Potential and limits of health management reform in Chile

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cepal.bibLevelSección o Parte de un Documento
cepal.callNumberX/C 22(59/96)
cepal.docTypeRevistas
cepal.idSade20087
dc.contributor.authorSojo, Ana
dc.coverage.spatialEngCHILE
dc.coverage.spatialSpaCHILE
dc.date.accessioned2014-01-02T18:41:41Z
dc.date.available2014-01-02T18:41:41Z
dc.date.issued1996-08
dc.descriptionIncludes bibliography
dc.description.abstractAgainst a background of increased expenditure and improved equity, this reform of public health management in Chile, set in the context of a dual health system, aims to consolidate a cost advantage over the private sector. Emphasis has been placed on the distinction between the regulatory, financial and supply functions in the public sector, and a relative opposition of interests between them has been encouraged, with a view to generating quasi-markets. The "management commitments" entered into between the Ministry of Health and the Health Services mark a departure from the strategy of resource allocation guided by historical budgets and make results the decisive factor of funding. These commitments establish each year the types of service that are to be provided, the allocation and transfer of resources, and the performance indicators, in an overall perspective that includes the areas of programme content, financing, human resources and investment, and they govern the many dealings between the Ministry and the Health Services. The other focus of the reform is the improvement of labour productivity, to which end attempts are being made to change the existing conditions of recruitment and pay. The duality of the health model significantly limits the financial control of aspects that are endogenous to it, such as absenteeism and medical hours not worked. The changes also clash with current budgetary frameworks, which inhibit decentralized resource management. Performance measurement has emphasized micro-economic efficiency more than effectiveness: in order to evaluate quality, the ultimate aim of management reform, there is a need to set standards of performance which will make it possible to measure the quality of the service provided.
dc.formatTexto
dc.format.extentpáginas. 127-145
dc.format.mimetypeapplication/pdf
dc.identifier.unSymbolLC/G.1931-P
dc.identifier.urihttps://hdl.handle.net/11362/10574
dc.language.isoeng
dc.physicalDescriptionp. 127-145
dc.relation.isPartOfCEPAL Review
dc.relation.isPartOfNo59
dc.relation.isPartOfSeriesCEPAL Review
dc.subject.unbisEngHEALTH ECONOMICS
dc.subject.unbisEngHEALTH POLICY
dc.subject.unbisEngHEALTH SERVICES
dc.subject.unbisEngMEDICAL TREATMENT
dc.subject.unbisEngPUBLIC HEALTH
dc.subject.unbisEngSOCIAL CHANGE
dc.subject.unbisSpaATENCION MEDICA
dc.subject.unbisSpaCAMBIO SOCIAL
dc.subject.unbisSpaECONOMIA DE LA SALUD
dc.subject.unbisSpaPOLITICA SANITARIA
dc.subject.unbisSpaSALUD PUBLICA
dc.subject.unbisSpaSERVICIOS DE SALUD
dc.titlePotential and limits of health management reform in Chile
dc.type.coarrevista
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