Eficiencia del Gasto Público y Resultados. Tendencias en América Latina y Aplicaciones a Redes Sanitarias en Argentina

DANIEL MACEIRA

Conferencia; Taller sobre Eficiencia en el Gasto Público en Salud; 2016

LAC health care systems show profound differences between and within countries that affect both public expenditure efficiency and health outcomes. The most important differences are related to: -Total health spending capacity;-Participation of government vs out-of-pocket in financing health care; -Incidence and degree of coordination among the different subsystems (public, social security, and private);-Regulatory capacity of LAC governments;-Quality of management.Differences between health systems in LAC can be analyzed based on two dimensions: The horizontal dimension refers to the interactions and the degree of coordination among the public, private and social security subsystems, where equity issues can be identified; on the other hand, the vertical dimension refers to the health system functions (regulation, financing, insurance methods, management, and services provision), where efficiency in resource allocation rely on.Lessons learned for LAC: The key issues for researcher and policy makers when dealing with productivity and management of the health care networks in LAC are: -Structure and absorption capacity at the health care centers level; -Structure and absorption capacity at the hospital level;-Formal and informal linkages among the different levels of care. As seen in the Argentine case study, policy makers can leverage informal mechanisms in the provision of services in order to strengthen the health care networks when there is lack of coordination, a dual agency model is being implemented and/or formal rules are not well established. LAC countries should keep pushing for the development of formal mechanisms and stronger regulatory frameworks, while leveraging informal mechanisms as a temporary solution.