000			01696naa a2200181uu 4500
001			8071416021010
003			OSt
005			20190211163939.0
008			080714s2008 xx ||||gr |0|| 0 eng d
100	1		_913543 _aRamesh, M.
245	1	0	_aAutonomy and control in public hospital reforms in Singapore
260			_aThousand Oaks, CA : _bSage Publications, _cMarch 2008
520	3		_aThe Singapore government began to reform public hospitals in the mid-1980s because of mounting public expenditures on health care. It granted public hospitals managerial autonomy and required them to compete for patients' fees. Correspondingly, patients were required to pay a larger proportion of the costs. When subsequent evidence showed that costs were increasing rather than decreasing, in the mid-1990s the government began to reassert its control while retaining the essence of the earlier reforms. In recent years, the reforms have emphasized management autonomy coupled with strong government guidance. This article assesses the autonomy and control mechanisms in place to promote effective service delivery in public hospitals in Singapore and concludes that reliance on market competition requires more state intervention than often realized. For market competition to deliver outcomes that are not only economically efficient and consumer-friendly but also politically acceptable, constant governmental oversight and coordination is essential
773	0	8	_tThe American Review of Public Administration _g38, 1, p. 62-79 _dThousand Oaks, CA : Sage Publications, March 2008 _xISSN 02750740 _w
942			_cS
998			_a20080714 _b1602^b _cTiago
998			_a20081111 _b1501^b _cZailton
999			_aConvertido do Formato PHL _bPHL2MARC21 1.1 _c26987 _d26987
041			_aeng