title: Fend for yourself. Systemic failure in the Dominican health system.
abstract: Despite relatively high levels of total spending and enormous growth in the supply of services during five decades, the Dominican health system demonstrates low performance in addressing the health needs of its population, ensuring acceptable quality of care, reducing the financial burden of health care on the poor, or providing adequate insurance coverage for those with the ability to pay. The paper analyzes deficiencies in financing, organization and delivery of health services in both the public and private sectors. The paper argues that government failure has undermined the health system and health care. Despite calls for reforms, attempts to restructure the system have not yet taken shape.
authors.affiliation: The World Bank, 1818 H St. NW, Washington, DC 20433, USA. glaforgia@worldbank.org
authors.forename: Gerard
authors.initials: G
authors.lastname: La Forgia
authors.forename: Ruth
authors.initials: R
authors.lastname: Levine
authors.forename: Arismendi
authors.initials: A
authors.lastname: Díaz
authors.forename: Magdalena
authors.initials: M
authors.lastname: Rathe
mesh_terms: D003258:Consumer Behavior / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000639:trends; D004293:Dominican Republic; D017598:Efficiency, Organizational; D033161:Government Regulation; D005102:Health Expenditures / Q000706:statistics & numerical data / Q000639:trends; D006291:Health Policy / Q000639:trends*; D006301:Health Services Needs and Demand; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration* / Q000706:statistics & numerical data / Q000639:trends; D009936:Organizational Innovation; D011050:Policy Making; D011203:Poverty; D017149:Private Sector / Q000191:economics; D017150:Public Sector / Q000191:economics; D011787:Quality of Health Care; D012946:Social Welfare / Q000639:trends