Mecanismos de control de costes en el sistema sanitario chileno

Abstract

This work has got a double purpose. The first one is analyse the theoretical foundations of the instruments of restraint of the implemented cost during the last two decades and their effectiveness on the Chilean sanitary system. The second one, evaluate quantitatively the effect that the mechanisms of payment recently created have got on the use of hospital services in the Metropolitan Region and their regions in the country. The results reverald that the first mechanism of prospective payment has fulfilled the expectations of restraint in the use of the resources however. The second mechanism of payment didn t fulfil these expectations. In conclusion we can say that the second mechanism of payment has generated neither incentives in the reduction of the averaged stay in the country nor higher levels of efficiency. That is to say, not only more resources are used but also it is possible that the system is acting in a wicked way making difficult to take measures that favour the efficiency.