Primary Health Care Governance: Case Studies in Argentina and Brazil

Abstract

Transaction Cost Economics is a recent perspective
to organizations analysis, and it is still little applied in the public
sector. The purpose of this paper is to assess the relative
efficiency of two primary health care platforms, one in Argentina
and the another one in Brazil. The transaction costs are
categorized, counted and normalized into quartiles from direct
observation, interviews and documental review. Besides,
institutional arrangements are described. The discriminating
hypothesis of association between organizational efficiency and
the alignment of transaction characteristics with the governance
mode is comparatively tested. The analysis showed that the
Brazilian case presented lower frequency of transaction costs
because its institutional arrangement contains more coordination
and incentives with less strategic uncertainty. The evaluation
method developed in this paper highlights the importance of
studying the characteristics of organization for the generation of
knowledge and production of managerial contributions over
public health service’s delivery.