Journal article

Is the Colombian health system reform improving the performance of public hospitals in Bogota?

B McPake, FJ Yepes, S Lake, LH Sanchez

Health Policy and Planning | OXFORD UNIV PRESS | Published : 2003

Abstract

Many countries are experimenting with public hospital reform - both increasing the managerial autonomy with which hospitals conduct their affairs, and separating 'purchaser' and 'provider' sides of the health system, thus increasing the degree of market pressure brought to bear on hospitals. Evidence suggesting that such reform will improve hospital performance is weak. From a theoretical perspective, it is not clear why public hospitals should be expected to behave like firms and seek to maximize profits as this model requires. Empirically, there is very slight evidence that such reforms may improve efficiency, and reason to be concerned about their equity implications. In Colombia, an ambi..

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