Comparative Review of Health System Integration in Selected Countries in Latin America
Peer Reviewed
Date issued
Jan 2014
Subject
Health Care Service
JEL code
D61 - Allocative Efficiency • Cost—Benefit Analysis;
H44 - Publicly Provided Goods: Mixed Markets;
H51 - Government Expenditures and Health;
H55 - Social Security and Public Pensions;
I10 - Health: General;
I11 - Analysis of Health Care Markets;
I13 - Health Insurance, Public and Private;
I14 - Health and Inequality;
I15 - Health and Economic Development;
I18 - Government Policy • Regulation • Public Health;
I38 - Government Policy • Provision and Effects of Welfare Programs;
L33 - Comparison of Public and Private Enterprises and Nonprofit Institutions • Privatization • Contracting Out;
N46 - Latin America • Caribbean;
P46 - Consumer Economics • Health • Education and Training • Welfare, Income, Wealth, and Poverty
Country
Chile;
Costa Rica;
Colombia;
Mexico;
Spain;
Ecuador;
Brazil
Category
Technical Notes
This technical note presents a comparative analysis of Latin America's fragmented health systems. It provides a detailed account of health system fragmentation along six dimensions (organizations, risk pooling, eligibility, benefits, premium/contributions, payments) and the effects of historical reforms in Costa Rica, Colombia, Ecuador, Brazil, Mexico, and Chile, as well as examples of successful integration in Spain and Turkey. Additionally, it offers a set of policy options for promoting the integration of health systems and a series of practical steps for implementing health system reforms. It concludes that analyzing the fragmentation of various dimensions of health systems can be useful for developing policy, but further research is needed to determine the effect of fragmentation on health system performance.
