Pezza P E, Barquero Bolaños J F
Health Policy and Management Providence College, Rhode Island 20918.
J R Soc Health. 1994 Oct;114(5):252-5. doi: 10.1177/146642409411400508.
Several experiments in health services delivery featuring contractual arrangements between government and the private sector have been initiated in Costa Rica. This report describes a public-private partnership serving a community of 50,000. A 'cooperative' of providers stands to gain financially if it succeeds in providing clinic services in an efficacious and efficient manner. This experimental approach retains elements of the existing public system for health promotion and disease prevention while introducing innovations for increased organizational efficiency and client satisfaction. The clinic provides easier access to better care, including ambulatory surgery, pharmacy service, and home visits, and at a lower cost to government than that budgeted under pre-existing arrangements. Inappropriate usage of area hospitals has been reduced; and a commitment to community participation and organized programming permit greater responsiveness to community needs. Those served by the clinic report satisfaction. Personnel also report satisfaction and enthusiasm for their work. Issues concerning extension of this model are considered.
哥斯达黎加已经开展了多项以政府与私营部门之间的合同安排为特色的卫生服务提供实验。本报告描述了一个服务于5万人口社区的公私合作伙伴关系。如果一个由提供者组成的“合作社”能够以有效和高效的方式提供诊所服务，它将在经济上获利。这种实验性方法保留了现有公共卫生促进和疾病预防系统的要素，同时引入创新措施以提高组织效率和客户满意度。该诊所提供了更便捷的优质医疗服务，包括门诊手术、药房服务和家访，而且与先前安排下的预算相比，政府的成本更低。地区医院的不当使用情况有所减少；对社区参与和有组织规划的承诺使诊所能够对社区需求做出更大的响应。在该诊所接受服务的人表示满意。工作人员也对他们的工作表示满意并充满热情。报告还考虑了有关推广这一模式的问题。
