis exploring the effectiveness of the Crispi-Pagliani Health Reform (1888) in Italy

Abstract

This study compares the healthcare management systems for cholera epidemics in Italy before and after the Crispi-Pagliani Health Reform of 1888. Specifically, we compare the monitoring, accounting, and reporting systems of deaths and infections during the 1884 and 1893 epidemics. Based on an econometric analysis of data from the Italian National Statistical Institute, we demonstrate that the post-reform system was more effective in reducing deaths by optimising medical personnel allocation in areas with higher epidemic intensity. From a Foucauldian perspective, we provide insights into the role of accounting in supporting noso-politics, bio-politics, and bio-power. Further, this study advances our understanding of reporting systems and the dynamics that governments trigger as part of strategies for preventing or containing contagion during epidemics. Finally, this study supports the use of econometrics in accounting history.