Reformas y cambios organizativos en el Sistema Nacional de Salud español
- de Manuel Keenoy, Esteban
- Martín Martín, José Jesús
ISSN: 0210-9107
Year of publication: 1998
Issue: 76
Pages: 176-190
Type: Article
More publications in: Papeles de economía española
Abstract
This study examines and evaluates the recent organizational changes that have taken place in the Spanish National Health System. The centralized public hierarchies of the INSALUD and other regional health services are being oriented towards hybrid models and contractual relations through two instruments in particular: the programme contract and the creation of new legal organizational formsgoverned by private law. Developing these reforms, generalizing them and minimizing the potential perverse effects they entail would involver changes in the framework of institutional regulation and strategies for overcoming the path dependence in which the Spanish state health organizations are confined at the present time.