Challenges in Assessment of Health Systems Decentralization: The Role of Path Dependence and Choice of Indicators; Comment on “The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis”
Optimal resource allocation within national health systems represents the ultimate challenge in diverse countries worldwide. Major part of the literature points that health systems decentralization potentially address the challenge. The present commentary focuses on the debate referring to effects o...
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| Format: | Article |
| Language: | English |
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Kerman University of Medical Sciences
2023-12-01
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| Series: | International Journal of Health Policy and Management |
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| Online Access: | https://www.ijhpm.com/article_4466_f33647e39753deda119a5afab5c77927.pdf |
| _version_ | 1827281674363207680 |
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| author | Flavia Mori Sarti |
| author_facet | Flavia Mori Sarti |
| author_sort | Flavia Mori Sarti |
| collection | DOAJ |
| description | Optimal resource allocation within national health systems represents the ultimate challenge in diverse countries worldwide. Major part of the literature points that health systems decentralization potentially address the challenge. The present commentary focuses on the debate referring to effects of health systems decentralization, based on the evidence of the study of Arianna Rotulo and colleagues. Studies on the subject emphasize the role of path dependence and the influence of choice of indicators for measurement of effects in the assessment of health systems decentralization. Acknowledging the complexity of the phenomena, the results of the study of Rotulo et al on health system decentralization in Italy are highlighted through the analysis of recent evidence from the literature. The present commentary shows that there are diverse indicators adopted in the literature on the subject, pointing to mixed results, depending on country characteristics and selection of indicators in the analysis. The synthesis of indicators gathered in recent studies also indicate that health system indicators are sensitive to path dependence, thus, requiring additional attention to assumptions of studies on health systems decentralization. Thus, studies should consider the influence of path dependence on organizational practices and institutional structures involved in decentralization processes, in addition to acknowledging that assessments on decentralization vary substantially according to indicators adopted in the analysis, and their links with previous decisions within health systems. |
| first_indexed | 2024-04-24T09:04:07Z |
| format | Article |
| id | doaj.art-8cd5260655504a41a6a1cfcad25008ec |
| institution | Directory Open Access Journal |
| issn | 2322-5939 |
| language | English |
| last_indexed | 2024-04-24T09:04:07Z |
| publishDate | 2023-12-01 |
| publisher | Kerman University of Medical Sciences |
| record_format | Article |
| series | International Journal of Health Policy and Management |
| spelling | doaj.art-8cd5260655504a41a6a1cfcad25008ec2024-04-15T19:04:26ZengKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59392023-12-0112Issue 11410.34172/ijhpm.2023.742744466Challenges in Assessment of Health Systems Decentralization: The Role of Path Dependence and Choice of Indicators; Comment on “The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis”Flavia Mori Sarti0School of Arts, Sciences and Humanities, University of Sao Paulo, Sao Paulo, BrazilOptimal resource allocation within national health systems represents the ultimate challenge in diverse countries worldwide. Major part of the literature points that health systems decentralization potentially address the challenge. The present commentary focuses on the debate referring to effects of health systems decentralization, based on the evidence of the study of Arianna Rotulo and colleagues. Studies on the subject emphasize the role of path dependence and the influence of choice of indicators for measurement of effects in the assessment of health systems decentralization. Acknowledging the complexity of the phenomena, the results of the study of Rotulo et al on health system decentralization in Italy are highlighted through the analysis of recent evidence from the literature. The present commentary shows that there are diverse indicators adopted in the literature on the subject, pointing to mixed results, depending on country characteristics and selection of indicators in the analysis. The synthesis of indicators gathered in recent studies also indicate that health system indicators are sensitive to path dependence, thus, requiring additional attention to assumptions of studies on health systems decentralization. Thus, studies should consider the influence of path dependence on organizational practices and institutional structures involved in decentralization processes, in addition to acknowledging that assessments on decentralization vary substantially according to indicators adopted in the analysis, and their links with previous decisions within health systems.https://www.ijhpm.com/article_4466_f33647e39753deda119a5afab5c77927.pdfhealth systemdecentralizationpath dependenceoutcome indicatorpublic healthhealthcare |
| spellingShingle | Flavia Mori Sarti Challenges in Assessment of Health Systems Decentralization: The Role of Path Dependence and Choice of Indicators; Comment on “The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis” International Journal of Health Policy and Management health system decentralization path dependence outcome indicator public health healthcare |
| title | Challenges in Assessment of Health Systems Decentralization: The Role of Path Dependence and Choice of Indicators; Comment on “The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis” |
| title_full | Challenges in Assessment of Health Systems Decentralization: The Role of Path Dependence and Choice of Indicators; Comment on “The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis” |
| title_fullStr | Challenges in Assessment of Health Systems Decentralization: The Role of Path Dependence and Choice of Indicators; Comment on “The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis” |
| title_full_unstemmed | Challenges in Assessment of Health Systems Decentralization: The Role of Path Dependence and Choice of Indicators; Comment on “The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis” |
| title_short | Challenges in Assessment of Health Systems Decentralization: The Role of Path Dependence and Choice of Indicators; Comment on “The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis” |
| title_sort | challenges in assessment of health systems decentralization the role of path dependence and choice of indicators comment on the effects of health sector fiscal decentralisation on availability accessibility and utilisation of healthcare services a panel data analysis |
| topic | health system decentralization path dependence outcome indicator public health healthcare |
| url | https://www.ijhpm.com/article_4466_f33647e39753deda119a5afab5c77927.pdf |
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