Actores, contratos y mecanismos de pago: El caso del Sistema de Salud de Salta

Authors

  • Daniel Maceira UBA - CIPPEC - CEDES - CONICET
  • Cintia Cejas CEDES - FLACSO - CIPPEC

DOI:

https://doi.org/10.52292/j.estudecon.2010.854

Keywords:

health care service, decentralization, health care market

Abstract

Decentralization in health care strategy and goals definition, as well as in program implementation moves public discussion to the provincial level. This study analyzes the association among the market structure of the private health care services, payments mechanisms and responses related to internal organization and transference of risk between health providers and financiers in Salta. In depth interviews to key acctors and a survey performed to a sample of public and private institutions allows to obtain information about perceived competition, strategies, contracts and payment mechanisms. The study finds a correlation between population scale, competition and relative bargaining power of the main competitior. This scheme friggers incentive to differentiated production using different strategies beyond prices, as reputation, product mix and infraestructure.

Downloads

Download data is not yet available.

References

Chawla, M. et al., (1997), Paying the Physician: Review of Different Methods, Department of Population and International Health, Harvard School of Public Health, Boston, Massachusetts.

Chernichovsky, D., Bolotin, A. y De Leeuw, D. A Fuzzy (2003), Logic Approach Toward Solving the Analytic Enigma of Health System Financing, The European Journal of Health Economics, Vol. 4, (3). pp. 158 - 175. DOI: https://doi.org/10.1007/s10198-003-0168-3

Hart, O. y Holmstrom, B., (1987) The Theory of Contracts, en Advances in Economic Theory, Fifth World Congress, ed. T. Bewley. Cambridge University, Press. DOI: https://doi.org/10.1017/CCOL0521340446.003

Langenbrunner, J. y Xingzhu L., (2004), How to Pay? Understanding and Using Incentives, The International Bank for Reconstruction and Development, The World Bank.

Llaya, J., (2007), Actores y Agenda en el Sistema de Salud Argentino, Ministerios de Salud Provinciales: El Caso de Salta, Serie Seminarios Salud y Política Pública, CEDES, WP N°4, Buenos Aires, Argentina, Agosto.

Maceira, D., (2006), Descentralización y Equidad en el Sistema de Salud Argentino, en Flood, C., "La política del gasto social: lecciones de la experiencia argentina", Editorial La Colmena, Buenos Aires, Argentina.

Maceira, D., (2010), Financiamiento, Aseguramiento y Prestación de Servicios de Salud en Argentina, en Sistemas de Salud Comparados en América Latina, Knaul, F. (coordinadora), IDRC, en prensa.

Maceira, D., (2008), Crisis Económica, Política Pública y Gasto en Salud: La Experiencia Argentina. CIPPEC, Buenos Aires, Enero 2008.

Maceira, D. y Poblete, C., (2003), Estructura de mercado y mecanismos de pago en salud: Experiencias en la provincia de Mendoza, Argentina, 1989-1999, Desarrollo Económico, Vol.43, (171), oct-dic. DOI: https://doi.org/10.2307/3455893

Maceira, D., (1998), Provider Payment Mechanisms in Health Care: Incentives, Outcomes, and Organizational Impact in Developing Countries, Partnerships for Health Reform. Primers for Policymaking, Bethesda, Maryland, Abt Associates Inc.

Milgrom, P. y Roberts, J., (1992), Economics, Organization and Management, Englewood Cliffs, EUA. Prentice-Hall.

Ministerio de Salud de la Nación,(2000), Guía de Establecimientos de Salud. Trabajo publicado en: www.deis.gov.ar, Buenos Aires, Argentina.

Petersen, L. et al., (2006), Does Pay-for-Performance Improve the Quality of Health Care?, Annals of Internal Medicine. Agosto. DOI: https://doi.org/10.7326/0003-4819-145-4-200608150-00006

Prats J. y Zeckhauser R., (1992), Principals and Agents, Boston, Harvard Bussines School Press, 1992.

Robinson, J., (2001), Theory and Practice in the Design of Physician Payment Incentives. The Milbank Quarterly, Vol. 79, (2). pp. 149 - 177. DOI: https://doi.org/10.1111/1468-0009.00202

Shen Y., (2003), Selection incentives in a performance-based contracting system. Health Services Research, Vol. 38, (2), pp. 535-552, Abril. DOI: https://doi.org/10.1111/1475-6773.00132

Downloads

Published

2010-06-01

How to Cite

Maceira, D., & Cejas, C. (2010). Actores, contratos y mecanismos de pago: El caso del Sistema de Salud de Salta. Estudios económicos, 27(54), 29–66. https://doi.org/10.52292/j.estudecon.2010.854

Issue

Vol. 27 No. 54 (2010)

Section

Articles

License

The authors who publish in Estudios económicos agree to the following terms:

The authors retain copyright and guarantee to the journal the right to be the first to publish the work as well as licensed under a Creative Commons Attribution-NonCommercial 4.0 International license, which allows others to share the work with an acknowledgement of the authorship of the work and initial publication in this journal.

Authors may separately enter into additional agreements for non-exclusive distribution of the version of the work published in the journal (e.g., placing it in an institutional repository or publishing it in a book) with an acknowledgment of its initial publication in this journal.

Authors are allowed and encouraged to disseminate their work electronically (e.g., in institutional repositories or on their own website) before and during the submission process, as this can lead to productive exchanges as well as earlier and greater citation of published work.

Crossref
Scopus
Google Scholar
Europe PMC