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- W3125913366 abstract "Several national health systems in Latin America embarked on health reforms to tackle widespread criticisms for low equity and efficiency. These reforms have included contracting by public purchasing agencies of external providers. This paper seeks to propose an analytical framework to support decision making and orient future search for evidences. It was built upon a literature review and four illustrations from Costa Rica Guatemala, Nicaragua and Salvador which focus on primary care providers. A preliminary literature review helped in proposing an initial framework with basic dimensions. Thereafter, we used four illustrations of contractual relation between public purchasers and external primary care providers in Central America to further develop the framework. Two types of themes emerged. The first group corresponds to choices that need to be done in the design of the contractual relation. Theses choices are not only technical but also value-based. The second group is mostly beyond the control of the contractual relation designers, or includes unexpected consequences of the contractual relation. Our framework would need further development. It might help however in designing more adequate processes and tools in assisting future decision in contracting or not external providers for primary care." @default.
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- W3125913366 date "2007-06-15" @default.
- W3125913366 modified "2023-09-27" @default.
- W3125913366 title "Contracting External Primary Care Providers in Central America for Better Responsiveness, Efficiency of Health Care and Public Governance: A Framework for Analysis" @default.
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