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Resilient managed competition during pandemics: lessons from the Italian experience
1Universitat de Barcelona, Barcelona, Spain.
Health Economics, Policy, and Law
|September 5, 2020
Summary
Decentralized managed competition (MC) may improve public service efficiency and quality compared to centralized vertical integration. However, understanding how these decentralized systems handle increased demand remains crucial for effective governance.
Area of Science:
- Public Administration
- Health Services Management
- Health Economics
Background:
- Policymakers face a key decision between centralized and decentralized public service delivery models.
- Managed competition (MC) involves service providers competing for market share, requiring oversight.
- Vertical integration represents a more centralized approach to service management.
Purpose of the Study:
- To explore the performance of decentralized managed competition versus vertical integration in public services.
- To investigate the resilience of decentralized systems under varying circumstances, such as increased service demand.
Main Methods:
- Comparative analysis of governance models: managed competition vs. vertical integration.
- Review of existing evidence on efficiency and quality outcomes.
- Identification of knowledge gaps regarding system reactions to demand fluctuations.
Main Results:
- Emerging evidence suggests decentralized MC can outperform vertical integration in efficiency and quality.
- Limited understanding exists on how decentralized systems adapt to sudden increases in service demand.
Conclusions:
- Decentralized managed competition is a growing trend, particularly in European health services.
- Further research is needed to understand the operational dynamics and robustness of decentralized models under stress.
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