Abstract

MACEIRA, Daniel  and  CEJAS, Cintia. Actores, contratos y mecanismos de pago: El caso del Sistema de Salud de Salta. Estud. Econ. [online]. 2010, vol.27, n.54, pp. 29-66. ISSN 2525-1295.

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 actors 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 competitor. This scheme friggers incentive to differentiated production using different strategies beyond prices, as reputation, product mix and infrastructure.

Keywords : Health care service; Decentralization; Health care payment mechanism; Health care market; Public and private actors in health care.