The aim of this paper is to analyze the variables that affect the level of accountability of a public policy that involves a multilevel implementation. In particular, I focus on the possible explanations for the differences in the level of accountability in the implementation of health policy across the seventeen Autonomous Communities of Spain. The research questions I will analyze are the following: Why a public policy is more accountable in some governments than others? What conditions affect the level of formal accountability of health policy in the governments of the Autonomous Communities of Spain? In order to answer these questions, first, I will compare the different levels of accountability in the implementation phase of health policy in the Autonomous Communities in Spain and, second, I will empirically analyze the impact of the following six variables on the level of formal accountability of this policy: decentralization processes, public-private management, government capacity, political salience, ideological position of government, and majority government. Methodologically, I will apply fuzzy set qualitative comparative analysis (fsQCA), because this technique allows analyzing a moderate number of cases (seventeen autonomous communities) and, specially, it allows to analyze the conditions -the influence of each one of the variables mentioned above-, and / or the combination of conditions that lead to a higher level of accountability of health policy in the governments of the Autonomous Communities of Spain. For example, it would be possible to analyze whether a higher level of accountability is related to a particular ideological position of the party in government, if it is relevant that the issue is perceived as salient, or, if it requires government capacity at the same time that a minority government.
