[Mechanisms for allocating financial resources after decentralization in the state of Jalisco].
OBJECTIVE
To analyze, from the decision maker's perspective, the financial resource allocation process of the health services of the state of Jalisco (SSJ, per its abbreviation in spanish), within the context of decentralization.


METHODS
Through a qualitative approximation using semi-structured individual interviews of key personnel in managerial positions as the method for compiling information, the experience of the SSJ in financial resource allocation was documented. From September to November 2003, the perception of managers and administrators regarding their level of autonomy in decision-making was explored as well as the process they follow for the allocation of financial resources, in order to identify the criteria they use and their justifications.


RESULTS
From the point of view of decision-makers, autonomy of the SSJ has increased considerably since decentralization was implemented, although the degree of decision-making freedom remains limited due mainly to high adminstrative costs associated with salaries. In this sense, the implications attributable to labor situations that are still centralized are evident. Some innovative systems for financial resource allocation have been established in the SSJ for the sanitary regions and hospitals based upon administrative-managerial and productivity incentives. Adjustments were also made for degree of marginalization and population lag, under the equity criterion.


CONCLUSIONS
General work conditions and decision-making autonomy of the sanitary regions constitute outstanding aspects pending decentralization. Although decentralization has granted more autonomy to the SSJ, the level of decision-making freedom for allocating financial resources has been held within the highest hierarchical levels.
Pérez-Núñez
Ricardo
R
Instituto Nacional de Salud Pública/Escuela de Salud Pública de México, Cuernavaca, Morelos, México. rperez@correo.insp.mx
Arredondo-López
Armando
A
Pelcastre
Blanca
B
D003695:Delivery of Health Care / Q000458:organization & administration*; D008800:Mexico; D011057:Politics; D040841:Resource Allocation / Q000379:methods*