Argentina: current activities in the field of quality in health care

Abstract

Argentina is the second largest country in South America (3 761 274 km2). In 1998 the total population was estimated at 35.8 million, and around 88.6% live in urban areas. The per capita income is US$ 9300 and the unemployment rate is around 12.5%. Some basic data from the health sector indicate that there are 26.8 physicians and 5.4 graduate nurses per 10 000 population and 4.5 beds per 1000. The per capita expenditure on health is calculated at around US$550 and total health expenditure is around 7% of the gross national product. The medical care system consists of three models: the government or ‘public' system, the social security system, the private system. The population coverage of these different systems is not easy to identify. Theoretically the whole population has the right of access to the public system. However, the real coverage is estimated from the system's bed capacity as 45% of the population. The social security system and the private sector provide the remainder — around 55% of all coverage. The demand for health care is divided according to the capacity to pay. The poor and the lower middle class are served by the public system. The middle class utilizes private hospitals financed by the social security system. The upper class has access to exclusive private hospitals through prepaid systems. From this brief background it is clear that the Argentinean health care system is a combination of different subsystems. The possibilities and incentives to provide quality in health care are not clear. Public hospitals are suffering from lack of an adequate budget to cover operational costs and appropriate maintenance of their basic infrastructure. Most private hospitals are facing problems related to the financing mechanisms that influence the quality of their services.