Building up the national integrated health system

Overview

Prior to reform, health financing and delivery in Uruguay was fragmented. The public State Health Services Administration provided health services free of charge to predominantly low-income groups, and a collective of small insurers and lenders, purchased care for workers in the formal sector through a network of private hospitals and clinics. The collective had complex, diverse contribution schemes, which varied by geographical location, their ability to attract clients and the age and risk of the affiliated population. In 2007, the National Integrated Health System brought together the private and public subsystems. Its aim was to provide comprehensive, equitable universal health coverage under a single benefits plan known as the Integrated Health Care Plan, which shifted the focus of service delivery back towards primary health care, prevention of noncommunicable diseases and health promotion activities. The paper discusses the reform which led to a number of positive changes and efficiency gains from improving health insurance institutional arrangements, governance, and service provision.

Synthesis report

The Uruguay case study is part of a synthesis report that applied a causal framework to synthesize lessons from ten case studies of various health system reforms which aimed to improve the efficiency in health systems.