Contrato de gestión de áreas de gestión clínica

20 de enero de 2021 |
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Contrato de gestión de áreas de gestión clínica


La introducción de la contratación no implica necesariamente la competencia entre proveedores. La relación contractual se puede considerar como la formalización del proceso de planificación y gestión con las partes contratantes con compromisos explícitos para lograr objetivos. Pero si queremos que la contratación dé el máximo de beneficios, se han de resolver diversas cuestiones relativas a la naturaleza, la capacidad, la responsabilidad y el poder de los compradores. Al mismo tiempo se plantean problemas similares cuando hablamos de proveedores, estructuras de autodeterminación, tipo de autonomía financiera y de gestión, y responsabilidades. Es preciso avanzar progresivamente hacia formas de contratación que permitan exigir de forma detallada resultados en cuanto a la atención sanitaria. La financiación capitativa ajustada por riesgo, es una alternativa para conseguir la integración entre niveles asistenciales, puesto que potencia la transversalidad asistencial, permite una cierta descentralización de riesgos a los proveedores sanitarios y estimula la capacidad resolutiva.

La experiencia de la unidades o áreas de gestión clínica se encuadran dentro de la teoría económica contractual, que se denomina economía institucional. La herramienta organizativa es, por tanto, el contrato de gestión que, manteniendo la propiedad de los activos en sus titulares, compromete a las partes – financiador/comprador en este caso y al prestador de servicios-, a la clasificación de los objetivos dentro de la organización mediante la aceptación de compromisos en forma de obtención de resultados a cambio de una compensación. Para hacer efectivo este contrato se debe introducir un cierto nivel de riesgo en los directivos, lo que permitirá contar con una mayor información sobre las actividades realizadas y los costes incurridos, lo que supone una mayor responsabilidad con los resultados.

{Dr. Jesús Caramés Bouzán}

{Gestión Sanitaria}

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