EVALUATING THE IMPACT OF HEALTH CARE REFORM IN COLOMBIA: FROM THEORY TO PRACTICE

Alejandro Gaviria, Carlos Medina and Carolina Mejía ()

No 2647, Documentos CEDE from Universidad de los Andes, Facultad de Economía, CEDE

Abstract: This article presents an evaluation of an ambitious health reform implemented in Colombia during the first half of the nineties. The reform attempted to radically change public provision of health services, by means of the transformation of subsidies to supply (direct transfers to hospitals) into a new scheme of subsidies to demand (transfers targeted at the poorest citizens). Although the percentage of the population having medical care insurance has notably increased, mostly among the poorest, problems of implementation have been numerous. It has not been possible to achieve the transformation of subsidies to supply into subsidies to demand. At the same time, competition has not made it possible to increase the efficiency of many public hospitals, which continue to operate with very low occupation rates, while receiving hefty money transfers. Subsidies increased demand for medical consultations, but have curbed demand for hospitalizations. Nonetheless, subsidies might have adversely affected female´s labor market participation and even household consumption. As a whole, evidence suggests that the health reform has been effective in rationalizing households´ demand for health, but not in rationalizing public supply, and neither in increasing the efficiency of service providers.

Keywords: demand subsidies; targeted social services; instrumental variables (search for similar items in EconPapers)
JEL-codes: I1 I11 I18 I38 (search for similar items in EconPapers)
Pages: 57
Date: 2006-01-24
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (23)

Downloads: (external link)
https://repositorio.uniandes.edu.co/bitstream/handle/1992/7976/dcede2006-06.pdf

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:col:000089:002647

Access Statistics for this paper

More papers in Documentos CEDE from Universidad de los Andes, Facultad de Economía, CEDE Contact information at EDIRC.
Bibliographic data for series maintained by Universidad De Los Andes-Cede ().