2026-04-17T21:26:57Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/1845202025-12-05T05:49:31Zcom_2072_1057col_2072_478808col_2072_478917

00925njm 22002777a 4500 dc Bel i Queralt, Germà, 1963- author Esteve Laporta, Marc author 2022-03-30T10:20:59Z 2022-03-30T10:20:59Z 2022-04 2022-03-30T10:21:00Z One of the main governance decisions that policymakers need to make is whether to implement public services via centralised or decentralised forms. As Costa et al. discuss in their manuscript, when public services are implemented via competing systems, service providers contend to provide good services with the ultimate objective of gaining market quota. This is known as managed competition (MC), as the authorities will have to manage the panoply of public and private organizations offering the service. The alternative is to manage the service more centrally, in what it is identified as vertical integration. As the authors describe, several governments around the globe have abandoned their vertical integrated models in favour of decentralized models. This is the case, as the authors recall, for most health services in Europe. While there is an emerging body of evidence suggesting that decentralized MC outperforms vertically integrated models both in terms of efficiency and in terms of service quality, little is known on how these systems react under different circumstances. This means, for example, how these systems can cope with a sudden increase in their service demands. Descentralització administrativa Serveis sanitaris COVID-19 Integració vertical Decentralization in government Health services COVID-19 Vertical integration Resilient managed competition during pandemics: Lessons from the Italian experience