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LA REGULACIÓN DE TARIFAS EN EL SECTOR DE LA SALUD EN COLOMBIA Translated title: TARIFF REGULATION IN THE COLOMBIAN HEALTH SECTOR

1 , 2

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Abstract

Este artículo estudia la regulación de las tarifas en el sector de la salud en Colombia. El objetivo de la regulación es evitar una guerra de precios que lleve a la disminución de la calidad. Se presentan los antecedentes de la regulación de precios y los esquemas de tarifas del sector de la salud. Utilizando las herramientas de la teoría de la regulación y de la organización industrial se analiza la eficiencia de la regulación y algunos de sus problemas de implementación.

Translated abstract

This article studies the tariff regulation of the Colombian Health Sector. The aim of regulation is to avoid a price war that could produce quality reductions. It presents the background of price regulation and the health sector tariff system. Using regulation and industrial organization theories, this paper analyses the efficiency of regulation and its implementation problems.

Most cited references26

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Theory and Practice in the Design of Physician Payment Incentives

(2001)
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Uncertain demand, the structure of hospital costs, and the cost of empty hospital beds.

(1995)
In this paper we reformulate the theory of cost and production to take account of uncertain demand facing a firm. In the reformulated theory the duality between cost and production no longer obtains, and demand distribution parameters enter the cost function as well as the traditional outputs and input prices. We then estimate a short run cost function for a hospital facing uncertain demand using data from a national sample of over 5000 hospitals for the years 1983-1987. The traditional cost model is strongly rejected in favor of the reformulated model. This model is used to calculate the cost of empty hospital beds, controlling for the effect of uncertain demand on the structure of hospital costs. The cost of an empty hospital bed is calculated as $36,443 in 1987 dollars. We estimate that a one percent decrease in the number of hospital beds would decrease hospital costs by slightly over one-third of one percent. Increasing the occupancy rate from the average 1992 level (65 percent) back to the average 1980 level (76 percent) is estimated to save the average hospital over$2 million, or 9.5 percent of costs.
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Social health insurance reexamined.

(2010)
Social health insurance (SHI) is enjoying something of a revival in parts of the developing world. Many countries that have in the past relied largely on tax finance (and out-of-pocket payments) have introduced SHI, or are thinking about doing so. And countries with SHI already in place are making vigorous efforts to extend coverage to the informal sector. Ironically, this revival is occurring at a time when the traditional SHI countries in Europe have either already reduced payroll financing in favor of general revenues, or are in the process of doing so. This paper examines how SHI fares in health-care delivery, revenue collection, covering the formal sector, and its impacts on the labor market. It argues that SHI does not necessarily deliver good quality care at a low cost, partly because of poor regulation of SHI purchasers. It suggests that the costs of collecting revenues can be substantial, even in the formal sector where non-enrollment and evasion are commonplace, and that while SHI can cover the formal sector and the poor relatively easily, it fares badly in terms of covering the non-poor informal sector workers until the economy has reached a high level of economic development. The paper also argues that SHI can have negative labor market effects.
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Author and article information

Contributors
Role: ND
Role: ND
Journal
s_rei
Revista de Economía Institucional
Rev. Econ. Inst.
0124-5996
December 2007
: 9
: 17
: 347-357
Affiliations
[1 ] Universidad del Rosario Colombia
[2 ] Universidad del Rosario Colombia
Article
S0124-59962007000200014

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