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Financiación capitativa, articulación entre niveles asistenciales y descentralización de las organizaciones sanitarias

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Abstract
Public organisations are subjected to weak incentives for competition. Therefore, institutional Darwinism cannot apply. Regulation and performance monitoring is required to protect the public interest. This is particularly the case of organisations in the health care arena, since strong incentives may risk the whole supply of public health services. Regarding to the path dependence of the Spanish public health institutions with respect to the international experience and the observed health technological changes, this paper tries to ground some theoretical bases for the organisational change in our health system. We do this by building our argument from the very basic public goal: the improvement of the health status of the Spanish population. This requires a better integration of health care services. To this regard, capitation in finance shows some comparative advantages: it takes an integral view for the care of the population, it allows for a better decentralisation ('deconcentration') of risks to health providers and favours managed care under a global perspective, replacing partial payment to different providers. However, the paper shows some potential limitations for this purpose and the need of a gradual strategy for its implementation.

Suggested Citation

  • Vicente Ortún & Guillem López, 2000. "Financiación capitativa, articulación entre niveles asistenciales y descentralización de las organizaciones sanitarias," Economics Working Papers 523, Department of Economics and Business, Universitat Pompeu Fabra.
    • Handle: RePEc:upf:upfgen:523
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    Keywords

    The Spanish health system; capitation financing; incentives in health care management;
    All these keywords.

    JEL classification:

    • H11 - Public Economics - - Structure and Scope of Government - - - Structure and Scope of Government
    • H57 - Public Economics - - National Government Expenditures and Related Policies - - - Procurement
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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