Publication:
Contracting arrangements in the health strategy contex. A regional approach for Spain

dc.contributor.authorCabasés Hita, Juan Manuel
dc.contributor.authorGaminde, Idoia
dc.contributor.authorGabilondo, Luis
dc.contributor.departmentEconomíaes_ES
dc.contributor.departmentEkonomiaeu
dc.date.accessioned2016-05-10T07:40:05Z
dc.date.available2016-05-10T07:40:05Z
dc.date.issued2000
dc.description.abstractBackground. Several different proposals have been made recently to reform the organisation, financing and management of the health care system in Spain. The aim is to obtain improved efficiency, without prejudicing the equity level already achieved, by creating a more competitive framework. However, current health strategies seem not to be in accord with these proposals. This paper approaches the issue of matching these two main components of the health systems, health strategy and contracts, and emphasises the need to develop contracting arrangements within the general health policy framework. Design: Case studies, analysis of published and unpublished documents, and semi-structured interviews with key informants. Results and discussion. A review of regional health strategies and regional contracts developed in the 1990s is presented, followed by an analysis of the degree of incoherence between them. Then we discuss whether the programme contract can be an instrument guided by the health plan, commenting on its potential and limitations. Conclusion. The relationship between health strategy and health care management is practically non-existent in Spain. The need to insert the contract cycle within the broader framework of the planning cycle has led to proposals to adapt contracts and health plans to guarantee their coherence. This will require changes in the structure of both of these instruments and, probably, deeper structural modifications of the context within which both have been developed. To this aim, we make some recommendations for policy making.en
dc.format.extent16 p.
dc.format.mimetypeapplication/pdfen
dc.identifier.urihttps://academica-e.unavarra.es/handle/2454/20564
dc.language.isoengen
dc.relation.ispartofseriesDocumentos de Trabajo DE - ES Lan Gaiakes
dc.relation.ispartofseries0011en
dc.rightsCC Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)en
dc.rights.accessRightsAcceso abierto / Sarbide irekiaes
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessen
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectHealth strategyen
dc.subjectContractingen
dc.subjectRegionalen
dc.subjectSpainen
dc.titleContracting arrangements in the health strategy contex. A regional approach for Spainen
dc.typeDocumento de trabajo / Lan gaiakes
dc.typeinfo:eu-repo/semantics/workingPaperen
dspace.entity.typePublication
relation.isAuthorOfPublication1a8dab3a-5e54-4aa0-bc0f-7d7fa49b3268
relation.isAuthorOfPublication.latestForDiscovery1a8dab3a-5e54-4aa0-bc0f-7d7fa49b3268

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