Analysing contractual environments: Lessons from indigenous health in canada, Australia and New Zealand

Josee Lavoie, Amohia Boulton, Judith Dwyer

    Research output: Contribution to journalArticlepeer-review

    23 Citations (Scopus)

    Abstract

    Contracting in health care is a mechanism used by the governments of Canada, Australia and New Zealand to improve the participation of marginalized populations in primary health care and improve responsiveness to local needs. As a result, complex contractual environments have emerged. The literature on contracting in health has tended to focus on the pros and cons of classical versus relational contracts from the funder's perspective. This article proposes an analytical framework to explore the strengths and weaknesses of contractual environments that depend on a number of classical contracts, a single relational contract or a mix of the two. Examples from indigenous contracting environments are used to inform the elaboration of the framework. Results show that contractual environments that rely on a multiplicity of specific contracts are administratively onerous, while constraining opportunities for local responsiveness. Contractual environments dominated by a single relational contract produce a more flexible and administratively streamlined system.

    Original languageEnglish
    Pages (from-to)665-679
    Number of pages15
    JournalPublic Administration
    Volume88
    Issue number3
    DOIs
    Publication statusPublished - Sep 2010

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