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Governance and the Effectiveness of the Buenos Aires Public Health Insurance Implementation Process

Báscolo, Ernesto MSc, MPH; Yavich, Natalia MPH

Journal of Ambulatory Care Management: April-June 2009 - Volume 32 - Issue 2 - p 91–102
doi: 10.1097/JAC.0b013e31819941bb
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A multiple-case study was conducted to explain the relationship between the governance of the Buenos Aires Public Health Insurance (PHI) implementation process and its effectiveness in 8 municipalities. The heterogeneity in the effectiveness of PHI implementation was explained by the characteristics of the governance implementation process. The local health authorities' position on the PHI (favorable reception, formal acceptance, or rejection) influenced the nature of the articulation of the PHI within the municipal health system. Support for local management teams on the part of the municipal health and social development authorities affected the possibilities of implementing strategies to overcome unfavorable context-related conditions.

Health Economics and Management Department, Juan Lazarte Health Institute, Rosario, Argentina.

Corresponding Author: Ernesto Báscolo, MSc MPH, Juan Lazarte Health Institute, España 401, 1er piso (Biblioteca); Rosario (2000), Provincia de Santa Fe, Argentina (ebascolo@gmail.com)

This research was conducted with support from the Pan American Health Organization and the International Development Research Centre of Canada. The authors acknowledge the support of Roberto Bazzani, Eduardo Levcovitz, Soledad Urrutia, Claudia Travassos, and Víctor Martínez. We express immense gratitude to Juan Herrmann, Gabriela Nestares, and Néstor Ponce, and all of the research team members. Adolfo Sánchez de León, Rafael Ventaffrida, Aurelia Furnari, and Carlos Benedetti made valuable contributions to the study in developmental phase. We also thank the PHI municipal and provincial staff members, without whose collaboration the study could not have been possible.

© 2009 Lippincott Williams & Wilkins, Inc.