Actores, contratos y mecanismos de pago: El caso del Sistema de Salud de Salta

Decentralization in health care strategy and goals definition, as well as in program implementation moves public discussion to the provincial level. This study analyzes the association among the market structure of the private health care services, payments mechanisms and responses related to internal organization and transference of risk between health providers and financiers in Salta. In depth interviews to key acctors and a survey performed to a sample of public and private institutions allows to obtain information about perceived competition, strategies, contracts and payment mechanisms. The study finds a correlation between population scale, competition and relative bargaining power of the main competitior. This scheme friggers incentive to differentiated production using different strategies beyond prices, as reputation, product mix and infraestructure.Este estudio analiza la asociación existente entre la estructura del mercado privado de servicios de salud, mecanismos de pagos a proveedores por parte del sistema de aseguramiento social, y respuesta en términos de organización interna y transferencia de riesgo en la provincia de Salta. Para ello se realizaron entrevistas en profundidad a actores claves y se relevaron indicadores de competencia, estrategias, contratos y mecanismos de pago en una muestra de prestadores públicos y privados de salud. Se concluye que un aumento en la escala poblacional incrementa el nivel de competencia entre prestadores y disminuye el poder relativo del principal competidor. A su vez, se desarrollan mayores incentivos a diferenciarse mediante estrategias diferentes a los precios como la reputación, hotelería e infraestructura

Lives Versus Livelihoods: The Epidemiological, Social, And Economic Impact Of COVID-19 In Latin America And The Caribbean

During the COVID-19 pandemic, Latin American and Caribbean countries implemented stringent public health and social measures that disrupted economic and social activities. This study used an integrated model to evaluate the epidemiological, economic, and social trade-offs in Argentina, Brazil, Jamaica, and Mexico throughout 2021. Argentina and Mexico displayed a higher gross domestic product (GDP) loss and lower deaths per million compared with Brazil. The magnitude of the trade-offs differed across countries. Reducing GDP loss at the margin by 1 percent would have increased daily deaths by 0.5 per million in Argentina but only 0.3 per million in Brazil. We observed an increase in poverty rates related to the stringency of public health and social measures but no significant income-loss differences by sex. Our results indicate that the economic impact of COVID-19 was uneven across countries as a result of different pandemic trajectories, public health and social measures, and vaccination uptake, as well as socioeconomic differences and fiscal responses. Policy makers need to be informed about the trade-offs to make strategic decisions to save lives and livelihoods

Development and application of a dynamic transmission model of health systems’ preparedness and response to COVID-19 in twenty-six Latin American and Caribbean countries

The global impact of COVID-19 has challenged health systems across the world. This situation highlighted the need to develop policies based on scientific evidence to prepare the health systems and mitigate the pandemic. In this scenario, governments were urged to predict the impact of the measures they were implementing, how they related to the population’s behavior, and the capacity of health systems to respond to the pandemic. The overarching aim of this research was to develop a customizable and open-source tool to predict the impact of the expansion of COVID-19 on the level of preparedness of the health systems of different Latin American and the Caribbean countries, with two main objectives. Firstly, to estimate the transmission dynamics of COVID-19 and the preparedness and response capacity of health systems in those countries, based on different scenarios and public policies implemented to control, mitigate, or suppress the spread of the epidemic. Secondly, to facilitate policy makers’ decisions by allowing the model to adjust its parameters according to the specific pandemic trajectory and policy context. How many infections and deaths are estimated per day?; When are the peaks of cases and deaths expected, according to the different scenarios?; Which occupancy rate will ICU services have along the epidemiological curve?; When is the optimal time increase restrictions in order to prevent saturation of ICU beds?, are some of the key questions that the model can respond, and is publicly accessible through the following link: http://shinyapps.iecs.org.ar/modelo-covid19/. This open-access and open code tool is based on a SEIR model (Susceptible, Exposed, Infected and Recovered). Using a deterministic epidemiological model, it allows to frame potential scenarios for long periods, providing valuable information on the dynamics of transmission and how it could impact on health systems through multiple customized configurations adapted to specific characteristics of each country.Fil: Santoro, Adrián Gabriel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: López Osornio, Alejandro. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Williams, Iván. Universidad de Buenos Aires. Facultad de Ciencias Económicas; ArgentinaFil: Wachs, Martín. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Cejas, Cintia. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Havela, Maisa. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: López, Analía. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Pichón Riviere, Andrés. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentin

Argentinian digital health strategy

Digital Health is one of the three pillars for the effective implementation of Universal Health Coverage in Argentina. The Ministry of Health published the National Digital Health Strategy 2018-2024 in order to establish the conceptual guidelines for the design and development of interoperable health information systems as a state policy. The World Health Organization "National eHealth Strategy Toolkit", "Global Strategy on Digital Health" and other international and local evidence and expert recommendations were taken into account. The path to better healthcare involves adopting systems at the point of care, allowing for the primary recording of information and enabling information exchange through real interoperability. In that way, people, technology and processes will synergize to enhance integrated health service networks. In this paper, we describe the plan and the first two years of implementation of the strategy.Fil: Rizzato Lede, Daniel A.. Ministerio de Salud de la Nación; ArgentinaFil: Pedernera, Federico A.. Ministerio de Salud de la Nación; ArgentinaFil: López, Emiliano. Ministerio de Salud de la Nación; ArgentinaFil: Speranza, Cintia D.. Ministerio de Salud de la Nación; ArgentinaFil: Guevel, Carlos Gustavo. Ministerio de Salud de la Nación; ArgentinaFil: Maid, Jesse J.. Ministerio de Salud de la Nación; ArgentinaFil: Mac Culloch, Patricia. Ministerio de Modernización; ArgentinaFil: Rolandi, Florencia. Ministerio de Modernización; ArgentinaFil: Ayala, Fabiana. Ministerio de Modernización; ArgentinaFil: Abadie, Daniel A.. Ministerio de Modernización; ArgentinaFil: Baqué, María I.. Ministerio de Modernización; ArgentinaFil: Gassino, Fernando. Ministerio de Salud de la Nación; Argentina. Hospital Italiano; ArgentinaFil: Campos, Fernando. Hospital Italiano; ArgentinaFil: Kaminker, Diego. No especifíca;Fil: Cejas, Cintia A.. Ministerio de Salud de la Nación; ArgentinaFil: López Osornio, Alejandro. Ministerio de Salud de la Nación; ArgentinaFil: Rubinstein, Adolfo Luis. Ministerio de Salud de la Nación; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentin