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The consequences of hospital autonomization in Colombia: A transaction cost economics analysis

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dc.creatorCastano, Ramonspa
dc.creatorMills, Annespa
dc.date.accessioned2020-05-26T00:09:50Z
dc.date.available2020-05-26T00:09:50Z
dc.date.created2013spa
dc.description.abstractGranting autonomy to public hospitals in developing countries has been common over recent decades, and implies a shift from hierarchical to contract-based relationships with health authorities. Theory on transactions costs in contractual relationships suggests they stem from relationship-specific investments and contract incompleteness. Transaction cost economics argues that the parties involved in exchanges seek to reduce transaction costs. The objective of this research was to analyse the relationships observed between purchasers and the 22 public hospitals of the city of Bogota, Colombia, in order to understand the role of relationship-specific investments and contract incompleteness as sources of transaction costs, through a largely qualitative study. We found that contract-based relationships showed relevant transaction costs associated mainly with contract incompleteness, not with relationship-specific investments. Regarding relationships between insurers and local hospitals for primary care services, compulsory contracting regulations locked-in the parties to the contracts. For high-complexity services (e.g. inpatient care), no restrictions applied and relationships suggested transaction-cost minimizing behaviour. Contract incompleteness was found to be a source of transaction costs on its own. We conclude that transaction costs seemed to play a key role in contract-based relationships, and contract incompleteness by itself appeared to be a source of transaction costs. The same findings are likely in other contexts because of difficulties in defining, observing and verifying the contracted products and the underlying information asymmetries. The role of compulsory contracting might be context-specific, although it is likely to emerge in other settings due to the safety-net role of public hospitals. © The Author 2012; all rights reserved.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1093/heapol/czs032
dc.identifier.issn14602237
dc.identifier.issn02681080
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/24183
dc.language.isoengspa
dc.relation.citationEndPage164
dc.relation.citationIssueNo. 2
dc.relation.citationStartPage157
dc.relation.citationTitleHealth Policy and Planning
dc.relation.citationVolumeVol. 28
dc.relation.ispartofHealth Policy and Planning, ISSN:14602237, 02681080, Vol.28, No.2 (2013); pp. 157-164spa
dc.relation.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-84874909028&doi=10.1093%2fheapol%2fczs032&partnerID=40&md5=3bc1e7ef206b5f97bb91152c3bb3bee5spa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordColombiaspa
dc.subject.keywordPubliceng
dc.subject.keywordFinancial managementspa
dc.subject.keywordHealth care policyspa
dc.subject.keywordHealth economicsspa
dc.subject.keywordHealth insurancespa
dc.subject.keywordHospital costspa
dc.subject.keywordHumanspa
dc.subject.keywordOrganization and managementspa
dc.subject.keywordPublic hospitalspa
dc.subject.keywordArticlespa
dc.subject.keywordHealth economicsspa
dc.subject.keywordHospital costspa
dc.subject.keywordPublic hospitalspa
dc.subject.keywordColombiaspa
dc.subject.keywordContract Servicesspa
dc.subject.keywordEconomicseng
dc.subject.keywordHealth Care Reformspa
dc.subject.keywordHospital Costsspa
dc.subject.keywordHospitalseng
dc.subject.keywordHumansspa
dc.subject.keywordInsuranceeng
dc.subject.keywordColombiaspa
dc.subject.keywordContract Servicesspa
dc.subject.keywordEconomicseng
dc.subject.keywordHealth Care Reformspa
dc.subject.keywordHospital Costsspa
dc.subject.keywordHospitalseng
dc.subject.keywordHumansspa
dc.subject.keywordInsuranceeng
dc.subject.keywordContract incompletenessspa
dc.subject.keywordDeveloping countriesspa
dc.subject.keywordHealth care reformspa
dc.subject.keywordHospital autonomyspa
dc.subject.keywordInformation asymmetryspa
dc.subject.keywordTransaction cost economicsspa
dc.titleThe consequences of hospital autonomization in Colombia: A transaction cost economics analysisspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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