DESCENTRALIZAÇÃO
072
BOSSERT, Thomas J.; LARRAÑAGA, Osvaldo; GIEDION, Ursula et al. Descentralization and equity of resource allocation: evidence from Colombia and Chile. Bulletin of the World Health Organization, v. 81, n. 2, p. 95-100, 2003. Disponível em Scielo
Evidence from Colombia and Chile suggests that descentralization, under certain conditions and with some specific policy mechanisms, can improve equity of resource allocation. In these countries, equitable levels of per capita financial allocations at the municipal level were achieved through different forms of descentralization – the use of allocation formulae, adequate local funding choices and horizontal equity funds. Findings on equity of utilization of services were less consistent, but they did show that increased levels of funding were associated with increased utilization. This suggests that improved equity of funding over time might reduce inequities of service utilization.
DOENÇA CRÔNICA
073
CASALINO, Lawrence; GILLIES, Robin R.; SHORTELL, Stephen M. et al. External incentives, information technology, and organized processes to improve health care quality for patients with chronic diseases. The Journal of the American Medical Association, Chicago, v. 289, n. 4, p. 434-41, 22 Jan. 2003.
Organized care management processes (CMPs) can improve health care quality for patients with chronic diseases. The Institute of Medicine of the National Academy of Sciences has called for public and private purchasers of health care to create incentives for physician organizations (POs) to use CMPs and for the government to assist POs in implementing information technology (IT) to facilitate CMP use. Research is lacking about the extent to which POs use CMPs or about the degree to which incentives, IT, or other factors are associated with their use. The use of CMPs varies greatly among POs, but it is low on average. Government and private purchasers of health care may increase CMP use by providing external incentives for improvement of health care quality to POs and by assisting them in improving their clinical IT capability.
