Shares of improving the management of the health systems can be classified into three levels: actions about the bodies of the system, grouped under the name macro; actions on facilities providing health services or middle management and actions on the process of health care or micromanagement. The improved system performance will be achieved with the combination of three levels auctions. The management changes should be strongly targeted major objectives of health systems (population coverage, improving equity, increasing allocative efficiency, containment of spending growth health), So that they are real instruments for achieving themselves.
Changes in management of system without clearly defined objectives will lead you in the direction of groups with higher wishing pressure capability, regardless of what these changes are.
Actions on system management: macro
The health systems of Latin America need to increase coherence between supply and services needs of the population (overlapping partially with the demand expressed). Therefore, the planning based on these needs to be reinforced. The definition of priorities, performance guaranteed baskets of services or any other form of marking the supply of system must be following the study of population needs and developing health plans.
The ability to regulation the system must adapt to induced reforms changes. The regulation is quite simple in the integrating systems from providing financing to services in a single organism, but its complexity increases rapidly with separation measures functions and decentralization. The relationship between changes and regulatory capacity and as increased costs and management information that it produces, it must be carefully valued.
The implementation of allocation mechanisms financial resources consistent with the goals organization is probably the most powerful incentive is the lead financier for the production of the health establishments. In order to allocation mechanisms work properly it is necessary that the allocator and the service provider is independent and therefore there is an organic separation or functional procurement functions and service provision. This separation has an additional two positive effect: buyer and supplier organizations have different objectives, competitive among themselves, which encourage efficiency in both. The buyer wants to maximize the delivery of services to the insured resources available, while supplier will produce services they have purchased with minimum consumption of inputs. This is a cultural change of great importance within the systems coming from a model of vertical integration of functions.