Fragmentation and Incentives in Health Care Systems in Latin America and the Caribbean

(Available only in Spanish) This work argues that the organizational deficiencies in the bureaucratic and care structures based on the payment mechanisms utilized and the resulting generation of incentives, combined with financial restrictions, led to a sectoral restructuring in which the private sector plays a decisive role. The provision of services and the allocation of resources is defined between providers with relatively disparate capacities, where two factors are fundamental: diversity within the public sector, at both horizontal (relations between public providers and social security system providers), and vertical level (division of functions, allocation of resources and decentralization).