New Trends in Public Sector Management in Health : Applications in Developed and Developing Countries
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World Bank, Washington, DC
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This paper begins with a review of the
broad motivations behind the New Public Sector Management
(NPSM), including intrinsic differences between public and
private organizations that appear to impact on incentives
and performance. The experience in selected OECD countries
is reviewed where the financing and delivery of health and
other social services is heavily socialized with a strong
public sector role, taxpayers have expressed dissatisfaction
with traditional modes of public sector management, and NPSM
reforms have been hotly debated. Part II of the paper then
describes the NPSM paradigm in terms of three building
blocks that influence the performance of public agencies and
the behaviors of employees who work for them. It explains
how leverage points within the NPSM paradigm are expected to
create incentives for improved performance. It is when all
three building blocks of the NPSM paradigm work together
that synergies are expected to take place, and that
continuous improvements in the performance of public
agencies are expected to be generated over time. Part III
illustrates five organizational strategies that can be used
to introduce NPSM into public agencies in the national
health system. Much of Part III refers to developing country applications.
Palabras clave
ACCOUNTABILITY, ACCOUNTING, AGGRESSIVE, AUDITING, AUTONOMY, BORROWING, CAPACITY BUILDING, CIVIL SERVICE, CLINICS, DEBT, ECONOMIC PERFORMANCE, EDUCATION, EMPLOYMENT, EQUIPMENT, FINANCIAL SYSTEMS, FISCAL DEFICITS, GROSS DOMESTIC PRODUCT, HEALTH, HEALTH CARE, HEALTH OUTCOMES, HEALTH SERVICES, HOSPITALS, HOUSING, IMMUNIZATION, INCOME, INCOMES, INFORMATION CAMPAIGNS, INSTITUTIONAL DEVELOPMENT, INSTITUTIONAL ECONOMICS, INSURANCE, ISOLATION, MANAGEMENT INFORMATION SYSTEMS, MEDICINES, NATIONAL BANKS, NUTRITION, PLASTIC SURGERY, POLITICAL COMMITMENT, POLITICAL ECONOMY, POLITICAL POWER, POSITIVE EXTERNALITIES, PRIVATE GOODS, PRIVATE SECTOR, PRIVATIZATION, PROFITABILITY, PROPERTY RIGHTS, PUBLIC, PUBLIC ADMINISTRATION, PUBLIC AGENCIES, PUBLIC ENTERPRISES, PUBLIC EXPENDITURES, PUBLIC FUNDS, PUBLIC GOODS, PUBLIC HEALTH, PUBLIC HOSPITAL, PUBLIC HOSPITALS, PUBLIC HOUSING, PUBLIC INSTITUTIONS, PUBLIC MANAGERS, PUBLIC MONOPOLY, PUBLIC OFFICIALS, PUBLIC PROVIDERS, PUBLIC REVENUES, PUBLIC SECTOR, PUBLIC SECTOR MANAGEMENT, PUBLIC SECTOR MANAGERS, PUBLIC SECTOR ORGANIZATIONS, PUBLIC SECTOR PERFORMANCE, PUBLIC SECTOR REFORM, PUBLIC SERVICE, PUBLIC SERVICE DELIVERY, PUBLIC SERVICE PROVISION, PUBLIC SERVICES, PUBLIC SPENDING, RESOURCE ALLOCATION, RESOURCE ALLOCATIONS, RETURN ON INVESTMENT, REVENUE SOURCES, SAVINGS, SOCIAL SERVICES, STATE OWNED ENTERPRISES, SUSTAINABLE FINANCING, TAX, TAX COLLECTION, TAX REVENUES, TAXATION, TECHNICAL ASSISTANCE, TELECOMMUNICATIONS, TRANSACTION COSTS, TRANSPARENCY, TREASURY, UTILITIES, VOTERS, WASTE, WORKERS