Introduction
Decentralization in healthcare systems involves transferring responsibilities, resources, and authority from a higher level of government to a lower one. This can have a significant impact on the health of the population and is considered a solution to address inequalities in access to healthcare in different regions of Chile. Therefore, the aim of this study was to determine the effect of decentralization on equity in a healthcare system.
Materials and Methods
A systematic review was conducted using the PRISMA matrix, and current evidence was explored through World of Science (Core Edition) search engine. The analysis focused on the effects of decentralization on health equity, considering the decision-making framework.
Results
Given the difficulties in relating and extrapolating the different contexts and methodologies used in the studies, it is observed that the impact of decentralization is determined by both the amount of responsibility and power granted to lower levels of government and their ability to manage these new responsibilities. Additionally, the political, economic, and social characteristics of the intervened area also influence this impact.
Discussion
Although comparing different healthcare systems and their characteristics is complex, the observed similarities can serve as a starting point for developing evidence that facilitates the implementation of healthcare reforms. However, the challenge remains to quantify the impact of these policies. This research provides an approach to understanding how to address this complex and potentially beneficial element in healthcare systems.
Keywords:
Public health, Health equity, Health system, Health Policy, Health Care Economics and Organizations
Oñate-Schneider, C., & Poblete-Arrué, F. (2024). Decentralization: The path to achieving equitable healthcare in Chile?. Revista Chilena De Salud Pública, 28, e72196. https://doi.org/10.5354/0719-5281.2024.72196
