Managing the health care market in developing countries: prospects and problems

Area of Science:

• Health economics
• Public health policy
• Healthcare management

Background:

• Growing interest in managed market reforms for developing countries, driven by developed nations' experiences and public sector inefficiencies.
• Focus on hospital services within the broader context of healthcare provision and policy debates.

Purpose of the Study:

• To review the prospects and analyze the arguments for managed market reforms in developing countries.
• To assess the relevance of developed country evidence for developing nations, particularly concerning hospital services.

Main Methods:

• Analysis of theoretical arguments and empirical evidence from developed countries regarding managed market reforms.
• Examination of claims about increased provider competition, efficiency of contractual relationships, and cost-benefit analysis of reforms.

Main Results:

• Theoretical arguments and empirical evidence for managed markets enhancing efficiency and equity remain ambiguous.
• Key conditions for successful reform implementation are largely absent in most developing countries.
• Potential for substantial equity-related costs and challenges in developing nations.

Conclusions:

• Extensive managed market reforms are unlikely to succeed in most developing countries due to absent conditions and high costs.
• Limited introduction of specific reform elements may be more successful, informed by developed country experiences.
• Urgent need to evaluate existing contracting experiences in developing countries and interpret developed country reforms in local contexts.