Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory
A central theme of recent health care reforms has been a redefinition of the roles of the state and private providers. With a view to helping governments to arrive at more rational "make or buy" decisions on health care goods and services, we propose a conceptual framework in which a combi...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
The World Health Organization
2000-06-01
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| Series: | Bulletin of the World Health Organization |
| Subjects: | |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862000000600010&lng=en&tlng=en |
| _version_ | 1827333434258751488 |
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| author | Alexander S Preker April Harding Phyllida Travis |
| author_facet | Alexander S Preker April Harding Phyllida Travis |
| author_sort | Alexander S Preker |
| collection | DOAJ |
| description | A central theme of recent health care reforms has been a redefinition of the roles of the state and private providers. With a view to helping governments to arrive at more rational "make or buy" decisions on health care goods and services, we propose a conceptual framework in which a combination of institutional economics and organizational theory is used to examine the core production activities in the health sector. Empirical evidence from actual production modalities is also taken into consideration. We conclude that most inputs for the health sector, with the exception of human resources and knowledge, can be efficiently produced by and bought from the private sector. In the health services of low-income countries most dispersed production forms, e.g. ambulatory care, are already provided by the private sector (non-profit and for-profit). These valuable resources are often ignored by the public sector. The problems of measurability and contestability associated with expensive, complex and concentrated production forms such as hospital care require a stronger regulatory environment and skilled contracting mechanisms before governments can rely on obtaining these services from the private sector. Subsidiary activities within the production process can often be unbundled and outsourced. |
| first_indexed | 2024-03-07T17:22:11Z |
| format | Article |
| id | doaj.art-756652c1140a4a39b90f75ab84814df4 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T17:22:11Z |
| publishDate | 2000-06-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-756652c1140a4a39b90f75ab84814df42024-03-02T19:38:03ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862000-06-01786779790S0042-96862000000600010Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theoryAlexander S Preker0April Harding1Phyllida Travis2World BankWorld BankWorld Health OrganizationA central theme of recent health care reforms has been a redefinition of the roles of the state and private providers. With a view to helping governments to arrive at more rational "make or buy" decisions on health care goods and services, we propose a conceptual framework in which a combination of institutional economics and organizational theory is used to examine the core production activities in the health sector. Empirical evidence from actual production modalities is also taken into consideration. We conclude that most inputs for the health sector, with the exception of human resources and knowledge, can be efficiently produced by and bought from the private sector. In the health services of low-income countries most dispersed production forms, e.g. ambulatory care, are already provided by the private sector (non-profit and for-profit). These valuable resources are often ignored by the public sector. The problems of measurability and contestability associated with expensive, complex and concentrated production forms such as hospital care require a stronger regulatory environment and skilled contracting mechanisms before governments can rely on obtaining these services from the private sector. Subsidiary activities within the production process can often be unbundled and outsourced.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862000000600010&lng=en&tlng=endelivery of health caremethodspublic sectorprivate sectoroutcome and process assessmenthealth caredecision-makingmethodsmodelseconomicmodelsorganizational |
| spellingShingle | Alexander S Preker April Harding Phyllida Travis Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory Bulletin of the World Health Organization delivery of health care methods public sector private sector outcome and process assessment health care decision-making methods models economic models organizational |
| title | Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory |
| title_full | Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory |
| title_fullStr | Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory |
| title_full_unstemmed | Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory |
| title_short | Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory |
| title_sort | make or buy decisions in the production of health care goods and services new insights from institutional economics and organizational theory |
| topic | delivery of health care methods public sector private sector outcome and process assessment health care decision-making methods models economic models organizational |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862000000600010&lng=en&tlng=en |
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