Abstract:
:This study analyzes the mechanisms used in Brazil by health plan and insurance operators, hospitals and physicians for organizing the access to health care services and their strategies towards cost reduction and decision-making. The study is based on the literature about regulation of the health services, with special focus on micro-management and managed care. From an intentional sample of health care organizations selected according to the number of beneficiaries, organizational modality and geographic criteria we selected probabilistic samples of doctors and hospital services. Data were collected through questionnaires applied to key informants from health care operators and affiliated doctors and hospitals. Results suggest that the relationships between health care organizations, physicians and hospitals follow basically patterns inherited from the former social security system, mainly with fixed pricing and open account payments. More complex financing mechanisms, risk sharing and efficiency strategies are of minor interest. Mechanisms for risk reduction and encouragement of adequate use of technologies are weak. Cost control is mainly based on co-payment and barriers to access to the services. We conclude that in Brazil managed care is still in its beginning.
journal_name
Cien Saude Coletjournal_title
Ciencia & saude coletivaauthors
Ribeiro JM,Lobato Lde V,Vaitsman J,Farias LO,Vasconcellos M,Hollanda E,Teixeira CPdoi
10.1590/s1413-81232008000500013subject
Has Abstractpub_date
2008-09-01 00:00:00pages
1477-87issue
5eissn
1413-8123issn
1678-4561pii
S1413-81232008000500013journal_volume
13pub_type
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journal_title:Ciencia & saude coletiva
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journal_title:Ciencia & saude coletiva
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journal_title:Ciencia & saude coletiva
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journal_title:Ciencia & saude coletiva
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