La privatización y los nuevos modelos de gestión en sanidad.
Abstract
New Management models of Public Services have been developed in the context of privatization of public services that start in 1970s. Their justification is based in the hypothesis of the inefficiency of public provision and that market can provide efficiently all types of goods and services, included those with public character. However, empirical studies, both International and Spanish, indicate that private managed health is more expensive than public managed. An also appear problems on terms of equity and quality of the services. We analyze the development of this model in Spain and their development despite the evidences. There is a long-term strategy to transform health from universal service to a market good.
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References
AA.VV. (1989) El debate internacional. Público y privado en los sistemas sanitarios. Sanidad Pública. Madrid.
Acuerdo para la consolidación y modernización del Sistema Nacional de Salud. Ministerio de Sanidad y Consumo. Madrid 1998.
Bonet Pla A (2001): ¿Le saldrán bien las cuentas al hospital de Alzira. Salud 2000; 80: 21-22.
Comisión de Análisis y Evaluación del Sistema Nacional de Salud (1991). Informe Cortes Españolas. Madrid.
Declaración de Alma Ata. www.paho.org
Devereaux, PJ et al. Payments for care at private for-profit and private not-for-profit hospitals: a systematic review and meta-analysis.
Fisher P (2005) Las iniciativas de financiación privada. Salud 2000; 101: 16-17.
Himmelstein DU, Woolhandler S, Wolfe SM (2004) "Administrative waste in the US health care system in 2003: the cost to the nation, the states, and the district of Columbia, with state-specific estimates of potential savings". International Journal on Health Services 2004; 34: 79-86.
https://doi.org/10.2190/D2BL-HUXY-RLF8-ULXA
Ley General de Sanidad BOE 29/4/1986.
Ley 15/1997 sobre habilitación de nuevas formas de gestión del Sistema Nacional de Salud. BOE 26/4/1997.
Martín García M, Sánchez Bayle M (2004) Nuevas formas de gestión y su impacto en las desigualdades. Gaceta Sanitaria 2004 (Supl1): 96-101. https://doi.org/10.1157/13062257
OMS (Organización Mundial de la Salud), (1987). Los objetivos de salud para todos. Ministerio de Sanidad y Consumo. Madrid.
OMS (1997) Carta de Ljubljana sobre reformas de los sistemas sanitarios. Ministerio de Sanidad y Consumo. Madrid.
Organización Mundial de la Salud (2001): Salud para todos en el siglo XXI. www.cfnavarra.es/salud/anales/textos/vol24/n1/salud1.html
Plos Medicine (2006) A collection on articles on disease mongering in Plos Medicine. www.Collection.plus.org/plosmedicine/diseasemongering.2006.php
Pollock A (2005): NHS plc. Verso. London.
Real Academia Española: Diccionario de la lengua española. www.rae.es
Sánchez Bayle M. (1998) Hacia el estado del malestar. Los libros de la Catarata. Madrid.
Sánchez Bayle M (ed) (2006a) La sanidad en la comunidad de Madrid 2006. Ediciones GSP. Madrid.
Sánchez Bayle M (2006b) Los nuevos hospitales de Madrid. El País 19/4/2006.
Sánchez Bayle M, Colomo C, Repeto L (ed) (2005): Globalización y salud. Sanidad Pública. Madrid.
Sánchez Bayle M, Martín García M (2004) Nuevas formas de gestión: Las fundaciones sanitarias en Galicia. Documento de Trabajo 43/2004 Fundación Alternativas. www.falternativas.org
Santos B, Domínguez L (1998): Nuevos modelos de gestión en Andalucía. Salud 2000; 65: 10-19.
Starfield B, Shi L (2005) Contribution of primary care to health systems and health. Mibank Quarterly 2005; 83: 457-502. https://doi.org/10.1111/j.1468-0009.2005.00409.x
Tudor Hart J (2006) The political economy of health care: a clinical perspective. Policy Press. Oxford.
Woolhandler S, Campbell T, Himmelstein DU (2004): Health care administration in the United States and Canada: micromanagement, macro costs. International Journal on Health Services 2004; 34: 65-78. https://doi.org/10.2190/MJJW-GA0V-78KT-9RGX
Woolhandler S, Himmelstein DU (2004): The high costs of for-profit care. CMAJ 2004; 170: 1814-5.
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