Abstract

This article presents some of the results obtained from the analysis performed to the health sector budget. The study focused the analysis in the city of Lima. The methodology not only looks for a discussion of resource allocation in the health sector, it goes further and makes an analysis applying a Public Expenditure Tracking Survey (PETS) methodology. The core objective is to discover institutional bottlenecks which make the health expenditures less effective.The novelty in this type of research is the construction of three main flows, which represent the budget execution process; these flows are related to the transfer process of money, goods and services, and salaries; besides these three flows there is an additional one related to information. The topics of analysis are multiple; this article prioritized aspects such as the management of own collected resources from tariffs, goods management (specifically pharmaceuticals), and finally the management of petty cash and budget transfers received by health facilities.The study concludes that a poor budget management causes costs to the health system, which sometimes are absorbed by the population and sometimes bythe same health staff. The latter is the origin of perverse incentive to the same personnel who even prefer the status quo. The latter allows them to receive part in their salary from tariffs (with bonus), rather than acquiring needed goods for their facility.

Highlights

  • This article presents some of the results obtained from the analysis performed to the health sector budget

  • The study focused the analysis in the city of Lima

  • The methodology not only looks for a discussion of resource allocation

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Summary

Principales hallazgos en el flujo de efectivo

Como se explicó en los puntos anteriores, parte de la recaudación de las tarifas retorna a los establecimientos de salud como caja chica para la compra de bienes o servicios por una emergencia o porque no fueron programados. Las visitas de observación a los establecimientos de salud que fueron encuestados revela una necesidad de bienes o servicios para mejorar el ambiente y el confort tanto de los pacientes como del personal; los mismos que podrían comprarse con los recursos propios que estos establecimientos recaudan. El primero está relacionado con el tipo de vínculo laboral (nombrados, contratados o por servicios no personales) y el otro es que las redes de salud ubicadas en el área rural no tienen tanta capacidad para recaudar tarifas como para pagar bonos. El personal nombrado y algunos contratados reciben más bonos que el resto y las redes en las zonas rurales no pueden hacer un pool para mejorar el nivel de los salarios como una red en las zonas urbanas

Flujo de bienes
Número de establecimientos de salud
Flujo de efectivo
Promedio de demora
Según los establecimientos de salud

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