The health regionalization process from the perspective of the transation cost theory
Cien Saude Colet. 2017 Apr;22(4):1121-1130.
doi: 10.1590/1413-81232017224.2694016.
[Article in
Portuguese,
English]
Affiliations
- 1 Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro (UFRJ). Av. Horácio Macedo S/N, Ilha do Fundão. 21941-598 Rio de Janeiro RJ Brasil. leylasancho@gmail.com.
- 2 Curso de Graduação em Enfermagem, Universidade Federal da Fronteira Sul. Chapecó SC Brasil.
- 3 Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro. Rio de Janeiro RJ Brasil.
- 4 Curso de Ciências Econômicas, Universidade Federal da Santa Maria (UFSM). Palmeira das Missões RS Brasil.
- 5 Curso de Ciências Econômicas, UFSM. Palmeira das Missões RS Brasil.
Abstract
This study analyzes the incidence of transaction costs in the regionalization process of health policies in the Brazilian federal system. In this work, regionalized health actions contracted and agreed between federal agencies have assumed a transactional nature. A conceptual theoretical essay of reflective nature was prepared with the purpose of questioning and proposing new approaches to improve the health regionalization process. The main considerations suggest that institutional management tools proposed by the standards and regulations of the Unified Health System have a low potential to reduce transaction costs, especially due to hardships in reconciling common goals among the entities, environment surrounded by uncertainty, asymmetries and incomplete information, bounded rationality and conflict of interest. However, regionalization can reduce the incidence of social and/or operational costs, through improved access to health and the construction of more efficient governance models.
MeSH terms
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Brazil
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Delivery of Health Care / economics
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Delivery of Health Care / organization & administration
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Federal Government
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Health Policy*
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Health Services Accessibility*
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Humans
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National Health Programs / economics
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National Health Programs / organization & administration*
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Regional Health Planning / economics
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Regional Health Planning / organization & administration*