Modernization of Public Management in Health Care Systems: Approaches, Progress, and Challenges
DOI:
https://doi.org/10.5281/zenodo.24029557Keywords:
public administration, health care reform, health equityAbstract
The objective was to analyze the approaches, progress, and challenges of modernizing public management in the health sector in Latin America. A structured narrative review of 25 publications from 2020 to 2025 was conducted through searches in PubMed and SciELO. The selection process considered thematic relevance and the identification of specific contributions to the region. The information was organized into a matrix and examined through an interpretive synthesis. Four key themes emerged from the review and comparison: governance, stewardship, and institutional coordination; organizational management, efficiency, and performance evaluation; financing, coverage, and equity in access; and integrated care models and health system responsiveness. The publications described experiences with institutional reorganization, service evaluation, and the expansion of health protection, along with challenges related to segmentation, policy discontinuity, and inequalities in access. Progress was uneven and confined to specific contexts and designs, which limited comparisons and the attribution of effects to the reforms. It is concluded that modernization must be analyzed by considering the interplay between state capacities, service organization, and health protection. The reviewed evidence does not support the assumption that administrative changes automatically translate into sustained improvements in efficiency and equity.
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