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假设在这种市场波动较小情况下，市场失灵使大型公共部门的支出保持水平(一个因素不能单独由公共财政)。因此,有利的异常值可以在账户和医疗提供社会需要的基础上,而不是支付能力。同样,公共机构维护其权威是唯一的决策者,因此在社会精英中分配卫生资源。此外,根据McPake等“关于卫生保健供给模式的选择可能是由小对“无知”消费者的需求下直接公共供给——或者消费者可以更大作用”。因此一个平衡考虑需求评估和人口需求可以提供。这个因素在系统设计是至关重要的。进一步增加公共基金金融不确定性通过共享风险最小化。最后,医生在评估的作用强调货币系统的失败,衡量使金融效率最大化(通过确保低效的提供者不授予合同)。

在医疗、承包涉及公共部门之间的货物和服务的交换买家和私人机构按照事先商定的条件。一般来说,私人机构竞标公共部门合同,并可能通过货币提供了成功,排他性的产品,定性的组件或两者结合。

Contracting is emerging as a major common policy issue in developing countries (Cruz et al). It involves emulating private sector mechanisms within the public sector in order that public sector framework is maintained whilst deriving the benefits of private provision. Within such a framework, some public sector traits such as direct central planning, free provision and salaried public employees are exchanged with characteristics related to the private sector (McPake 1994).

Hypothetically such markets are less volatile to instances of market failure as they enable large levels of expenditure to remain in the public sector (a factor which cannot be maintained by public finance alone). As a result, advantageous outliers can be taken in to account and healthcare provided on the basis of social needs rather than ability to pay. Likewise, public institutions maintain their authority to be the sole decision-makers, and therefore allocate health resources on social meritocracy. Moreover, according to McPake et al 'choices regarding healthcare delivery patterns may be made with little regard for the demand of 'ignorant' consumers as under direct public provision- or consumers may be given a much greater role' (McPake 1994). Hence an equilibrium taking into account needs assessments and population requirements can be provided. This factor is vital in the system design. Further additions of public funds minimise financial uncertainty by sharing risks. (Bennett 1991). Lastly, the role of doctors in assessing monetary failure of the system in emphasised, a measure enabling financial efficiency to be maximised (by ensuring that inefficient providers are not awarded contracts).

In the case of healthcare, contracting involves the exchange of goods and services between a public sector buyer and a private institution in accordance to a pre-agreed set of conditions. Generally, private institutions bid for public sector contracts, and may succeed through monetary offers, exclusivity in products, qualitative components or a combination of these. Hence, the public sector draws the greatest benefit from competing institutions, whilst preserving its financing.

In developing countries, contracting out is restricted mainly to non-clinical aspects such as catering, elevator services and general hospital premise maintenance. However, clinical services are increasingly coming under scrutiny for their potential to be contracted out (McPake 1994) in a similar manner to Western European 'managed markets' in healthcare. At present, this policy of contracting out is being employed mainly in British territories in the Caribbean, who are emulating a UK-style healthcare structure. In other developing nations, contracting of services is larg本论文由英语论文网提供整理，提供论文代写，英语论文代写，代写论文，代写英语论文，代写留学生论文，代写英文论文，留学生论文代写相关核心关键词搜索。