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Resilient managed competition during pandemics: lessons from the Italian experience

One of the main governance decisions that policymakers need to make is whether to implement public services via centralized or decentralized forms. As Costa et al. discuss in their article, when public services are implemented via competing systems, service providers contend to provide good services...

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Detalles Bibliográficos
Autores principales: Bel, Germà, Esteve, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578629/
https://www.ncbi.nlm.nih.gov/pubmed/32883401
http://dx.doi.org/10.1017/S1744133120000365
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author Bel, Germà
Esteve, Marc
author_facet Bel, Germà
Esteve, Marc
author_sort Bel, Germà
collection PubMed
description One of the main governance decisions that policymakers need to make is whether to implement public services via centralized or decentralized forms. As Costa et al. discuss in their article, when public services are implemented via competing systems, service providers contend to provide good services with the ultimate objective of gaining market quota. This is known as managed competition (MC), as the authorities will have to manage the panoply of public and private organizations offering the service. The alternative is to manage the service more centrally, in what it is identified as vertical integration. As the authors describe, several governments around the globe have abandoned their vertical integrated models in favour of decentralized models. This is the case, as the authors recall, for most health services in Europe. While there is an emerging body of evidence suggesting that decentralized MC outperforms vertically integrated models both in terms of efficiency and in terms of service quality, little is known on how these systems react under different circumstances. This means, for example, how these systems can cope with a sudden increase in their service demands.
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spelling pubmed-75786292020-10-22 Resilient managed competition during pandemics: lessons from the Italian experience Bel, Germà Esteve, Marc Health Econ Policy Law Articles One of the main governance decisions that policymakers need to make is whether to implement public services via centralized or decentralized forms. As Costa et al. discuss in their article, when public services are implemented via competing systems, service providers contend to provide good services with the ultimate objective of gaining market quota. This is known as managed competition (MC), as the authorities will have to manage the panoply of public and private organizations offering the service. The alternative is to manage the service more centrally, in what it is identified as vertical integration. As the authors describe, several governments around the globe have abandoned their vertical integrated models in favour of decentralized models. This is the case, as the authors recall, for most health services in Europe. While there is an emerging body of evidence suggesting that decentralized MC outperforms vertically integrated models both in terms of efficiency and in terms of service quality, little is known on how these systems react under different circumstances. This means, for example, how these systems can cope with a sudden increase in their service demands. Cambridge University Press 2020-09-04 /pmc/articles/PMC7578629/ /pubmed/32883401 http://dx.doi.org/10.1017/S1744133120000365 Text en © The Author(s) 2020 http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Articles
Bel, Germà
Esteve, Marc
Resilient managed competition during pandemics: lessons from the Italian experience
title Resilient managed competition during pandemics: lessons from the Italian experience
title_full Resilient managed competition during pandemics: lessons from the Italian experience
title_fullStr Resilient managed competition during pandemics: lessons from the Italian experience
title_full_unstemmed Resilient managed competition during pandemics: lessons from the Italian experience
title_short Resilient managed competition during pandemics: lessons from the Italian experience
title_sort resilient managed competition during pandemics: lessons from the italian experience
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578629/
https://www.ncbi.nlm.nih.gov/pubmed/32883401
http://dx.doi.org/10.1017/S1744133120000365
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