Capita Financing, Integration, and Decentralization of Health Care Organizations

Résumé du livre

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 health care organisations, where strong incentives may become inappropriate. This paper tries to ground some theoretical bases for the organisational change in the Spanish health system. We do this by building our argument from the very basic public goal: the improvement of the health status of the 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 of risks to health providers and favours managed care under a global perspective. However, the paper shows some potential limitations for this purpose and the need of a gradual strategy for its implementation.