We explore the discontinuity in the allocation of the main federal grant to Brazilian municipalities to identify the local effects of health spending and the spillovers into the bordering jurisdictions. Fiscal reactions are asymmetric: small neighbors reduce health spending, while we do not find a significant budgetary response in the largest neighbor. Our results suggest a reduction in the spread of infectious diseases in the neighbors, with fewer residents hospitalized with gastrointestinal infections. In addition, the elderly demand less hospitalization in the largest bordering jurisdictions due to respiratory infectious diseases. Finally, we find a direct and significant reduction in infant mortality, consistent with the observed pediatricians' increase, while the spillover effects on neighbors' mortality rates are not conclusive.

中文翻译：

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卫生支出对传染病传播的影响

我们探讨了向巴西市政当局分配主要联邦拨款的不连续性，以确定卫生支出对当地的影响以及对毗邻辖区的溢出效应。财政反应是不对称的：小邻国减少了医疗支出，而我们在最大的邻国中没有发现显着的预算反应。我们的结果表明，传染病在邻居中的传播有所减少，因胃肠道感染住院的居民减少了。此外，由于呼吸道传染病，老年人在最大的接壤辖区需要较少的住院治疗。最后，我们发现婴儿死亡率直接显着降低，这与观察到的儿科医生的增加一致，而对邻居死亡率的溢出效应尚无定论。